Clinical Observation Of Tiaojingyiluan Fang Cycle Therapy On Decreased Ovarian Reserve

ObjectThis study was desined to evalute the clinical effect of Tiaojingyiluan Fang Cycle Therapy on decreased ovarian reserve(DOR)with Spleen-kidney Deficinency combined Blood Stasis Syndrome,through comparing the related clinical indicators and TCM symptom scores of patients before and after treatment.This study explore the possible mechanism of its treatment and summarize the clinical experience,it may provide new ideas for clinical treatment of decreased ovarian reserve.Methods:The study collects 70 patients of DOR with Spleen-kidney Deficinency combined Blood Stasis Syndrome from Department of Gynecology in the Maoming hospital of TCM from October 2018 to March 2020.All patients were divided randomly into two groups,35 as the control group and the other 35 as the treatment group.The control group was given Femonston for treatment,while the treatment group was given Tiaojingyiluan Fang Cycle Therapy.Two groups were treated for 3 menstrual periods and 3-month follow-up was performed after treatment.Then collect TCM symptom scores,the degrees of coronary atheroscleerosis(follicle stimilating hormone FSH,luteinizing hormone LH,estradiol E2),Anti Mullerian Hormone(AMH),Antral Follicle count(AFC)and Ovarian volum(0V).All the data were recorded and analyzed by SPSS20 statistical sofeware.Results:(1)Before the treatment,the baseline of the treatment group and control group in age,disease course,gravidity and parity history,TCM symptom scores,the degrees of coronary atheroscleerosis(FSH,LH,FSH/LH,E2),AMH and color ultrasound index(AFC and OV)had no significant difference(P>0.05).The two groups were comparable.(2)After the treatment,in control group,the total effective rate of TCM symptom was 91.4%,the significant efficiency rate was 57.14%(12 cases cured,8 cases effective significantly,12 cases effetive,3 cases of no effect).In the treatment group,the total effective rate of TCM symptom was 85.7%,the significant efficiency rate was 80%(15 cases cured,13cases effective significantly,2 cases effetive,5 cases of no effect).Through rank-sum test,there was significant difference of therapeutic effect between the two groups(P<0.01).Through chi-square test,there is no remarkble statistical significant of the total effective rate between two groups(P>0.05),while there is remarkble statistical significant of the significant efficiency rate(P<0.05).The TCM symptom scores,menstruation scores and other scores of two groups have decreased after the treatment(P<0.01).The compar between two groups,the difference of the TCM symptom scores and other scores had statistical significance(P<0.05),while the difference of menstruation scores has no statistical significance(P>0.05).After treatment,3-month follow-up shows TCM symptom scores of control group increased more significantly than treatment group(P<0.01).(3)After the treatment,FSH,LH in the two groups have decreased and the differences were significant(P<0.01).FSH/LH in the treatment group have decreased and the differences were significant(P<0.01),but there is no significant difference of FSH/LH in control group when compared with those before treatment.E2 has increased signficantly in both group after the treatment(P<0.01).Compared between two groups,FSH,E2 of the treatment group have improved more than those of the control group,the difference were significant(P<0.05),While LH,FSH/LH were similar in two groups and the difference were insignificant(P>0.05).(4)After the treatment,AMH in both groups have increased,the difference were significant(P<0.01).Compared between two groups,the treatment group increased more significantly than the control group(P<0.05).(5)After the treatment,two-side OV in both groups have enlarged,the difference were significant(P<0.01).The right-side 0V in the treatment group has enlarged more significantly than the right-side OV in the control group(P<0.05).But the left-side 0V in two groups has enlarged similarly(P>0.05).AFC in two groups have increased after the treatment and the differences were significant(P<0.01).AFC in the treatment group has increased more significantly than the control group(P<0.05).(6)In terms of security,this study has arranged all patients to do routine inspections before and after the treatment,such as blood and urine routine,liver and kidney funtion,electrocardiogrm,but no abnormal indicatiors were found.In terms of adverse drug reaction,3 cases had signs of nausea and retch,1 case had dizziness in the control group,while 1 case had loose stools in the treatment group.But the symptoms disappeared after drug time adjustment and psychologocal counseling.As a whole,drug in two groups were safe.Conclusion:(1)The study shows it is obviously effcetive for applying Tiaojingyiluan Fang Cycle Therapy on decreased ovarian reserve with Spleen-kidney Deficinency combined Blood Stasis Syndrome.It can improve menstrual disorders and decrease TCM symptom scores significantly.It is effective to corrceted female endocrine disorders and increase two-side Ovarian volum and Antral Follicle count.It improve ovarian funtion effectively.(2)Tiaojingyiluan Fang Cycle Therapy has less long-term clinical symptoms recurrence 3 months after the treatment.(3)There are less adverse drug reaction and more safe and effective in Tiaojingyiluan Fang,so it can be worthy of clinical application.