Clinical And Experimental Study Of Acupuncture Combined With Medicine In The Treatment Of POI With Yin Deficiency Of Liver And Kidney

Objective:（1）To investigate the clinical efficacy of Sanzi Tiaojing decoction combined with acupuncture in the treatment of POI with evidence of liver and kidney yin deficiency.（2）To explore the effects of Sanzi Tiaojing decoction combined with acupuncture on body weight,sex hormone and morphology of uterus and ovary in POI rat model.Methods:（1）60 patients with POI of liver and kidney yin deficiency syndrome were randomly divided into Femoston group（n=30）and Acupuncture combined with medicine group（n=30）.The Acupuncture combined with medicine group was treated with Sanzi Tiaojing decoction combined with acupuncture,and the Femoston group was treated with Femoston.The course of treatment of both groups was 3months.The menstruation,clinical symptoms and sex hormones were compared before and after treatment to evaluate the curative effect.（2）POI rat model was established by CTX and treated with acupuncture combined with medicine and Femoston respectively.Compared with normal rats and POI model rats,the body weight,serum sex hormone level and ovarian histomorphology of rats were compared to evaluate the therapeutic effect of acupunctur combined with medicine on ovarian function.Results:（1）Statistical analysis of 60 patients included:（1）Comprehensive curative effect:the effective rate of Acupuncture combined with medicine group was 80%,and that of Femoston group was 73.33%.Good results were obtained in both groups after treatment.Among them,the difference was not statistically significant（P>0.05）.（2）Month menstrual score:before treatment,there was no significant difference in menstrual score between the two groups（P>0.05）.After treatment,the average menstrual score of the two groups,but there was no significant difference before and after treatment（P>0.05）.（3）TCM syndrome score:before treatment,there was no significant difference in menstruation score between the two groups（P>0.05）.After treatment,the scores of TCM syndromes in both groups decreased,and the score in the Acupuncture combined with medicine group was significantly lower than that in the Femoston group（P<0.05）.（4）Sex hormone level:before treatment,there was no significant difference in FSH,LH and E₂between the two groups.After treatment,the decrease of FSH and LH in the Acupuncture combined with medicine group group was significantly higher than that in the Femoston group,but the increase of E₂in the Acupuncture combined with medicine group was not significantly different from that in the Femoston group.（5）Compliance:oral drug compliance was good.All the 60 patients completed three complete treatment cycles,with a compliance rate of 100%.The average number of acupuncture treatment was 32.73±2.53,and the compliance rate was more than80%.Among them,6 patients had acupuncture compliance rate of100%.（6）Safety:no treatment-related adverse events were reported during the observation period.（2）Eighteen POI rats were randomly divided into POI model group,Acupuncture combined with medicine group and Femoston group,and compared with normal rats.The results were statistically analyzed:（1）The change of estrous cycle:the abnormal rate of estrous cycle of 18model rats was 100%,of which 4 rats prolonged their estrous cycle and6 rats stagnated their estrous cycle.There were no normal estrous cycle changes in 8 rats after modeling.（2）Body weight:before the establishment of the model,there was no significant difference in the body weight of the rats in each group（P>0.05）.After the establishment of the model,except for the normal group,the body weight of all the POI model rats was significantly lower than that before modeling.（P<0.05）.Before treatment,there was no significant difference in the body weight of the rats in the POI model group,Acupuncture combined with medicine group and Femoston group,which was comparable（P>0.05）.After treatment,the body weight of rats in the Acupuncture combined with medicine group group was higher than that in the POI model group（P<0.05）,but there was no significant difference in body weight between the Femoston group and POI model group（P>0.05）.（3）Sex hormone level:after treatment,the FSH of POI model group was higher than that of normal rats（P<0.05）,and the FSH of rats in Acupuncture combined with medicine group was lower than that of POI rats（P<0.05）and significantly lower than that in Femoston group（P<0.05）.（4）Organ index:after treatment,the organ index of uterus and ovary in POI model group was lower than that of normal rats（P<0.05）.The organ index of rats in Acupuncture combined with medicine group was higher than those in POI model group（P<0.05）,and the average wet weight of uterus and ovary in the Femoston group was higher than that in the POI model group（P<0.05）,but there was no significant difference in organ index between the POI model group and the Femoston group（P>0.05）.（5）Histomorphology:compared with the normal rats,the uterine cavity of the POI model group shrank,the endometrium became thinner,the uterine tissue was denser than the normal tissue,and the ovarian stroma appeared proliferation and fibrosis（P<0.05）.After treatment,the number of follicles and corpus luteum in POI model group was significantly lower than that in normal rats（P<0.05）,while the number of follicles and corpus luteum in Acupuncture combined with medicine group was higher than that in POI model group（P<0.05）.The follicle count in Femoston group was higher than that in POI model group,but the increase in luteum count was not statistically significant（P>0.05）.Conclusion:（1）Sanzi Tiaojing decoction combined with acupuncture can effectively relieve the clinical symptoms of POI patients with liver and kidney yin deficiency syndrome,improve the quality of life,reduce the level of FSH and increase the level of E₂,so as to improve ovarian function,and it is safe and suitable for clinical promotion.（2）Compared with normal rats,CTX can reduce the body weight of rats,decrease the organ index of uterus and ovary,increase FSH,and inhibit the development of follicles and corpus luteum,thus impairing ovarian function.Sanzi Tiaojing decoction combined with acupuncture can promote the weight growth of POI model rats,decrease the level of FSH,increase the organ index of uterus and ovary,promote the development of follicles and corpus luteum.