The Clinical Study Of Combined Therapy Of Acupuncture And Julisanjiewan Concoction In The Treatment Of Hysteromyoma

Background:The julisanjiewan concoction originated from the late Professor Luo Yuan Kai.It consists of juhe,lizhihe,xuduan,xiaohuixiang,wuyao, chuanlianzi,haizao,ezhu,zhishouwu,gangniangen,dangshen,shengmuli, fenglvke,and yimucao.The concoction is able to promote qi and blood flow, thus able to remove local blood stasis which works to soften fibroids.It is mainly used in patients with hysteromyoma of the qi and blood stagnation syndrome.In the recent 20 years,many researches have been done to prove its effect in the treatment.They found that the concoction can not only reduce the size of the fibroid and other clinical symptoms,but can also increase the natural killing(NK) cell activity,decrease the estrogen receptor(ER) and progesterone receptor(PR) level,and PRmRNA expression in the uterine fibroid and smooth muscle tissue.Although the etiology of hysteromyoma is not clearly known,its connection with the ER activity is widely accepted.Conservative approach in its treatment has its long history, but it lacks extensive research and scientific support.Objective:In the light of above,the study observes the clinical effect of using a combined therapy,acupuncture and the use of julisanjiewan concoction, in the treatment of hysteromyoma.Method:During the period of January 2008 to March 2009,patients from Ande Chinese Medical Clinic in Taiwan were chosen to participate in the study.A total of 60 hysteromyoma patients were randomly divided into treatment (combined therapy) and control(western medication) groups.The 31 patients in the treatment group were treated with acupuncture and oral intake of julisanjiewan concoction for 3 courses of treatment(1 month equals one course). The 29 patients in the control group were treated with mifepristone(Ru486) 25mg once daily.Before treatment,the basic data,such as their marital status,age,course and severity of the condition,the types of Chinese medical syndrome,of all the patients were statistically similar and comparable.The hemoglobin count was estimated and the 3-D dimension of the tumor via ultrasound was done before and after treatment.At 2 to 7 days after menstruation,all patients were tested for their blood serum hormonal levels via enzyme-linked immunosorbent assay(ELISA).Results:The change in the overall effect of the treatment and control groups were significantly better after treatment,that of the treatment group was more significant(p＜0.05),indicating that the combined therapy of acupuncture and julisanjiewan concoction was more effective in treating hysteromyoma.As for the blood tests,the blood hemoglobin count before treatment was not significantly different in the two groups(p＞0.05).After treatment however, the count significantly increased(p＜0.05),causing the menstruation period to shorten.However,the change in the two groups were not significantly different(p＞0.05),which indicates that both therapies were effective in improving the patients' anemic condition.The tumor dimension became significantly smaller after treatment in both groups(p＜0.05),but the change in the treatment group was more significant than the control group(p＜0.05). The blood serum PR,FSH,LH,PRL,T and E2 levels were assessed after treatment. The PR,FSH,LH,PRL and T levels slightly lowered in both groups,but the change was not statistically significant(p＞0.05).For the E2 level,it dropped significantly after treatment(p＜0.05);however,the difference in the two groups was not significant(p＞0.05),indicating that both groups worked similarly in decreasing the E2 level.Conclusions:1.The total effective rate of the treatment group was significantly higher than that of the control group.The combined therapy of acupuncture and julisanjiewan concoction was effective in decreasing the dimension of the tumor.Both therapies were able to shorten the menstruation period,thus improving the patients' anemic condition by increasing their hemoglobin count.2.Both therapies were able to slightly decrease the level of PR,FSH,LH, PRL and T in blood serum;however,the difference in the groups and between the groups was not significantly different.As for the blood serum E2 level, the combined therapy of acupuncture and julisanjiewan concoction worked significantly better in decreasing its level.