Treatment Of Primary Ovarian Insufficiency By Acupuncture And Moxibustion At The Chief Physician

BackgroundRecently with the incidence of premature ovarian insufficiency (POI) rising year by year, experts pay more and more attention on it. Western medicine thinks the pathogenesis of the disease ncluding genetic factors,immune factors,gonadotropin receptors abnormalities,defects and abnormal of enzyme,iatrogenic factors,infection factors,bad habits and mental factors.The main treatment therapies are hormone replacement therapy, induced ovulation,the technology of ovarian transplantation,etc.But studies have shown that treatment of the disease so far there is no effective measures and exact and effective method to restore ovarian function;any treatment measures can’t increase pregnancy rates in patients with the disease;and it’s a risk that POI female patients with long-term of estrogen therapy might increase the incidence of endometrial cancer and breast cancer.It is thought in traditional Chinese medicine (TCM) it belongs to’blood depletion’ and other areas,the main pathogenesis of the disease is empty kidney,the syndrome type belongs to empty kidney and stong fire,Chong meridian and Ren meridian are empty and closed,the main treatment therapies for POI are Chinese herbs,acupuncture and moxibustion,etc.And the overall adjustment function of the female endocrine level may return to the normal dynamic equilibrium level,through the overall adjustment of the multi-system and multi-link.In recent years,a number of published studies have indicated that acupuncture in treatment of POI may be effective and has a potential advantage.Comprehensive treatment plans are the most common treatments of TCM in clinical, such as Chinese herbs in combination with acupuncture,Chinese herbs in combination with hormone replacement therapy,hormone replacement therapy in combination with acupuncture.But there were few clinical studies with mo no-acupuncture in treatment of POI.Through searching literature,there were only 18 studies,and the clinical curative effect evaluation standard is still a lack of consensus.ObjectiveTo summarize Dr.Zhishun Liu’diagnosis and treatment experience of acupuncture in treatment with POI, and conduct the clinical preliminary validation.MethodI followed and studied with Dr.Liu 1 or 2 times per week;analyses and summarized of the literature;observed and recorded the POI cases in treatment with acupuncture;and preliminary summarized effectiveness, and features of diagnostis and treatment.Result10 patients meeting the inclusion criteria were included from September 10th,2012 to December 30th,2014.The changes of menstrual cycle,menstrual amount,estradiol (E2),serum follicle-stimulating hormone(FSH),luteinizing hormone(LH) before and after the treatment,and the effectiveness of the follow-up were observed.After the treatment menstrual cycle of 9 cases (90%) with POI were recovered;of these 9 patients,menstrual amount of 4 cases were normal,the amount of 4 cases were less,and the amount of 1 case was more.E2 of the baseline of the 10 cases with POI was 54.11±74.17 pmol/L,which increased by 110.19±140.13 pmol/L after treatment.FSH of the baseline was 86.67±33.30 IU/L,and declined by 48.62±33.64 IU/L after treatment.LH of the baseline was 41.25±16.40 IU/L,and declined by 20.32±23.84 IU/L after treatment.The difference of E2,FSH and LH between the baseline and the end of the treatment were all statistically significant(P<0.05).Of the 10 cases with POI,5 cases completed the 3 months’follow-up,5 cases withdrew.In the 5 cases completed the 3 months’follow-up with POI,menstrual cycle and menstrual amount of 1 case was normal;menstrual cycle of 2 cases was disordered and menstrual amount was a little;and menstrual cycle of 2 cases was still not recovered.And E2 of the baseline of the 5 cases completed the 3 months’follow-up with POI was 40.18±50.75 pmol/L,which increased by 77.91±89.49 pmol/L at the end of follow-ups with 3 months.FSH of the baseline was 87.09±42.18 IU/L,and declined by 33.97±35.83 IU/L at the end of follow-ups with 3 months.LH of the baseline was 34.57±15.80 lU/L,and declined by 6.78±20.75 IU/L at the end of follow-ups with 3 months.The differences of E2,FSH and LH between the baseline and the end of follow-ups with 3 months were of no statistical significance (P>0.05).E2 of the 5 cases completed the 3 months’follow-up with POI was 167.03±164.15 pmol/L after the treatment,and declined by 48.94±48.88 pmol/L at the end of follow-ups with 3 month. FSH was 36.48±17.43 IU/L after the treatment,which increased by 16.64±14.23 IU/L at the end of follow-ups.LH was 21.67±14.48 IU/L after the treatment,which increased by 6.13±10.58 IU/L at the end of follow-ups.The differences of E2,FSH and LH between the end of the treatment and follow-ups with 3 months were of no statistical significance(P>0.05).Conclusion1.Dr. Zhishun Liu’diagnosis and treatment experience of acupuncture in treatment with POI was as the following:the treatment was majorly based on differentiation of different diseases, and attributable to meridians according to different parts of body.And therapeutic principle was to nourish kidney,tonify Chong and Ren meridians,Tianshu(ST25),Guanyuan(RN4), Zigong(EX-CA1) and Zhongliao(BL33),were deep acupunctured.All the patients were adopt electro-acupuncture of 3-5 times per week for continuous 2-6 months.2.Patients with POI who all adopted the treatment scheme can regain regular menstruation,gain E2 increased,and get FSH and LH reduced in the near future.The hormone-regulation effectiveness of acupuncture can be maintained for 3 months,but the long-term effectiveness is not obvious.