| Objectives:Diminished ovarian reserve (DOR) is a disease that affects women between 18-40 years of age and reduces the quantity or quality of the follicles.DOR also cause a range of menopausal symptoms and fertility problems. Its etiology is not clear. This condition is affected by environmental, genetic, mental and other factors. If not treated timelyin 1 year to 6 years it often develops into premature ovarian failure (POF). In this study, a prospective case series trial was adopted to observe the effect of acupuncture combined with moxibustion on FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), E2 (Estradiol),the menstrual conditionsand Kupperman clinical symptom score in order to assess the effect of acupuncture combined with moxibustion on DOR, and to provide treatment protocol for the clinical practice.Methods:Thirty patients were collected from the Acupuncture Clinic of the Acupuncture-Moxibustion Hospital, affiliated to the China Academy of Chinese Medical Sciences (CACMS). Twenty-nine patients completed the whole process.Acupuncture points included 4 points on the head, DU24 (shen ting), GB13 (ben shen) on both sides, DU20 (bai hui); sixteen points on the abdomen, RN12 (zhong wan), RN4 (guan yuan), and the following 7 pairs of both sides of KI12 (da he), ST25 (tian shu), SP15 (da heng), ST36 (zu san li), SP6 (san yin jiao), KI3 (tai xi), LR3 (tai chong); and 4 points on the lumbosacral region,2 pairs of both sides of BL32 (ci liao) and BL23 (shen shu). Patients were treated with acupuncture and moxibustion three times per week. On Monday and Friday, the nineteen points on the head, abdomen and lower limb were treated with mild reinforcing-reducing method and retained for 25 minutes. On Wednesday, the 4 points on the lumbosacral region were treated withmild reinforcing-reducing method and retained for 25 minutes. Moxibustion points include 3 points on the abdomen, RN4 (guan yuan), EX-CA1 (zi gong) on both sides,4 points on the legs ST36 (zu san li), SP6 (san yin jiao) both sides and 3 points on the lumbossacral region BL23 (shen shu), EX-B8 (Shi qi zhui). Patients are treated with moxibustion three times per week after acupuncture. Sessions on Monday and Friday the seven points on the abdomen and legs are treated with Happyall Moxibustion for 25 minutes. On Wednesday, the 3 points on the lumbossacral region were treated with Happyall Moxibustion for 25 minutes.The treatment was offered for twelve weeks. The FSH, LH, E2 and the menstrual conditions and Kupperman clinical symptom score before the treatment were compared those after the treatment of the twelve weeks.Results:1. The total effect observed in patients after treatment for 3 menstrual cycles in 29 cases, the results show:8 were considered cured, with 2 cases of pregnancy, equivalent to a 27.59% of cure rate; the treatment was considered effective in 19 cases,65.52% of effective rate. A total 93.11% of treatment cases were considered successful.2. Serum levels of sex hormones:The FSH and FSH/LH decreased after treatment (P<0.01).There was no significant difference of E2 level between after the treatment and before the treatment (P>0.05).3. Changes in menstruation:There was no significant change of menstrual cycle, period and color (P>0.05).There was a tendency of reducing of clot, but no significant change (P>0.05). There was significant increase of patients with proper amount of menstruation after the treatment (P<0.05).4. Kupperman score changes:There were no patients with severe menopause symptomes after the treatment. Patients with moderate menopause symptomes decreased, and patients with low menopause symptomes increased after the treatment (P<0.01).Conclusions:The use of acupuncture combined with moxibustion treatment in patients with diminished ovarian reserve(DOR)has a good effect. This therapy can adjust the hormone level, can especially decrease FSH and FSH/LH ratio, improving the menstrual clot and less menstrual,significant improvements in menopausal symptoms. |
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