Experience And Verification Of Diagnosis And Treatment Of Ovarian Reserve Function By Electroacupuncture Of Chief Physician

Background:Diminished Ovarian Reserve(DOR) refers to declination of ovaries’ ability to produce eggs and quality of follicles, which results in reduced fertility and suffers from irregular menstruation, amenorrhea, infertility, etc. DOR will develop further into premature ovarian failure(POF) without early diagnosis and treatment. The etiology and pathogenesis of the disease is complicated and there is no effective therapeutic drugs. Acupuncture may improve the ovarian function, but there are few clinical studies at present. Therefore, summary of clinical experience in diagnosis and treatment for DOR with acupuncture has certain guiding significance for the clinical application of acupuncture in the disease.Objective:To analyze and summarize the experience in the diagnosis and treatment of DOR with electroacupuncture by Zhishun Liu, director of the physician.Method:Patients with DOR were selectedfrom the Department of acupuncture and moxibustion,Guang’an men Hospital, China Academy of traditional Chinese medicine during January 2015to February 2016.They were all outpatients of Professror Zhishun Liu.Prospective clinical observation ofmentor’s treatment method and the curative effect with acupuncture was conducted.A total of 37 patients (30 casescompleted the treatment) met the inclusion criteria and were treated with electroacupuncture.Evaluation index:follicle stimulating hormone (FSH)of the first 2-3 days ofthe period, luteinizing hormone (LH), follicle stimulating hormone and luteinizing hormone (FSH/LH), estradiol (E2), antral follicle number of 2-7 days of the periodand size of the ovary, perimenopausal syndrome scale (MRS) symptom score; observing the recent curative effect and follow-up effect. At the same time, a detailed record of mentor dialectical and treatment,acupuncture point selection and operation parameters of electroacupuncture, treatment frequency, total treatment time and frequency characteristics and rules.On this basis,theanalysis summarized tutor’s experience of electroacupuncture treatment for DOR.Results:30 patients completed 12 weeks of electroacupuncture therapy,21 patients were followed up for 12 weeks. (1) The serum hormone levels before and after treatment: treatment of patients with pre FSH baseline 17.07+3.98mIU/ml. After treatment values of 9.84+5.63mIU/ml, difference between 7.23+4.23mIU/ml (P< 0.05). After the end of treatment during the follow-up period the average value of 10.58+4.21mIU/ml, compared with those before treatment decreased 7.58+4.32mIU/ml, with significant difference (P< 0.05). The baseline level of patients with LH was 6.32+4.56mIU/ml, the average value was 4.05+2.78mIU/ml, the difference was 12+3.59mIU/ml (P<0.05), and the difference was statistically significant. The average value of the follow-up period was 4.31+1.34mIU/ml, and the average value was 1.55+2.01mIU/ml, and there was a significant difference (P<0.05). The baseline level of FSH/LH in patients was 2.7+3.65,12 weeks after electroacupuncture treatment was 2.42+3.91,0.28+3.87, and no significant difference before treatment (P>0.05). The average follow-up period was 2.45+1.27, which was 0.64+ 1.59, and no significant difference (P>0.05). The baseline level of E2 in patients was 32.11+ 13.5pg/ml,12 weeks after electroacupuncture treatment was 105+10.35pg/ml,72.89+ 12.54pg/ml, the difference was statistically significant (P<0.05). The average follow-up period was 80.96+21.14pg/ml,51.42+14.67pg/ml higher than before treatment, with statistical significance (P<0.05). The results suggested that electroacupuncture could improve the hormone (FSH, LH, E2) levels in patients with ovarian reserve insufficiency, and have a long-term effect. (2) The number of follicles and ovary were compared before and after treatment:the number of follicles in the anterior sinus of the patients was 1.00±1.00, and thedifference was statistically significant (P<0.05). The average follow-up period was 3.2+ 1.21,2.2+1.13 more than before treatment, with statistical significance (P<0.05). The level of patients with ovarian size at baseline was 25.7+3.15mm,26.8+4.98mm,1.1+3.89mm, and no significant difference (P>0.05) after electroacupuncture treatment. The average follow-up period was 26.1+3.72mm,0.4+3.51mm, no significant difference compared with before treatment (P>0.05). The results suggest that the treatment of electroacupuncture can increase the number of follicles in the patients, and has a certain long-term effect. (3) The clinical symptom scores before and after treatment to compare:patients before Mrs (perimenopausal syndrome scale) score was 13.02+4.11 points. After 12 weeks after EA treatment, integral for 7.69+3.97 points, a drop of 5.33+3.99 points, the difference is statistically significant (P< 0.05). The integral of the follow-up period was 8.62+4.61 points, 4.31 points lower than the baseline, and there was a significant difference (P<0.05). The results suggest that EA can improve the clinical symptoms of patients, and has a certain long-term effect.Conclusion:(1)Electroacupuncture treatment can improve the ovarian reserve function of patients, including the benign regulation of female hormone levels, increase the number of follicles and improve the clinical symptoms, and have a certain long-term efficacy.(2)Diagnosis and treatment experience of Professor ZhishunLiu in the treatment of DORI Disease differentiation and syndrome differentiation, diseasedifferentiation and syndrome differentiationthrough the meridian pointsDOR clinical mainly is characterized byabnormal menstruation, fertility, infertility and depression, anxiety and other symptoms, belonging to the female reproductive endocrine disorders. The disease situated in ovary, belonging to pelvic floor. It relates to Chong Ren meridianand Foot Taiyang Bladder meridian;main points:first point prescription:bilateral ZhongLiao; second point prescription:bilateral Tianshu, Zigong and Guan yuan; two groups of acupoints alternating application.ZhongLiao belongs to Foot Taiyang bladder meridian, which is the key point for pelvicne floor disease;Tianshu belongs to Foot Yangming stomach meridian and is Mu Point of Large intestine meridian, adjusting and mending acquired Qi; Zigongis the extraordinary points, regulating and tonifying congenital Qi,which is effective point of reproductive diseases.II Operation keyZhongLiao needs to be pierced with 0.40 mm x 100 mm needles(underweight patients) or 0.45 mm x 125 mm needles (patients with partial fat), inward obliquely into the third sacral hole 80-100 mm; Needling at Tianshu, doctors need to use 0.30 mm x 50 mm(underweight patients) or 0.30 mm x 75 mmneedles(patients with partial fat), downwards perpendicularly the 45-70 mm fromTianshu point; Zigong and Guanyuan is needled with conventional pierce, into the muscular layer of the abdominal wall. And bilateral ZhongLiao, Tianshu, Zigong are respectively electroacupunctured, frequency of 20 Hz, continuous wave, intensity of 0.2-2 mA, to patients tolerance for 20 minutes.