| Objective:To study the effect and mechanism of Zichong Gruanles (ZCG) on stimulating follicular development.Method:Patients with follicular developmental disorders, Including POF、Menopause、 DOR、hypogonadotropic amenorrhea、PCOS、Hyperprolactinemia, poor ovarian response, endometriosis,(clever capsule stripping surgery), and reproductive dysfunction (kidney essence deficiency) in the out-patient department of gynecology, the Second Affiliated Hospital of Chengdu University of TraditionalChinese Medicine, were collected from January,2013to March,2014.Zichong Gruanles:Composed of shudi、lujiaojiao、tusizi and so on,10g/bag, batch number:130801, Delegated leaves in Sichuan baoguang pharmaceutical company limited production.The patients Met the inclusion criteria oraled ZCG, twice daily, Each2bags; combined with20g ZCG by enema administration once daily at night for one month. They were recommended withdrawal during menstruation, two days later to continue such treatment.Outcome measures:kidney essence deficiency, the number and size of bilateral ovarian follicles,the Endometrial thickness,the peak systolic velocity (PSV)、resistance index (RI) of the blood flow in spiral arterieshe and bilateral ovarian artery; follicle-stimulating hormone(FSH)、luteinizing hormone(LH) and estradiol(E2).The patients with recurrent menstruation were Detected of sex hormone and follicle quantity and size on the first day of menstruation. The Other monitoring of menstrual cycles correspond to points in time before and after treatment. were monitored for the period before and after treatment. Amenorrhea were measured before and after the treatment of one course.Data was processed by SPSS19.0statistical software.Result: There were30samples collected in total,11cases of primary infertility,19case of secondary infertility; including16cases of POF,7cases of DOR,52cases of PCOS,41cases of hypogonadotropic amenorrhea,2cases of Hyperprolactinemia,1cases of endometriosis(clever capsule stripping surgery),1cases of poor ovarian response.Their mean age was (35.60±6.29) years old. Mean disease duration was6.80±5.42years. There are surgical procedures related to the history of the ovaries and uterus in18cases, accounting for60.00%.1. After the treatment, there are3cases of pregnancy, syndrome of deficiency of kidney essence total effective rate is73.33%;2. Compaired with pre-post treatment,for patients with POF、Menopause、 DOR and hypogonadotropic amenorrhea,the number of follicles was significantly more (1.88±2.56,2.63±3.23),P<0.05;3. Compaired with pre-post treatment, the size of bilateral ovarian follicles was significantly bigger (0.29±0.36,0.39±0.47), he thickness of endometrium was significantly higher (0.41±0.26,0.47±0.29), P<0.05;4. Compaired with pre-post treatment,for the patients with POF, Menopause andDOR, the FSH was significantly lower (71.47±40.64,66.75±39.59), E2was significantly higher (13.13±13.09、16.61±17.48), P<0.05;but the LH was showed no difference (33.29±19.56,33.32±19.17), P>0.05;5. Compaired with pre-post treatment, for patients were improved ovarian function after treatment,the PSV of the blood flow in right and left ovarian artery were significantly higherleft (5.88±3.52、10.46±4.10) right (6.95±3.89、10.71±4.86), P<0.05; the RI of the blood flow in right and left ovarian artery were showed no difference, P>0.05.6. Compaired with pre-post treatment, for the patients with endometrial thickness improved after treatment,the PSV of blood flow in spiral arteries was significantly higher (5.20±2.21,6.35±2.69), the RI of blood flow in spiral arteries was significantly decreased (0.63±0.13,0.55±0.14),P<0.05;7. After the first course of treatment, patients with amenorrhea and endometrial thickness were increased in patients with menstrual cycle, Amenorrhea (0.21±0.12, 0.31±0.16) and menstruation (0.70±0.21,0.87±0.22), P<0.05; But just increase the number of follicles in patients with sinus menstruation, antral follicle number (4.89±1.76,7.11±1.83) and antral follicle size (0.64±0.30,0.87±0.25), P<0.05.Conclusion:1.ZCG is able to promote ovarian follicles growth and development, improving endometrial thickness and reproductive endocrine function in patients with ovarian dysfunction;2. The mechanism of ZCG is able to improve the blood flow in ovarian artery and uterine artery. |
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