| Objective:To observe the clinical efficacy of Yijing anti-ageing paste in treating diminished ovarian reserve(DOR)of kidney deficiency and liver depression,and to evaluate the effectiveness of early treatment of diminished ovarian reserve(DOR)splited by the level of FSH equal to 25 mIU/mL.Method:From January 2017 to October 2018,patients diagnosed as DOR with the syndrome of kidney deficiency and liver depression were selected in gynecology and reproductive department of Jiangsu Province Hospital of TCM.Sixty patients were divided into treatment group and control group,30 in each group.According to the value of FSH,the patients were divided into high FSH group(25<FSH<40mIU/mL)and low FSH group(10<FSH<25mIUm/L).The treatment group was given Yijing anti-ageing paste orally,while the control group was given Fenmotong(estradiol tablet-estradiol dydrogesterone tablet)orally for 12 weeks.Sex hormone levels(E2,LH,FSH),AMH,type-B ultrasound(AFC,OV,PSV),TCM syndrome scores and safety index were observed at the initial diagnosis and 12 weeks of treatment respectively.The pregnancy rate was observed as well.Results:(1)Scores of TCM symptoms:The treatment group was better than the control group in improving the scores of main symptoms(menstrual volume and color,painful distention in the chest and rib-side,painful distention in breast and lumber pain),the difference was statistically significant(P<0.01,P<0.05);the improvement of menstrual cycle in the two groups was similar,the difference was not statistically significant(P>0.05);the treatment group was better than the control group in improving the scores of secondary symptom(inhibited menstruation with clot,vexation and agitation,insomnia,frequent urination at night,distention in the lesser abdomen),the difference was statistically significant(P<0.01,P<0.05).There was no significant difference between the two groups in improving dizziness and tinnitus(P>0.05).The total score of the treatment group was significantly lower than that of the control group(P<0.01).(2)Sex hormone and AMH level:Compared with the former,FSH and LH in both groups decreased significantly different(P<0.01).AMH in the treatment group increased with significantly different(P<0.01).The level of E2 was increased,but the difference was not significant(P>0.05).The level of E2 in the control group increased significantly(P<0.01),AMH was higher than the fonner with no significant difference(P>0.05).There was no significant difference in FSH/LH between the two groups before and after treatment(P>0.05);The level of AMH in the treatment group was significantly higher than that in the control group(P<0.05);and The level of E2 in the control group was significantly higher than that in the treatment group(P<0.05).(3)Ultrasound ovarian parameters:The OV,AFC and PSV of the two groups were improved compared with those before treatment with significant difference(P<0.01).Compared with the two groups,the improvement of OV and AFC was similar before and after with no significant difference(P>0.05),while the treatment group was better than the control group in improving PSV with significant difference(P<0.05).(4)Comprehensive curative effect and pregnancy rate:The effective rate and curative effect distribution of the two groups were similar,and the difference was not statistically significant(P>0.05).After treatment,the pregnancy rate was 6.9%(2/29)in the treatment group while 3.4%(1/28)in the control group.Three months later,the pregnancy rate was 10.3%(4/29)in the treatment group while 3.4%(1/28)in the control group.Both of them with no significant difference(P>0.05).(5)Comparison clarified by the level of FSH:After treatment,the levels of FSH,LH and OV in the treatment group and the control group were improved significantly(P<0.01,P<0.05),regardless of the patients with high FSH or low FSH(P<0.05).In patients with low FSH group,E2 in the control group was higher than that before treatment.The level of FSH?LH?FSH/LH was lower than that before treatment with no statistical significance(P<0.05);AMH in the treatment group was higher than that before with statistical significance(P<0.05);AFC and PSV in the treatment group and the control group were higher than before with statistical significance(P<0.01,P<0.05).After the treatment of high FSH group,we found that the level E2 of patients in the treatment group and the control group was higher than before,and the AMH level in the treatment group was higher than before,the difference was statistically significant(P<0.01,P<0.05),while the AMH level in the control group had no significant change(P>0.05).The levels of AFC and PSV in the treatment group were higher than before with statistically significant difference(P<0.01),while the AFC in the control group was higher than before,and the difference was close to statistical significance(P=0.054).Although the levels of AFC and PSV were higher before and after treatment,the difference was not statistically significant(P>0.05).CONCLUSION:(1)Yijing Anti-aging paste,representative of "Preventive treatment of disease",has the same comprehensive effect as fenmotong in treating DOR of kidney deficiency and liver depression.It can improve clinical symptoms,sex hormone level and ovarian parameters under ultrasound,and AMH level.It is safe and reliable to use only with slight gastrointestinal adverse reactions,which are worth to promote.(2)Comparison clarified by the level of FSH,Yijing Anti-aging paste and Fenmotong can improve the sex hormone levels of patients with high FSH and low FSH,but the comprehensive effect of high FSH is not as good as low FSH group,and the pregnancy rate is low,which indicates that"prevention of senility,early treatment"is very important.(3)Some traditional Chinese medicines of Yijing Anti-aging paste have estrogen-like effects.They may regulate hypothalamus-pituitary-ovary axis and improve ovarian function through multi-target mode of action. |
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