| ObjectiveTo explore the effect of Gynecology Yangrong Capsule on the perimenopausal symptoms of perimenopausal women and its effect on ovarian function.MethodsFrom May 2018 to December 2018,63 patients with perimenopausal syndrome were collected and treated according to their wishes.They were divided into treatment group?gynecological Yangrong capsule group?and control group?without taking medicine?.There were 38 patients in treatment group and 25 patients in control group.Patients in the treatment group were randomly divided into high-dose group?gynecological Yangrong capsule,8 capsules per time,3 times per day?and low-dose group?gynecological Yangrong capsule,4 capsules per time,3 times per day?according to the order of visiting the doctor.The treatment course was 4 weeks for a total of 3 months,while the control group was not given any treatment.To compare the remission of perimenopausal symptoms,menstrual improvement,changes of serum FSH,LH,E2 and AMH,uterine volume,bilateral ovarian artery pulsation index?PI?,resistance index?RI?,maximum ovarian diameter of ovary?MOD?and antral follicle count?AFC?in low-dose group,high-dose group and control group before treatment,1 month and 3 months after treatment.To comprehensively evaluate the effect of Gynecological Yangrong Capsule on ovarian function in patients with ovarian dysfunction.Results?1?The remission of clinical symptoms in the three groups:1 month after treatment,there were significant differences between the low-dose group and the high-dose group and the control group(?2low=-2.532,P low=0.034;?2high=-4.056,P high=0.001);but there was no significant difference between the two groups??2=2.056,P=0.901?.After 3months of treatment,there were significant differences between low-dose group and high-dose group and control group(?2low=-5.928,P low<0.001;?2high=-6.349,P high<0.001);but there was no significant difference between low-dose group and high-dose group??2=1.256,P=0.916?;the total score of Kupperman scale in low-dose group and high-dose group decreased significantly compared with that before treatment(?2low=4.893,P low<0.001;?2high=5.011,P high<0.001.)The difference between low dose group and high dose group was statistically significant after 3 months of treatment and 1 month of treatment respectively(?2low=2.489,Plow=0.016;?2high=2.951,P high=0.035).After one month of treatment,there was significant difference in the relief of insomnia symptoms between the low dose group and the control group?P<0.05?.In the relief of depressive symptoms,there were significant differences between low dose group?P<0.05?and high dose group?P<0.05?and control group.After 3 months of treatment,there were significant differences in alleviating symptoms of hot flashes,night sweating,insomnia,agitation,depression,vertigo and fatigue among the three groups?P<0.05?;there were significant differences between the low-dose group and the high-dose group and the control group?P<0.05?;and there was no significant difference between the low-dose group and the high-dose group?P>0.05?.?2?Comparison of menstrual improvement before and after treatment in three groups:after one month of treatment,7 cases were effective in low-dose group,13 cases were ineffective,the effective rate was 35.00%;10 cases were effective in high-dose group,8 cases were ineffective,the effective rate was 55.56%.There was no significant difference in the effective rate between the two groups??2=0.841,P=0.395>0.05?.After three months of treatment,16 cases were effective and 4 cases were ineffective in the low dose group,the effective rate was 80.00%;17 cases were effective and one case was ineffective in the high dose group,the effective rate was 94.44%.There was no significant difference in the effective rate between the two groups??2=0.356,P=0.451>0.05?.There were statistical differences between low dose group and high dose group after three months of treatment and one month of treatment respectively(?2low=8.052,P low=0.014;?2high=3.347,P high=0.019).?3?Changes of serum hormone levels before and after treatment in three groups:?1?FSH:After three months of treatment in low dose group?average8.52±3.11mIU/ml?,the serum hormone levels decreased significantly compared with before treatment?average 16.67±7.11mIU/ml?,the difference was statistically significant??2=4.675,P<0.001?;after three months of treatment,the serum hormone levels in high dose group were significantly different from those before treatment and after 1 month of treatment respectively.(?23 months/1month=2.850,P3 months/1month=0.010,?23 months/before=5.473,P3 months/before<0.001).After three months of treatment,there were significant differences in low dose and high dose compared with the control group(?2low=-3.392,P low=0.004;?2high=-4.680,P high<0.001).?2?LH:After three months of treatment,there were significant differences between the low-dose group and the high-dose group and the control group(?2low/control=-2.877,Plow/control=0.013;?2 high/control=-3.982,P high/control=0.001).There was a significant difference between low-dose therapy three months later and one month later??2=2.677,P=0.029?.After three months of treatment,there were significant differences between high dose group and before treatment and after one month of treatment??23 months/before=2.876,P3 months/before=0.013;?23 months/1 month=2.677,P 3 months/1 month=0.038?.?3?E2:E2 in low dose group before treatment?average 59.76±58.37pg/ml??M±Q?,E2 in high dose group?average 72.18±26.78pg/ml??x?s?,and E2 in control group?average73.07±29.46pg/ml??x?s?.There was no significant difference among the three groups??2=0.367,P=0.912>0.05?.There was no significant difference between the low dose group,the high dose group and the control group after one month,three months and before treatment?P>0.05?,and there was no significant difference between the two groups?P>0.05?.?4?Changes of serum AMH in three groups before and after treatment:AMH in low dose group?average 0.19±0.13ng/ml?,AMH in high dose group?average 0.17±0.12ng/ml?and AMH in control group?average 0.16±0.07ng/ml?;there was no significant difference among the three groups?F=0.386,P=0.667>0.05?.There was no significant difference between the low dose group,the high dose group and the control group after one month,three months and before treatment?P>0.05?,and there was no significant difference between the groups?P>0.05?.?5?Changes of each index under ultrasound in three groups:There was no significant difference in uterine volume,ovarian maximum plane mean meridian?MOD?,left and right ovarian RI,PI value and bilateral ovarian sinus follicles?AFC?between low-dose group,high-dose group and control group after treatment for one month and three months?P>0.05?;there was no significant difference among the three groups?P>0.05?.Conclusion?1?Gynecological yangrong capsule has definite curative effect on perimenopause related symptoms,and high dose and long course of treatment?three months or more than three months?have prominent curative effect.?2?Gynecological Yangrong Capsule can stabilize the H-P-O axis and alleviate perimenopausal clinical symptoms by improving ovarian microenvironment rather than estrogen level in perimenopausal women. |
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