| Background:Premature ovarian failure(POF)is a disease in which follicles in the ovary are rapidly reduced to no or only a few follicles.It is related to many factors and is defined as a woman under 40 years old with a phenomenon of amenorrhea for at least 4 months,while the levels of FSH were higher than 40U/L(detected at least twice and at intervals of more than one month)with or without serum estradiol less than 73.2pmol/L.Patients always describe amenorrhea as the main symptom in hospital.The level of FSH was detected at least twice with or without serum estradiol(E2)less than 73.2 pmol/L.Patients often go to hospital due to amenorrhea.POF patients may have a series of symptoms,such as irregular menstruation,menopause,infertility,restlessness,vaginal dryness,loss of libido,and other symptoms,seriously affecting women's physical and mental health.Traditional Chinese medicine treatment of premature ovarian failure is the focus topic in domestic research.It is necessary to study the pathogenesis of POF in order to prevent women from the risk factors of premature ovarian failure and to explore the changes of T lymphocyte subgroups in peripheral blood of Erxian decoction.Objective:To investigate and analyze the related pathogenic factors of premature ovarian failure(POF)and the changes of T lymphocyte subgroups in peripheral blood of women treated with Erxian decoction.Finally,we can provide scientific and reasonable evidence for the prevention,health care and treatment of POF.Methods:1.Choose 110 patients with idiopathic premature ovarian failure(POF)diagnosed and treated in our hospital during January 2015 and December 2017 as POF group.110 healthy women aged 18-40 years with regular menstruation and normal laboratory sex hormones were chosen as control group.The levels of FSH and LH and E2 of patients were detected by ELISA methods.Questionnaires were filled out under the guidance of professional doctors.All the results were statistically analyzed.Single factor and multiple factor logistic regression analysis were used to show the risk factors of POF.2.80 patients with idiopathic premature ovarian failure were chosen during January 2016 and December 2016.Following the principle of random allocation,40 patients were treated with modified Erxian decoction as observation group.The prescriptions were composed of Xianmao 10g,Xianlingpi 15g,Zhiliquorice 6g,Cornus officinalis 15g,Yam 15g,Angelica sinensis 10g,Cinnamon9g and Peony 15g.Decoction was instructed to be taken in each morning and evening for six months.In the control group,40 patients were treated with"Kelingmeng"each day for one tablet.Both groups continued to take the medicine for 21 days without interruption,and continued to take the medicine on the 5th day of menstruation or 5 days after drug withdrawal to start the next course of treatment for 6months.The levels of FSH and LH and E2 andCD4+and CD8+T cells were detected both before and after treatment in the laboratory and statistically analyzed.Results:1.Logistic regression analysis showed that occupational stress,poor sleep,smoking or passive smoking,type A behavior pattern,history of pelvic gynecological surgery,history of abortion curettage were the risk factors of occurrence of POF.2.When treated with Erxian decoction,the total effective rate of premature ovarian failure patients was 85.0%(34/40),which was significantly higher than that of hormone treatment group(75.0%),with no significant difference(P>0.05).3.Serum levels of sex hormones(FSH,LH,E2)had no significant difference between the two groups before treatment(P>0.05);serum levels of FSH and E2 had statistical significance between the two groups after treatment with two methods(P<0.05),but LH had no statistical difference(P>0.05).4.There was no significant difference in the ratio of CD4~+,CD8~+,CD4~+/CD8~+T cells between the two groups before treatment(P>0.05);while after treatment CD4~+T cells in the observation group increased and CD8~+T cells decreased,CD4~+/CD8~+increased,with statistical difference(P<0.05).Conclusion:1.Occupational stress,poor sleep,smoking or passive smoking,type A behavior pattern,history of pelvic gynecological surgery,history of abortion curettage were the risk factors of occurrence of POF.Women should pay attention to the above risk factors of premature ovarian failure,reduce the negative impact of these aspects in daily life to actively prevent and slow down the occurrence and development of premature ovarian failure.2.Adding Erxian Decoction may effectively treat premature ovarian failure,and is better than hormone replacement therapy in relieving symptoms.3.The increase of CD4~+T cells and the decrease of CD8~+T cells in POF patients after treatment suggest that the occurrence of premature ovarian failure may be closely related to cellular immune mechanism. |
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