TCM Syndrome Character Of Premature Ovarian Failure And Method Of Tonifying Kidney And Dredging Liver Research On The Therapeutic Mechanism

Part I clinical researchObjective:To investigate the distribution characteristics of disease location,syndrome elements and syndrome types of premature ovarian failure in Chinese medicine,in order to further understand the pathological characteristics of premature ovarian failure.Methods:Collected in January 2019 to December 2019 in fujian province people's hospital of department of gynaecology clinic and hospital,a total of 60 patients with POF,using the standard four diagnostic information collection table?appendix B?collecting the basic condition and four diagnostic data,use of health status identification system syndrome factor points,four diagnostic information can be converted to analysis the general situation of POF patients and disease,disease syndrome factor and syndrome type distribution.Results:1.Disease location and syndrome factors in patients with premature ovarian failure:According to the frequency of occurrence,the distribution was as follows:kidney,liver,cell,spleen,mind,gallbladder,surface,half surface and half interior,in which the differences between kidney,liver and other disease sites were significant?P<0.01?.2.Syndrome elements of asthenia and venereal disease in patients with premature ovarian failure:According to the distribution of occurrence frequency,Yin deficiency,blood deficiency,qi deficiency,Yang deficiency,Jing deficiency,qi deficiency and qi depression were in order,among which Yin deficiency,blood deficiency,qi deficiency,Yang deficiency,Jing deficiency and other deficiency syndromes were significantly different?P<0.01?.3.Clinical syndromes of patients with premature ovarian failure:According to the occurrence frequency,the distribution is:qi stagnation,blood stasis,heat,phlegm,cold,wet,blood heat,blood cold,drink,among which qi stagnation is significantly different from other solid disease syndromes?P<0.01?.4.Distribution characteristics of syndrome types in patients with premature ovarian failure:the first 5 syndrome types were liver and kidney Yin deficiency,liver depression and qi stagnation.Liver stagnation and blood deficiency syndrome;Deficiency of liver and kidney;Liver kidney Yin blood deficiency syndrome;Deficiency syndrome of liver,kidney and blood.There are few single syndrome types,and most of them are disease location,disease combination and inclusion.Conclusion:Premature ovarian failure may involve multiple disease sites and diseases,and the disease sites are mainly in kidney and liver.The syndrome type is conjunct,the real and imaginary inclusion.Part?experimental researchObjective:Through the observation method of kidney and liver of ovarian premature aging model rats oestrous cycle,the effect of follicle-stimulating hormone?FSH?,estradiol?E₂?,luteinizing hormone?LH?,prolactin?PRL?,the influence of the ovarian reserve capacity?INH-B,AMH?,the influence of the expression of hypothalamus,pituitary situation?GnRH,GnRH-R?of ovarian tissue and the influence of the project such as morphological observation,from the hypothalamus-pituitary gonadal axis Angle discusses the intervention of kidney and liver method?HPG axis?the mechanism of action of ovarian premature aging.Methods:Healthy female SD rats of SPF grade 3 months of age were selected.Except for the blank group?A?,other rats were given intraperitoneal injection of cyclophosphamide to prepare POF model.At the end of 15 days after injection,the success of modeling was judged by observation of vaginal exfoliated cell smear and whether FSH and E₂ were disordered.The rats with successful modeling were selected as the model group.POF model rats were randomly divided into model control group?B?,kidney-tonifying group?C?,liver-tonifying group?D?and kidney-tonifying and liver-tonifying group?E?.Group A and group B were given normal saline,group C was given zuoguiyin,group D was given chaihu shugan powder,and group E was given zuoguiyin and chaihu shugan powder.Each group underwent continuous gavage for 28 days.1 day after the last administration of the drug in the experiment,the blood was collected from the severed head of the experimental rats after anesthesia,and the serum was isolated.The values of FSH,E₂,LH and PRL,the values of INHB and AMH and the expression levels of GnRH-R in the hypothalamus and pituitary were measured by ELISA.After the severed head,bilateral ovaries were rapidly dissected,fixed,dehydrated,and paraffin-embedded,and then sectioned and stained successively.The histological morphology of ovaries was observed under a microscope.Results:1.Modeling:rats in the model group had irregular estrus cycle,serum FSH significantly increased and E₂ significantly decreased compared with the blank group?P<0.01?,indicating successful modeling.2.Endocrine hormones:compared with group B,the serum FSH,LH and PRL values of group C,D and E decreased,and the serum E₂ values increased,with statistically significant differences?P<0.05?.3.Ovarian reserve function:the serum INH-B and AMH values of group C,D and E increased compared with group B,and the difference was statistically significant?P<0.05?.4.HPG axis:compared with group B,the expression of GnRH in the hypothalamus of group C,D and E decreased,and the expression of GnRH-R in the pituitary increased,with statistically significant differences?P<0.05?.5.Ovarian histomorphology:the number of follicles at all levels in group C,D and E increased and pathological fibrosis decreased compared with group B.Conclusion:The method of tonifying kidney and soothing liver may improve the disorder of endocrine hormone,improve the reserve function of ovary,improve the pathological morphology of ovarian tissue,and achieve the comprehensive effect of treating premature ovarian failure through the regulation of hypothalamic-pituitary-gonadal axis?HPG?.