Systematic Evaluation Of Bushen Tiaochong Method In The Treatment Of Secondary Amenorrhea And Data Mining Research On Professor Han Bing's Treatment Of Secondary Amenorrhea

Aim:Through meta-analysis,the clinical effect of Bushen Tiaochong on secondary amenorrhea was systematically evaluated,which provided the clinical basis for the treatment of secondary amenorrhea by Bushen Tiaochong;Through data mining,this paper studies the medication rule of Professor Han Bing in the treatment of secondary amenorrhea,summarizes the clinical experience of Professor Han Bing in the treatment of secondary amenorrhea,and inherits the academic thought of famous old Chinese medicine.Method:1.The published literatures on the treatment of secondary amenorrhea by Bushen Tiaochong herbs before January 2020 were searched.The target literatures were selected according to the acceptance criteria.Revman5.3 was used to analyze the menstrual cycle,the frequency of menstrual re tide,basic hormones,endometrial thickness and ovarian storage capacity after the drug withdrawal,and to evaluate the clinical efficacy of Bushen Tiaochong herbs in the treatment of secondary amenorrhea.2.The cases of secondary amenorrhea diagnosed and treated by Professor Han Bing were collected and divided into two parts: amenorrhea and menstruation after treatment.Microsoft Office Excel 2007 was used to establish the basic information of patients,medical information and drug efficacy table.According to the artificial syndrome differentiation and menstrual stage,the formula was entered into the Chinese medicine auxiliary inheritance platform v2.5,and the drug frequency,meridian tropism,four Qi,five flavor and efficacy distribution in different periods were obtained,and the commonly used drug combinations were obtained by using association rules.Results:1.The study results of the observation group: 22 randomized controlled studies were included,3 with high score and 19 with low score on Jadad scale.The results showed that Bushen Tiaochong Chinese medicine alone could effectively improve the normal cycle probability,increase the frequency of menstrual continous recuperation,reduce the risk ofrecurrence and the level of basic FSH after drug withdrawal,but there was no significant improvement in the level of basic LH,basic E2,endometrial thickness,AMH and the number of antral follicles.2.The observation group used Bushen Tiaochong Chinese medicine + hormone treatment literature research results: a total of 29 randomized controlled studies,Jadad scale score high 5,low 24.The results showed that: Bushen Tiaochong Chinese medicine combined with hormone treatment can effectively improve the normal probability of menstrual cycle,the frequency of menorrhea,the level of basic E2,the level of AMH,the thickness of endometrium,the number of antral follicles,the risk of recurrence,the level of basic FSH and the level of basic LH.3.The results of Professor Han Bing's research on the treatment of secondary amenorrhea:(1)A total of 317 patients and 1651 prescriptions were collected,involving 188 traditional Chinese medicines.(2)The commonly used single drug combinations are: Leonurus,angelica,Achyranthes bidentata,peach kernel,safflower,Cistanche,etc.;the commonly used two drug combinations are: peach kernel + safflower,safflower + Leonurus,peach kernel + Leonurus,Achyranthes +angelica,Chuanxiong + angelica and Chuanxiong + Leonurus;the commonly used three drug combinations are: peach kernel + Leonurus + safflower,peach kernel + Angelica + safflower,Chuanxiong + Leonurus + angelica,peach kernel + Rutong + Red Flower and safflower +Achyranthes bidentata + peach kernel;commonly used four drug combinations are: peach kernel + motherwort + Angelica + safflower.(3)The most of the four drugs are warm drugs,followed by plain drugs,cold drugs,hot drugs and cool drugs;the most of the five drugs are sweet,bitter and bitter drugs;the most of the drugs are liver channel,followed by kidney channel,heart channel and spleen channel.(4)The most effective drugs are tonic drugs,followed by blood activating drugs,Qi regulating drugs,surface resolving drugs and heat clearing drugs;tonic drugs are mainly tonic drugs and blood nourishing drugs,commonly used tonic drugs are angelica,antler cream,Psoralea,white peony and Radix Rehmanniae;commonly used drugs for blood activating and stasis removing are: Leonurus,Niuxi,safflower,peach kernel and Chuanxiong;commonlyused Qi regulating drugs are: Fructus aurantii,LULUTONG,Cyperus,orange kernel It is mainly composed of cinnamon twigs and Bupleurum;commonly used antipyretic drugs are:red peony,mulberry leaves,peony bark,yellow cypress and Anemarrhena.(5)The common syndrome types are blood stasis,deficiency of kidney,stagnation of liver qi,phlegm dampness and stasis,and deficiency of blood.A.The commonly used drugs of blood stasis,Chong Ren and Yu Zhi are: motherwort,angelica,safflower,peach kernel,Ligusticum chuanxiong,Achyranthes bidentata,etc.the commonly used drug combinations are: Safflower + peach kernel,peach kernel + safflower + motherwort,angelica + safflower +peach kernel,Ligusticum chuanxiong + angelica,motherwort + Ligusticum chuanxiong,motherwort + peach kernel;B.the commonly used drugs of kidney deficiency,Chong Ren and non solid are: Psoralea,angelica,Cistanche,epimedium,white peony,Achyranthes bidentata,etc Drug combination: Angelica + Psoralea,Cistanche + angelica,angelica + white peony,Cistanche + Psoralea,Cistanche + Psoralea + angelica,Achyranthes bidentata +angelica and Psoralea + white peony + Angelica;C liver depression and qi stagnation commonly used drugs: bupleurum,motherwort,liquorice,angelica,safflower,etc.,commonly used drug combination: liquorice + bupleurum,motherwort + liquorice + bupleurum,safflower + peach,hawthorn + Bupleurum and peach+ Bupleurum + safflower;D.common drugs for phlegm,dampness,stasis and Chong resistance: Atractylodes,Cyperus,dannanxing,motherwort,peach kernel,etc.,common drugs group: dannanxing + Atractylodes,dannanxing+ Cyperus + Atractylodes,safflower + peach kernel + peach kernel,peach kernel +Atractylodes + safflower,safflower + Atractylodes and peach kernel + Atractylodes;e.common drugs for deficiency of blood and Chong Ren and decline of Ren are angelica,radix rehmanniae,Paeoniae Alba,motherwort,psoralen,etc.,common drugs group Combination:Angelica + rehmannia,white peony + angelica,angelica + Rehmannia + white peony,Chuanxiong + angelica and Angelica + Chuanxiong + rehmannia.4.the research results of Professor Han Bing on the cycle medication after the treatment of secondary amenorrhea(1)A total of 130 patients and 579 prescriptions were collected,including 124 menstrual periods,194 late menstrual periods,80 interphase periods and 181 early menstrual periods,involving 172 traditional Chinese medicines.(2)After menstruation,the commonly used Chinese medicines are angelica,motherwort,white peony,rehmannia,Psoralea,etc.;the commonly used medicine groups are: white peony+ angelica,Chuanxiong + angelica and Rehmannia + angelica.A.During menstruation,the commonly used drugs are angelica,Leonurus,white peony,Ligusticum chuanxiong,rehmannia,etc.the commonly used drugs group: Ligusticum chuanxiong + angelica,white peony + angelica,angelica + Leonurus,Rehmannia + angelica,cassia twig + angelica,Ligusticum chuanxiong + Leonurus + angelica,Ligusticum chuanxiong + Leonurus and Rehmannia + Ligusticum chuanxiong + Angelica;B.the commonly used drugs in later menstruation are: Angelica,Psoralea,white peony,Cistanche deserticola,dodder,etc Group A:white peony + angelica,Psoralea + white peony + angelica,Cistanche + angelica and Cistanche + white peony + Angelica;C.common drugs in the menstrual interval: Angelica,Psoralea,Achyranthes bidentata,Cistanche,Leonurus,etc.,common drugs group:Achyranthes bidentata + angelica,Cistanche + Psoralea,white peony + Angelica and Cistanche + Angelica;D.common drugs in the early menstrual period: motherwort,angelica,peach,safflower,Ligusticum chuanxiong,etc.,common drugs Group A: Safflower + peach kernel,peach kernel + Leonurus + safflower,peach kernel + Angelica + safflower,Chuanxiong + angelica and peach kernel + Leonurus + Angelica + safflower.(3)In all menstrual cycles,the most common drugs are warm drugs,followed by plain drugs,cold drugs,cool drugs and hot drugs,and the four drugs in different menstrual stages are basically the same;in all menstrual cycles,the most drugs are sweet drugs,followed by bitter drugs and bitter drugs,and the frequency of five drugs in menstrual period,late menstrual period and inter menstrual period are basically the same,but the most drugs are bitter drugs in early menstrual period In all menstrual cycles,liver meridian is the most common channel,followed by kidney meridian,spleen meridian and heart meridian.(4)In all menstrual cycles,the drugs for invigorating deficiency are the most effective,followed by the drugs for promoting blood circulation and removing blood stasis,for regulating qi,for clearing heat and for resolving external symptoms.The drugs for invigorating blood circulation and removing blood stasis in prophase are more effective than those for invigorating deficiency.The most commonly used tonic drugs are Yang tonic,followed by blood tonic,yin tonic and Qi tonic.The tonic drugs are basically the same inmenstrual period,late menstrual period and inter menstrual period,but in early menstrual period,the main tonic drugs are blood tonic,followed by Yang tonic.The commonly used tonic drugs are angelica,antler cream,Psoralea,white peony,rehmannia,Cistanche deserticola,etc.;the commonly used tonic drugs are motherwort,Achyranthes bidentata,Carthamus tinctorius Peach kernel and Ligusticum chuanxiong;common Qi regulating drugs include: Fructus aurantii,LULUTONG,Xiangfu,orange kernel;common heat clearing drugs:red peony,peony skin,mulberry leaf,phellodendron and Arnebia purpurea;surface resolving drugs are mainly Bupleurum and Ramulus Cinnamomi.Conclusion:1.Bushen Tiaochong traditional Chinese medicine can improve the menstrual cycle of patients,increase the frequency of menstruation after drug withdrawal,reduce the risk of amenorrhea recurrence,reduce the level of basic FSH,and improve the level of basic E2 and AMH,increase the thickness of endometrium,increase the number of antral follicles,and reduce the level of basic LH after combined use with hormone.However,due to the large heterogeneity,small sample size and low quality of the included literature,the analysis results should be treated with caution.2.Professor Han Bing thinks that secondary amenorrhea is the disease of deficiency and excess.The disease is located in liver and kidney and Chong Ren.The common pathological factors are kidney deficiency,blood deficiency,blood stasis,liver depression,phlegm dampness and so on.In the treatment,nourishing liver and kidney,nourishing blood and promoting blood circulation are the main treatment methods.3.For the patients with secondary amenorrhea after treatment,Professor Han Bing advocated to continue to use drugs periodically.It can nourish the liver and kidney by nourishing blood and promoting blood circulation during menstrual period;it can nourish the liver and kidney by later period and warm the kidney yang;it can nourish the kidney and promote blood circulation by inter period;it can warm the meridians,promote blood circulation and dredge collaterals,and regulate the Chong Ren.