| Objectives1 To analyze and summarize Professor Liu Yanfeng's medication rule,clinical thinking and academic thought in the treatment of polycystic ovary syndrome with oligomenorrhea and amenorrhea.2 To observe the clinical effect of tonifying kidney,relieving depression and regulating chong method on oligomenorrhea and amenorrhea in polycystic ovary syndrome of kidney deficiency and liver depression.Methods1 Medical records of polycystic ovary syndrome with oligomenorrhea and amenorrhea patients treated by Professor Liu Yanfeng from April 2018 to December 2019 in the outpatient clinic of of Dongzhimen Hospital were collected and screened.Recorded the patient's name,age,visiting time,number of visits and traditional Chinese medicine prescription,established the database,and uploaded the medical records to the "Ancient and Modern Medical Records Cloud Platform(V2.2.2)" database.Used the function of "standardization of medical records",standardized the data of traditional Chinese medicine,and selected the"data mining analysis" module to count the frequency of drugs,four properties,five flavors,and Zang Fu meridian tropism in the prescription.The representative drug combinations were obtained by using data mining methods such as association analysis and cluster analysis,and Professor Liu Yanfeng's experience in the treatment of polycystic ovary syndrome with oligomenorrhea and amenorrhea was analyzed.2 With self-control as the research method,34 patients with polycystic ovary syndrome of oligomenorrhea and amenorrhea diagnosed as kidney deficiency and liver depression in the outpatient clinic of Professor Liu Yanfeng of Dongzhimen Hospital of Beijing University of traditional Chinese Medicine from November 2018 to December 2019 were collected and treated with the method of tonifying kidney,relieving depression and regulating chong.Observed the difference of menstrual cycle score,TCM syndrome score,hirsutism score,acne score,black acanthosis score,BMI,self-rating anxiety scale score,self-rating depression scale score,serum sex hormone level and pregnancy before and after treatment.To analyze the clinical effect of tonifying kidney,relieving depression and regulating chong method on oligomenorrhea and amenorrhea in patients with polycystic ovary syndrome.Results1 Analysis of Professor Liu Yanfeng's medication rules for treating PCOS with oligomenorrhea and amenorrhea(1)A total of 117 patients were included in this study,and the age distribution is mainly 20-35 years old,accounting for 98.3%.(2)A total of 574 prescriptions were screened and collected,including 166 kinds of Traditional Chinese Medicine with a total frequency of 9608.There were 30 kinds of traditional Chinese medicine with a frequency of more than 20%.The top 6 frequently used Traditional Chinese Medicines were Dipsacus,Mulberry Parasitism,Caulis Spatholobi,Angelica Sinensis,Radix Curcumae,Salvia Miltiorrhiza.(3)Warm drugs were the most common.Mild drugs were the second.Mild cold drugs were the third.Bitter drugs,sweet drugs and pungent drugs were the top three drugs.The drugs of liver meridian were the most,followed by kidney meridian.(4)According to the method of association rules,a total of 17 drug association rules were obtained,including 10 kinds of traditional Chinese medicine,which were the combinations of Dipsacus,Mulberry Parasite,Angelica Sinensis,Caulis Spatholobi,Amethyst,Rhizoma Drynariae,Fructus Ligustri,Fructus Lycii,Nutgrass Galingale Rhizome,Salvia Miltiorrhiza.(5)Based on the cluster analysis of the first 30 high-frequency drugs,five core clusters were obtained.The first group was Fructus Ligustri,Fructus Lycii,Lobed Kudzuvine Root,Largetrifoliolious Bugbane Rhizome,Manyflower Solomonseal Rhizome and Fragrant Solomonseal Rhizome.The second group was Liquorice Root,Thunberbg Fritillary Bulb,Baical Skullcap Root,Pinellia Ternata,Jackinthepulpit Tuber,Mongolian Dandelion Herb,Capillary Wormwood Herb.The third group was Radix Curcumae,Salvia Miltiorrhiza,Rhizoma Drynariae,Amethyst,Angelica sinensis,Caulis Spatholobi,Dipsacus and Mulberry parasite.The fourth group was Nutgrass Galingale Rhizome,Largehead Atractylodes Rh and Indian Buead Tuckahoe.The fifth group was Sargentgloryvine Stem,Red Paeony Root,Tree Peony Bark,Sichuan Lovase Rhizome,Common Motherwort Herb and Herba Lycopi.2 Clinical observation of tonifying kidney and relieving depression and regulating chong method in treating PCOS with oligomenorrhea and amenorrhea(1)A total of 34 patients were included in this study,the age distribution was 20-33 years old,the patients with bachelor's degree or above accounted for 76.5%,and the patients with family history accounted for 79.4%.(2)Curative effect of TCM syndromes:after treatment,2 cases were cured.13 cases were markedly effective.15 cases were effective.4 cases were ineffective.The total effective rate was 88.2%.(3)The scores of menstrual cycle and TCM syndrome:the method of tonifying kidney,relieving depression and regulating chong could significantly reduce the scores of menstrual cycle(P<0.001)and TCM syndrome(P<0.001).(4)The scores of hirsutism,acne and acanthosis nigricans:the method of tonifying kidney,relieving depression and regulating chong could effectively reduce the acne scores(P<0.01).Although it could reduce the scores of hirsutism and acanthosis nigricans,but there were no significant difference before and after treatment(P>0.05).(5)BMI:the method of tonifying kidney,relieving depression and regulating chong could reduce BMI.Although there was some improvement,but there was no significant difference before and after treatment(P>0.05).(6)The scores of self-rating anxiety and depression scale:the method of tonifying kidney,relieving depression and regulating chong could significantly reduce the scores of anxiety and depression(P<0.001).(7)The level of sex hormone:the method of tonifying kidney,relieving depression and regulating chong could effectively reduce the T level of patients(P<0.05).The levels of LH,FSH and LH/FSH were decreased,but there were no significant difference before and after treatment(P>0.05).(8)Pregnancy:a total of 17 patients had fertility needs,and 6 patients had clinical pregnancy during the treatment period,with a pregnancy rate of 35.3%.Conclusions1 The results of clinical data mining research show that Professor Liu Yanfeng treats polycystic ovary syndrome with oligomenorrhea and amenorrhea by mild drugs,attacking and tonifying,paying attention to tonifying deficiency,not blindly promoting blood circulation and promoting menstruation,and protecting female yin blood and yang qi at all times.The pathogenesis of polycystic ovary syndrome with oligomenorrhea and amenorrhea is most closely related to kidney and liver.Kidney deficiency and liver depression is the important pathogenesis of polycystic ovary syndrome,which is consistent with Professor Liu Yanfeng's clinical experience.Professor Liu Yanfeng's clinical treatment of polycystic ovary syndrome with oligomenorrhea and amenorrhea is based on combination of disease identification and syndrome differentiation,tonifying the kidney and regulating the liver as the basic treatment,and supplemented by invigorating the spleen and resolving phlegm,clearing heat and removing dampness,activating blood circulation and removing blood stasis according to the different clinical manifestations.2 The results of clinical observation showed that the method of tonifying kidney,relieving depression and regulating chong could effectively adjust the menstrual cycle of patients diagnosed as polycystic ovary syndrome with oligomenorrhea and amenorrhea,improve the symptoms of acne,relieve mental and psychological disorders such as anxiety and depression,reduce serum T level,improve endocrine environment and increase pregnancy rate.The method of tonifying kidney,relieving depression and regulating chong is clinically effective. |
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