Based On The HPO Axis And Oxidative Stress, To Explore The Effect Of Zhu's Tiaojing Cuyunfang On Patients With Type II Ovulation Dysfunction Infertility (kidney Deficiency Type)

Objective:To observe Zhu’s Tiaojing Cuyun Recipe the treatment of type II ovulation obstructive infertility（kidney deficiency）clinical curative effect,and contrast with clinical first-line drug Clomifene,verify its at the same time of guarantee ovulation can improve clinical symptoms and the receptivity of endometrium,explore its effective mechanism and regulation Hypothalamic-pituitary-ovarian axis and the correlation of oxidative stress.Methods:Selection during October 2019 to March 2017 in Yueyang Hospital of SHUTCM gynecology clinic patients with type II ovulation obstructive infertility（kidney deficiency）,using randomized controlled method,divided into the treatment group and control group,treatment group take Zhu’s Tiaojing Cuyun Recipe,the control group take the Clomifene,treatment for six months in a row,observed before and after treatment in patients with ovulation index（follicles discharge rate,blood LH peak,dominant follicle number and follicle luf rate）,clinical efficacy,（clinical pregnancy rates comprehensive curative effect,menstrual symptoms score and TCM syndrome score）,and the receptivity of endometrium index（endometrial thickness under ultrasound,three lines,endometrial spiral artery blood flow RI）,H-P-O axis related indicators（LH,FSH,E₂,PRL and P,T）,as well as oxidative stress related indicators（ROS,MDA,GSH-Px,SOD,AOPP）were analyzed by SPSS21.0 software.Results:A total of 62 patients were enrolled,31 in the treatment group and 31 in the control group.There were no significant differences in age,infertility type,and infertility years between the two groups before treatment.After treatment,the results of the two groups are compared:（1）Effects on ovulation:There was no significant difference in the superior follicle discharge rate and blood LH peak rate between the control group and the treatment group（P>0.05）.The probability of multiple dominant follicles and the probability of follicular luteinization in the control group were significantly higher than those in the control group（P<0.05）.（2）Effects on clinical symptoms:（1）The pregnancy rate and clinical comprehensive efficacy of the treatment group were comparable to those of the control group（P>0.05）.（2）The treatment group and the control group can significantly reduce the menstrual symptom score（P<0.05）,but there is no significant difference between the two groups（P>0.05）.The treatment group and the control group could significantly improve the menstrual and meridional quality（P<0.05）,and the control group was more effective in improving the meridian（P<0.05）.（3）The treatment group and the control group can significantly reduce the TCM syndrome score（P<0.05）,and the effect of the treatment group is more significant（P<0.05）.Both the treatment group and the control group can significantly relieve dysmenorrhea（P<0.05）,but there is no significant difference between the two groups（P>0.05）.The treatment group can also significantly improve the waist and knees,thin stools,tinnitus,fatigue,and The symptoms were less（P<0.05）,and the treatment group had a significant effect on improving the symptoms of lumbar and soft knees（P<0.05）.（3）Effects on endometrial receptivity:（1）The endometrial thickness of the treatment group was significantly thickened（P<0.05）,and the endometrial thickness of the control group was significantly thinner（P<0.05）.There was a significant difference between the groups（P<0.05）.（2）The positive rate of endometrial three-line type in the treatment group was significantly higher than that in the control group（P<0.05）.（3）The RI value of the treatment group was significantly lower（P<0.05）,and the RI value of the control group was significantly increased（P<0.05）.There was significant difference between the groups（P<0.05）.（4）Effects on HPO axis:（1）Follicular phase:Compared with before treatment,LH in the control group increased significantly and E₂decreased significantly（P<0.05）.（2）ovulation period:Compared with before treatment,the treatment group and the control group were significantly increased in LH,FSH and E₂（P<0.05）.Compared with the control group,FSH and E₂was more obvious in the control group（P<0.05）.（5）Effects on oxidative stress:Compared with before treatment,ROS,MDA and GSH-Px were significantly decreased in treatment group and control group,SOD and AOPP were significantly increased（P<0.05）.There was no significant difference in the control group（P>0.05）.Conclusion:（1）Zhu’s Tiaojing Cuyun Recipe in the treatment of type II ovulatory obstructive infertility（kidney deficiency type）,the ovulation rate is equivalent to the first-line medication of clomiphene citrate tablets,while reducing the side effects of follicular luteinization and excessive number of dominant follicles.（2）The pregnancy rate,the clinical comprehensive efficacy is same as first-line drugs Clomifene,at the same time can improve menstrual color,quality,alleviate dysmenorrhea,soreness and weakness of waist and knees,loose stool pond,fatigue,leucorrhea,enuresis nocturna and other clinical symptoms.（3）Zhu’s Tiaojing Cuyun Recipe promotes pregnancy to improve endometrial receptivity by reducing endometrial spiral arterial blood flow resistance index,increasing endometrial thickness and endometrial three-line positive rate.（4）Zhu’s Tiaojing Cuyun Recipe can up-regulate FSH,LH and E₂levels during ovulation,and improve the functional status of H-P-O axis.（5）Zhu’s Tiaojing Cuyun Recipe promotes pregnancy to reduce oxidative stress in the body by reducing ROS,MDA,GSH-Px and increasing SOD and AOPP.