| 1.Research BackgroundInfertility is a common disease of the female reproductive system.It refers to a regular life.Those who have not been pregnant for 12 months or more without contraception are divided into primary infertility and secondary infertility.The causes of infertility are complex and diverse.Ovulation disorders and pelvic factors are the main reasons,and ovulation disorders are one of its important reasons,accounting for about 20%-40%of the occurrence of infertility.Under the common regulation of the hypothalamus-pituitary-ovarian reproductive axis,the central nervous system,and the endocrine system,the normal ovulation process can proceed smoothly.Any one of the links is abnormal,such as abnormal function of the hypothalamic-pituitary axis,abnormal positive and negative feedback mechanisms,Ovarian factors,abnormal function of other endocrine glands,age,obesity,mental stress and other factors can all cause ovulation disorders in women.For the treatment of ovulation dysfunction infertility,Western medicine mainly uses drugs to promote ovulation,including surgical treatment,psychological treatment,etc.Although clinical effects have been achieved,the incidence of adverse reactions is relatively high,such as OHSS and endometrial growth retardation.,LUFS,luteal insufficiency,etc.,eventually leading to multiple pregnancy,ectopic pregnancy,low pregnancy rate,high abortion rate and even fetal malformations.Physicians of the past believe that the occurrence of ovulation dysfunction infertility is not caused by a single visceral dysfunction,but is the result of a combination of multiple viscera,meridians,qi,blood,body fluid and other dysfunctions.Therefore,ovulation and conception are a complex physiological process,which is based on the kidney and requires kidney yin nourishment,kidney yang agitation and warmth,liver qi stabilization,and unceasing qi and blood.Any abnormality in any of the links is acceptable.Affect ovulation function and eventually lead to infertility.Among them,kidney deficiency is the most basic pathogenesis leading to ovulation dysfunction infertility;liver qi stagnation is a common cause;Chong-ren disorder is an important cause;blood stasis and phlegm dampness are important pathological factors.Traditional Chinese medicine has the characteristics of multiple pathways,multiple targets,and multiple forms.It has certain advantages in the treatment of ovulation-related infertility,including syndrome differentiation and treatment,single prescriptions,Chinese patent medicines,acupuncture,moxibustion,and acupuncture combination There are many ways of treatment and integrated traditional Chinese and Western medicine.With the liberalization of the national second-child policy,the demand for fertility has increased significantly,and the delayed reproductive age has made female fertility face severe challenges,and the incidence of infertility has increased year by year.Among them,ovulation dysfunctional infertility not only has the characteristics of infertility,but also has its own particularity.With the purpose of "reproductive health and eugenics",the research team has been committed to the systematic research of "menstrual adjustment seeds" since the 1990s.,Carry out systematic research from 4 aspects of pathological mechanism,formula basis,experiment and clinical research,and put forward the theory of"kidney deficiency and blood stasis" in ovulation dysfunction infertility.The research team believes that kidney deficiency and blood stasis is the main pathological mechanism of ovulatory infertility,and kidney deficiency is the decisive factor for ovulatory infertility;blood stasis is an important factor that runs through ovulatory infertility.The two are mutually cause and effect,affecting the kidney-Tiankui-Chongren-Uterine reproductive axis,blocking the growth and development of follicles and orderly discharge,leading to ovulation infertility.Clinical treatment of ovulation-dysfunctional infertility is based on invigorating the kidney and activating blood circulation,focusing on regulating the"Kidney-Tiankui-Chongren-Ugong" reproductive axis.Self-made prescription for invigorating the kidney and promoting ovum,which has been confirmed by a number of clinical and experimental studies in the early stage.The method of invigorating the kidney and activating blood It can regulate the kidney-Tiangui-Chongren-uterine axis,improve ovarian function,improve the quality of oocytes,promote smooth discharge of follicles,improve uterine receptivity,etc.,highlighting the diagnosis and treatment of "different diseases with the same treatment" and "syndrome" in traditional Chinese medicine.Thinking mode has achieved significant social and economic benefits.2.Research Hotspots and Trends of TCM Diagnosis and Treatment of Ovulatory Infertility Based on Knowledge Graph Visualization2.1 ObjectUsing the map of scientific knowledge,this study conducted descriptive statistics and map visualization analysis on the literature of Chinese journals in the field of diagnosis and treatment of ovulation disorder infertility with traditional Chinese medicine in the past 20 years to comb and summarize the research status of the field,and excavated its research hotspots and frontiers,to provide the reference basis in the future,better service and guide clinical for diagnosis and treatment of traditional Chinese medicine ovulation obstructive infertility related research.2.2 Methods2116 Chinese journal articles which were about TCM diagnosis and treatment of ovulatory dysfunction infertility were exported from CNKI.The export format is"Refworks".The literature data was converted into the "download_***.txt" format through the citespace software to further remove the review,comment,report and other types of literature and duplicate literature.Finally,1614 valid literatures were included in the analysis range.NotexpressV and Excel 2013 were used to perform descriptive statistical analysis of the total number of articles,authors,research institutions,journals,etc.included in the literature.Citespace5.0.R1,Citespace5.7.R3 and VOSviewer1.6.15 software were used to draw a scientific knowledge graph with the authors,research institutions,and keywords of valid documents as node types,and visually analyze the three map indicators.2.3 Results1.From the perspective of annual publications,the number of publications in the field of TCM diagnosis and treatment of ovulatory dysfunction has been on a rapid rise in the past 20 years.In the past five years,the average annual number of publications has been 175,but the number of publications in 2020 will be 152,which may be affected by the COVID-19 epidemic compared with that in 2019.2.From the perspective of the authors and the cooperation network,the top 10 authors with the amount of articles published are statistically analyzed.The top 3 authors with the amount of articles published are 20 articles by Yong Tan,13 articles by Kun Ma,and 11 articles by Xuan Wang.In the field of traditional Chinese medicine,a stable cooperative team with Tan Yong,Ma Kun,Pang Baozhen,Pang Qiuhua,and Wang Qiuqin as academic leaders has been formed.3.From the perspective of research institutions and cooperation networks,a total of 458 institutions are involved.Nanjing University of Traditional Chinese Medicine has the largest number of publications with 45 papers.Nanjing University of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine and Liaoning University of Traditional Chinese Medicine have been formed.It is a core organization that cooperates with regional organizations.4.From the perspective of journals and magazines,all the documents were published in 317 journals and magazines.Guangming TCM published the highest amount of articles,up to 42 articles.5.From the high-frequency keywords,it can be seen that "polycystic ovary syndrome" has the highest frequency,reaching 687 times;10 high-central keywords(centrality≥0.1),polycystic ovary syndrome,clomiphene,Integrated Chinese and Western medicine,acupuncture and moxibustion therapy,clinical efficacy,ovulation promotion,famous doctors’ experiences,corpus luteum insufficiency,cycle therapy of traditional Chinese medicine,clinical research,represent the current hot issues in the research field of diagnosis and treatment of ovulatory dysfunction infertility.6.Judging from the keyword clustering knowledge map,a total of 14 clustering tags are formed,namely:#0 metformin,#1 famous doctor’s experience,#2 clomiphene,#3 letrozole,#4 luteal insufficiency,#5 endometrium thickness,#6 traditional Chinese medicine cycle therapy,#7 ovulation induction,#8 acupuncture therapy,#9 hormone levels,#10 nourishing kidney and promoting blood circulation,#11 combined traditional Chinese and western medicine,#12 acne,#13 hyperprolactinemia.7.It can be seen from the emergent words that polycystic ovary syndrome,kidney deficiency and blood stasis and low ovarian reserve are the key emergent words in the past 10 years.2.4 Conclusion1.The number of authors and institutional teams in the same region is small,and weaker connections between authors and research institutions are not conducive to the formation of a stable cooperation network.2.Polycystic ovary syndrome,kidney deficiency and blood stasis and low ovarian reserve may become the focus and trend of research in the field of traditional Chinese medicine in the treatment of ovulatory infertility.3.It is worthy of further exploration and excavation to adopt the method of combining Chinese and Western medicine to treat ovulation dysfunction infertility.4.The evaluation system for clinical efficacy includes not only the total effective rate and ovulation rate,but also hormone levels,ovarian function,endometrium,pregnancy rate and pregnancy outcome,lifestyle intervention,and patient psychological status.5.High-quality research methods such as data mining,randomized controlled studies,evidence-based medicine,and the real world will also become future development trends.3.Follow-up Study on the Growth and Development of the Offspring of Infertility Patients with Ovulation Disorder of Kidney Deficiency and Blood Stasis by the Method of Invigorating the Kidney and Activating Blood3.1 ObjectAfter treatment with the method of invigorating the kidney and activating blood,follow-up surveys of ovulatory infertility patients who succeeded in pregnancy were carried out,and the related indicators of the growth and development of their offspring were followed up to make up for the gaps in the safety of offspring by the method of invigorating the kidney and activating blood,evaluainge the therapeutic value of the method of invigorating the kidney and promoting blood circulation in the clinic,and providing a reference basis for later in-depth research.3.2 MethodsAfter treatment by Professor Ma Kun with the method of invigorating the kidney and promoting blood circulation,a total of 205 infertility patients with ovulatory dysfunction(syndrome type of kidney deficiency and blood stasis)who had succeeded in pregnancy were selected.Through follow-up investigation,30 live birth offspring of patients who gave birth successfully were screened(0-3 years old)as the observation group,taking children’s age(same month of birth),birth region,and basic parents’ basic information as matching factors,32 offspring who were naturally conceived in a hospital in Beijing during the same period were randomly selected as the matching factors.In the control group,the physical development of the offspring of the two groups was compared through investigation and research through medical history review,child care manual review,email and telephone follow-up.3.3 Results1.A follow-up survey of the physical development of 62 infants and young children,30 in the observation group and 32 in the control group,between the parents’reproductive age,educational background and feeding method(P>0.05);No birth defects were found;both groups were single births;3 children in the observation group were premature babies,and the control group were all full-term babies.2.There was no significant difference in the gender and delivery method of children between the two groups(P>0.05);the 1-minute Apgar scores of infants between the two groups were all>7,which were all normal.3.Compared with the control group,the average birth length,birth weight,and birth head circumference of the offspring of the observation group were significantly different(P<0.05),and the difference was statistically significant.4.The body length,weight and head circumference of the offspring of the observation group at the age of 1,2,and 3 years old were compared with the physical development indexes of the offspring of the control group at the same time(P>0.05).3.4 Conclusion1.The baseline data of children between the two groups is well balanced(P>0.05)and comparable.2.The method of invigorating the kidney and activating blood has no adverse effects on the offspring,and the safety is better;3.The method of invigorating the kidney and activating blood has no adverse effect on the physical development of the offspring. |
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