Effect Of Western Medicine Assisted By Bushen Tiaojing Decoction in The Treatment Of Information With Polycystic Ovary Syndrome Due To Kidney Deficiency And Blood Stasis
Oct 08, 2022
Abstract:
Objective: To explore the effect of western medicine assisted by Bushen Tiaojing's decoction in the treatment of Infertility patients with polycystic ovary syndrome (PCOS) due to kidney deficiency and blood stasis.
Methods: The clinical data of 81 patients with kidney deficiency and blood stasis type PCOS infertility treated in Zhuhengzhouhou Daqiao Hospital from 2019 to February 2021 were retrospectively analyzed. According to the treatment methods, they were divided into study groups (40cases, treated with conventional western medicine) and control group (41 cases, treated with western medical combined Bushen Tiaojing Decision).
Ovarian function, sex hormone levels, ovulation, and pregnancy were compared between the two groups before and after treatment. Results After treatment, the number of follicles with a diameter of 2 - 8 mm in both groups Decreased, and the volume of ovaries decided (P < 0.05). The mount of 2 - 8 mm follicles in study group was less than that in control group, and the ovarian volume in study group was small than that in control group (P < 0.05). After treatment, the levels of follicle-stimulating hormone (FSH) and estradiol (E2) in the two groups increased, while the levels of luteinizHormone (LH) and testosterone (T) decreased (P < 0.05). The levels of FSH and E2 in study group were higher than those in the control group, while the levels of LH and Tin study group were lower than those in control group (P < 0.05).
The ovulation rate [85. 00% (34 / 40)] and pregnancy rate [42. 50% (18 / 40)] of study group were higher than those of the control group [60. 98% (24/41)], 21.95% (9/41)])] (P < 0.05). Conclusion The addition of Bushen Tiaojing decoction on the basis of Conventional western medicine in the adjuvant treatment of PCOS information can better regulate the level of sex hormones, and ovarian function, and promote ovulation and pregnancy.
Keywords: polycystic ovary syndrome; infertility; kidney deficiency and blood stasis type;Cistanche
Polycystic ovary syndrome (PCOS) is a common disease in women of childbearing age, mainly manifested as abdominal pain, and anovulation.
The risk of gestational diabetes and miscarriage is higher after ovulation induction, which affects the physical and mental health of women of childbearing age [1]. Conventional western medicine is often used in clinical treatment of PCOS. Traditional Chinese medicine also has its own unique syndrome differentiation therapy for infertility [2]. Traditional Chinese medicine believes that PCOS infertility is a syndrome of deficiency and excess, which is based on kidney deficiency and phlegm-dampness as the standard. ].
In view of this, this study retrospectively analyzed the clinical data of 81 cases of PCOS infertility patients with kidney deficiency and blood stasis type, and explored the clinical application effect of Bushen Tiaojing Decoction.
1 Material and methods of TCM treat Polycystic Ovary Syndrome
1. 1 General data The clinical data of 81 cases of PCOS infertility patients diagnosed and treated in Zhengzhou Daqiao Hospital from January 2019 to February 2021 were retrospectively analyzed, and they were divided into study group (40 cases) and control group (41 cases) according to the treatment method. . The age of the control group was 21-34 (26.59 ± 2.35) years, the duration of PCOS was 1-10 (5.31 ± 1.95) a, and the infertility time was 1-7 (3.82 ± 1.15) a; The age of the study group was 20-33 (27.14 ± 2.54) years old, PCOS The course of disease was 1 to 9 (5.24 ± 1.73) a, and the time of infertility was 1 to 8 (4.23 ± 1.26) a. There was no statistically significant difference in the baseline data between the two groups (P >0.05).
1. 2 Diagnostic criteria
(1) Diagnostic criteria of Western medicine: Referring to the diagnosis of PCOS in the Chinese Guidelines for Diagnosis and Treatment of Polycystic Ovary Syndrome [4], there are symptoms such as long-term anovulation, ovarian cyst-like changes, and elevated androgen levels.
(2) TCM syndrome differentiation standard: refer to the syndrome differentiation standard of kidney deficiency and blood stasis type in "Guidelines for Clinical Research of New Chinese Medicines" [5]. Main symptoms: oligomenorrhea, amenorrhea, obesity. Secondary symptoms: wet turbidity, chills in the limbs, fullness of the chest and abdomen, dull color of the menstrual cycle and heavy sleepiness, etc. Tongue pulse: The tongue coating is white and greasy, and the pulse is slow. 2 main symptoms combined with 3 secondary symptoms combined with tongue and pulse were diagnosed.
1. 3 Selection criteria
(1) Inclusion criteria: meet the above diagnostic criteria of traditional Chinese and western medicine; not use other drugs that may affect the results of this study; follow medical treatment.
(2) Exclusion criteria: those with infertility caused by other reasons; those with other endocrine system diseases; those with organic diseases of reproductive organs; those who are allergic to the drugs in this study.
1. 4. Treatment methods (1) Control group: received conventional western medicine treatment. Clomiphene citrate tablets (CODAL SYNTO LTD, approval number H20140688) were taken orally on the 5th day of menstrual cramps, 1 tablet per day for 21 days; ethinyl estradiol cyproterone tablets (Jenapharm GmbH & Co. KG , Approval No. H20170210) was orally started on the 5th day of menstruation, 50 mg per day, and continued for 21 days.
(2) Study group: combined with Bushen Tiaojing Decoction on the basis of control group. Traditional Chinese medicine prescription: Amethyst, Salvia miltiorrhiza, Dodder, 15g each, Cistanche, 12g each Pinellia, 10g each of Morinda officinalis, Dannanxing, Saponin, Cyperus officinalis, Rehmannia glutinosa. add water
Soak and decoct 2 times, take a total of 400 mL of concoction, and take it twice in the morning and evening. like
If you are not pregnant, take it continuously for 3 months.
1. 5 Observation indicators
(1) Ovarian function: Ultrasound examination (Samsung Disson ultrasound diagnostic apparatus, model HS70A) was performed, the ovarian volume was calculated by the simplified ellipse formula, and the volume of follicles with a diameter of 2-8 mm on both sides was recorded.
(2) Sex hormone levels: including testosterone (T), estradiol (E2), luteinizing hormone (LH) and follicle stimulating hormone (FSH). (3) The ovulation rate and pregnancy rate of the two groups after 6 months of treatment.
1. 6 Statistical methods
Data were analyzed with SPSS 23.0 software. The measurement data conformed to the normal distribution and were expressed as mean ± standard deviation (x ± s). The intra-group comparison was performed by paired t-test, and the inter-group comparison was performed by independent samples t-test. The enumeration data were described by the number of cases and rates, and the χ2 test was used. P < 0.05 was considered statistically significant.
2 Results of TCM Treat Polycystic Ovary Syndrome
2. 1 Ovarian function
Before treatment, there was no significant difference in the number of follicles with a diameter of 2-8 mm and ovarian volume between the two groups (P > 0.05). The 2-8 mm follicles in the study group were less than that in the control group, and the ovarian volume was smaller than that in the control group (P < 0.05).
2. 2 sex hormone levels
Before treatment, there was no significant difference in the levels of FSH, E2, LH and T between the two groups (P > 0.05); after treatment, the levels of FSH and E2 in the two groups increased, while the levels of LH and T decreased, and the levels of FSH and E2 in the study group were significantly higher than those in the study group. The level was higher than that of the control group, and the LH and T levels were lower than those of the control group (P < 0.05).
2. 3 Ovulation and pregnancy
The ovulation rate [85.00% (34/40)] and pregnancy rate [42.50% (18/40)] of the study group were higher than those of the control group [60.98% (24/41)] and pregnancy rate [ 21.95% (9/41)] (P < 0.05).
3 Discussion of TCM Treat Polycystic Ovary Syndrome
Among women of childbearing age, the incidence of PCOS is 5% to 10%, and the spontaneous abortion rate of re-pregnancy is 70% to 80%, which has a serious impact on women's physical and mental health [6].
. The pathogenesis of PCOS is still unclear, but it is generally believed that it is related to abnormal endocrine metabolism, and the hypothalamus-pituitary-ovarian axis is destroyed, which leads to ovulation disorders and infertility. At present, the treatment of PCOS infertility is mainly based on western medicine, which can directly regulate the stimulation of infertility.
However, long-term use can cause various adverse reactions such as breast enlargement, gastrointestinal reactions and nervous system reactions [7].
With the gradual deepening of the concept of TCM treatment, studies have shown that in the treatment of PCOS infertility through TCM syndrome differentiation, good therapeutic effects can be achieved by invigorating the kidney and regulating meridians, dissolving phlegm and dredging collaterals, and promoting blood circulation and removing blood stasis [8].
In TCM, PCOS infertility is classified into the categories of "infertility" and "amenorrhea", and the syndrome of kidney deficiency and blood stasis is the most common. Kidney is the root of qi and the source of blood. Insufficient kidney essence, deficiency of Yuan yin, lack of sufficient collaterals, blood stasis and stasis, no uterine injection, can cause amenorrhea [9-10]. "Plain Questions" says: "A woman is seven years old, her kidney qi is prosperous, her teeth are more hairy, her teeth are more elongated, and when she is two or seven years old, the heavenly guile arrives, the Ren pulse is open, the Taichong pulse is strong, and the menstrual period is in the current period, so she has a child." The kidney is the foundation of fertility. , the place to store the essence, the main reproduction, the deficiency of kidney qi can affect the development of follicles and ovulation. Bushen Tiaojing Decoction is a commonly used Chinese herbal formula for the treatment of kidney deficiency and blood stasis syndrome. Nuan Gong soothe the nerves, mostly used for deficient cold and infertility; Dodder tonifies the kidney and replenishes the essence, and can relieve miscarriage; Cistanche, Morinda officinalis, and Ciconia are all yang-tonifying medicines, which can nourish kidney-yang, strengthen muscles and bones; Phlegm; Pinellia to reduce inversion and stop vomiting; Saponin thorns to drain pus and reduce swelling; Make incense sticks to relieve stagnation and relieve pain; The combination of various medicines can invigorate the kidney and spleen, dispel blood stasis and relieve pain, regulate qi and regulate yin. Modern pharmacological studies have shown that amethyst can improve ovarian function in patients; Cistanche and Dodder can regulate the function of the gonadal axis and improve the abnormal endocrine state; continuous interruption can regulate immune function and resist premature abortion; Salvia miltiorrhiza can improve kidney function and slow down liver damage. It can promote blood circulation and improve the symptoms of blood stasis in patients[11-12].
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This study showed that after treatment, the follicles and ovarian volumes with a diameter of 2-8 mm in the two groups were improved compared with those before treatment, and the improvement in the study group was more significant. This suggests that Bushen Tiaojing Decoction combined with conventional western medicine is effective in treating PCOS infertility, and can promote the improvement of ovarian function in patients. The reason is that kidney-tonifying medicine is beneficial to the improvement of ovarian function, and the blood-activating and menstrual medicine can slow down the pelvic blood flow disorder, reduce the thickness of the ovarian capsule, shorten the onset time of the kidney-tonifying medicine, and promote the recovery of ovarian function. This study also showed that the levels of FSH, E2, LH, and T in the two groups were improved after treatment, and the research group had more significant advantages, which was basically consistent with the research results of Zhang Chunling et al.[13]. Sex hormones such as LH and FSH can regulate the growth and development of egg cells, and if they are abnormal, they can lead to reproductive dysfunction. Excessive levels of LH can stimulate androgen secretion, and after conversion into estrone, it can affect the generation of LH peaks in the menstrual cycle, thereby hindering the maturation and excretion of follicles. FSH can induce the development and maturation of primordial follicle cells, and if the level is too low, it will affect mitosis and cause follicles to fail to develop normally [14]. The pregnancy rate and ovulation rate in the study group were higher than those in the control group, suggesting that Bushen Tiaojing Decoction combined with western medicine in the treatment of PCOS infertility can reduce reproductive dysfunction and improve pregnancy by regulating hormone levels. To sum up, adding Bushen Tiaojing Decoction to adjuvant treatment of PCOS infertility on the basis of conventional western medicine can better regulate sex hormone levels, improve ovarian function, and promote ovulation and pregnancy.
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