Advances In Research On The Decline Of Ovarian Reserve Function In Chinese And Western Medicine And The Law Of Traditional Chinese Medicine

Background:Diminished ovarian reserve means the decrease in the number of follicles and the decline in the quality of oocyte. Modern medicine considers that diminished ovarian reserve may be the result of joint action of many factors. In general physiological conditions, the ovarian reserve begins to decline from the age of 30, after 35 years of age it declines more significantly. As the accelerated pace of nowadays, the increasing of mental stress and environmental pollution, the incidence rate of DOR increases gradually, and tends to be younger. In nearly 30 years, the technology of IVF-ET develops and popularizes rapidly, ovarian response and ovarian reserve play important role in the success of controlled ovarian hyperstimulation, those who impact the specific treatment programs in IVF-ET cycles. For diminished ovarian reserve, there is no explicit definitions or specific diagnosis criteria in the traditional Chinese medical books, but TCM showed a detailed description and the systemic treatments of infertility and the change of menstrual pattern. TCM also showed the significant efficacy in regulating menstruation, promoting gestation rate and improving clinical symptoms.Objective:Discussing the common medical evaluation methods of modern medicine in evaluating ovarian reserve, to intervention the process of diminished ovarian reserve as early as possible. By literature analysis, researching the etiology and pathogenesis of diminished ovarian reserve and the principle of herbs used by TCM treatment.Method:1.Retrievalling the domestic and foreign literatures these explored DOR, retrospective analysising the research of western medicine and traditional Chinese medicine in the past 30 years.2.A retrospective analysis study that included TCM treatments of clinical document types from January 2000 to December 2015, sorting out the clinical classifications, counting the percentage and the frequency of TCM of classifications, Siqi theory, Wuwei theory and channel tropism, to discuss the medication feature of TCM treatments of DOR.Results:1. Modern medicine considers that the morbidity of DOR is associated with age, genetic factors, immune factors, social and environmental factors, infections, iatrogenic injury, previous obstetric historyobstetric and so on. In clinical, age, ovarian reserve, FSH, E2, F-SH/LH, INHB, AMH, AFC, OV, ovarian artery, CCCT and so on are commonly used to evaluate the ovarian reserve, but the standard has big difference in different studies. Generally believed that, bFSH> 10IU/L and bE2 levels> 80pg/ml (293.6pmol/L) or<20 pg/ml (73.4pmol/L) and bFSH/bLH≥2, INHB<40-56ng/L, OV<3cm3, MOV<2mm, AFC<6 or ovarian stimulation test abnormalities prompted DOR. The main treatments of modern medicinere are moving the cause, hormone replacement therapy, ovulation induction, assisted reproductive technology and so on.2.The number of literatures that meet the requirements is 46, which included 87 kinds of drugs,499 times of occurrence frequency of drugs and 1757 cases of cottoms. Syndrome Distribution:as the occurrence frequency of the type of syndrome from high to low, kidney essence deficiency syndrome> kidney and blood stasis syndrome>liver stagnation and kidney syndrome>liver kidney yin>kidney deficiency syndrome> both spleen and kidney> kidneys do not pay license>renal deficiency of both yin and yang. The overall drug laws: ① According to drug occurrences, top 5 of TCM are shudi, danggui, tusizi, shanyurou, baishao; ② According to drug classification, top 3 of TCM are tonify deficiency medicine, promoting blood circulation to remove blood stasis drugs, antipyretic; ③ According to channel tropism, top 3 are liver, kidney, spleen; ④ According to Siqi theory, as the kinds of drugs from high to low, warm-natured>cold-natured>flat-natured> cold-natured=hot-natured, as the frequency of drugs from high to low, warm-natured>cold-natured>flat-natured>cold-nature; ⑤ According to Wuwei theory, as the kinds of drugs from high to low, sweet>bitter>sheen>acid>salty>astringent>light, as the frequency of drugs from high to low, sweet>bitter>sheen>acid> astringent> salty> light.Conclusions:In TCM that can treat DOR,the most frequent used herb kind is tonify deficiency medicine,the most frequent channel tropism is liver and kidney,the most fr equent Siqi theory is warm-natured,the most frequent Wuwei theory is sweet,that are c onsistent with pathogenesis and syndromes.Thus,the main pathogenesis of DOR is kid ney,the fundamental is deficiency,the standard is empirical.Therapeutically,kidney-invigor ating and tune up Chong and Ren are of all thing.