| Objective:1.Longitudinally observing ovarian and follicular development and analyzing ovarian stromal blood flow parameters VI,FI and VFI by using three-dimensional power doppler ultrasound combined with 4 d-view software.quantitatively evaluating ovarian reserve function and the effect of Zishen Yutai pill on intervening follicular growth and ovarian blood flow perfusion in patients with PCOS.2.The clinical curative effect that Zishen Yutai pill can improve follicular development and ovarian blood flow in patients with PCOS is further confirmed by comparing the change of the parameters before and after the treatment,which provides more accurate imaging basis for clinical application of Zishen Yutai pill.Method:1.27 patients with PCOS and 20 healthy women with normal menstruation.were enrolled in this study.All the women accepted trans-vaginal 3D power Doppler ultrasound examination.Recording their ovarian volume,follicle numbers and calculating the ovarian stromal artery VI,FI and VFI with VOCAL software,then analyzing and comparing the difference between the two groups of each parameter by combing with laboratory examination of sex hormone levels.All the inspections were accepted in 3 to 5 days after menstrual cycle.2.This research take method of their comparison before and after on the basis of previous studies.27 patients with PCOS enrolled in the study accepted Zishen Yutai pill for 3 months,then observing changes of each index before and after treatment to evaluate the curative effect,using three-dimensional power doppler ultrasound.Results:1,Results of PCOS group and normal group before treatment1.1 Two-dimensional ultrasonic characteristics:ovarian volume,follicle number of PCOS group were significantly higher than that of normal control group,while the largest follicle diameter was less than normal group.The difference was statistically significant(P<0.01).1.2 Three-dimensional power doppler ultrasound blood flow parameters of ovarian stromal arteries:VI and VFI in PCOS group was significantly higher than normal group,the difference was statistically significant(P<0.05);while FI had no obvious difference between the two groups(P>0.05).1.3 Sex hormone levels:Serum LH,PRL,T level and LH/FSH ratio in the PCOS group were significantly higher than normal group.Differences between two groups have significantly statistical significance(P<0.0001,P＝0.002,P=0.0001,P(0.05).Serum FSH,E2,P level of two groups had no significant difference(P>0.05).1.4 The correlation between the parameters:The ovarian follicle numbers in PCOS group were positively correlated with LH,LH/FSH ratio(r = 0.631,r= 0.543,P<0.05),while that had no ignificant correlation in normal group(r=＝0.123,r= 0.123,P>0.05).PCOS group VI and VFI was a positive correlation with LH,LH/FSH levels(r=0.884,r=0.884;r=0.919,r = 0.639,P<0.05)and normal group was no significant correlation with(r = 0.745,r= 0.745;r= 0.115,r= 0.039,P>0.05).2.Self-reflection of PCOS group after treatment2.1 Two-dimensional ultrasound changed:Ovarian volume,follicle numbers decreased and increased follicles appeared in PCOS group after treatment.OV,FN after treatment in PCOS group were lower than before the treatment,the largest follicle diameter was significantly greater than before,the difference has statistical significance(P<0.05).2.2 Change of blood flow parameters:Ovarian stromal arteries VI and VFI after treatment in patients with PCOS were significantly lower than before treatment,with significant difference statistically significant(P<0.01);FI has no obvious change before and after the treatment,there was no statistically significant difference(P>0.05).2.3 Sex hormone levels:Serum LH,PRL,T levels and LH/FSH after treatment were lower than before the treatment in PCOS group,difference was statistically significant(P<0.05).But FSH,E2,P level had no significant difference(P>0.05).Conclusion:1.3 D power Doppler ultrasound can observe ovarian blood flow parameters VI,FI and VFI in patients with PCOS to quantitatively evaluate peripheral blood perfusion and microvascular density of ovarian and follicle,which can be applied to evaluate the curative effect of Zishen Yutai pill in the treatment of PCOS,and can provide new ideas and image data support for clinical drug treatment.2.The hormone level of serum LH,LH/FSH,T,PRL play important roles in blood perfusion of ovarian and follicle,which may have a certain correlation with ovarian blood flow parameters VI,FI and VFI.3.Zishen Yutai pill can improve the endocrine environment of kidney deficiency syndrome PCOS patients,increasing peripheral blood perfusion in ovarian and follicles and recovering ovarian function to promoting ovulation,by lowering the serum LH,LH/FSH,T,PRL levels. |
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