| ObjectiveDysfunction of ovarian reserve(DOR)refers to the decrease in the number and quality of follicles in women’s ovaries,and the weakened ability of follicles to develop into high-quality oocytes,which has a series of negative effects on women’s fertility and quality of life There are certain limitations to the treatment of this disease by simply adopting Western medicine.This clinical study uses a comprehensive Chinese medicine plan(compound Zuogui capsule,moxibustion,massage,mental health counseling,and healthy life education)to treat kidney deficiency based on Western medicine treatment.For patients with type DOR,evaluate the effect and safety of comprehensive treatment of traditional Chinese medicine on serum hormone levels,sinus follicle counts,clinical symptoms,etc.in patients with DOR with kidney deficiency,with a view to early detection,diagnosis,and treatment of DOR patients to improve their ovarian function and clinical symptoms.And improve its quality of life to provide more diagnosis and treatment ideas and reference basis.MethodsUsing a randomized,single-blind method,60 patients with kidney deficiency type of DOR who were diagnosed in the in the Second Hospital of TCM of Guangdong Province from January 2018 to November 2018 and met the criteria of Western medicine diagnosis and TCM syndrome differentiation were randomly divided into observation group and The control group(30 cases in each group),the control group was given oral estradiol valerate+progesterone;the observation group was given the compound Zuogui capsule on the basis of the medication in the control group,combined with moxibustion,massage,and mental health grooming treatment And healthy life education,after continuous intervention treatment for 3 menstrual cycles,test records and compare the two groups of patients before and after treatment with follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),FSH/LH,sinus follicles Changes(AFC),blood routine,liver and kidney function,clinical symptoms.Statistical analysis was performed on the data before and after treatment,and the comprehensive treatment effect and safety of the two groups of patients were evaluated.Results1.Comparison of total effective rate before and after treatmentAfter 3 menstrual cycles of treatment,the cure rate in the observation group was 18.52%,and the cure rate in the control group was 6.90%.Comparing the observation group with the control group,the Fishr x2 test showed no significant difference in clinical cure rate(P=0.244>0.05);the total effective rate in the observation group was 92.59%,and the control group was 68.97%.The Fishr x2 test showed that there were always There was a significant difference in efficiency(P=0.042<0.05);Mann-Whitney U non-parametric rank sumtest statistics showed that there was a significant difference in treatment effect(P=0.019<0.05).2.Comparison of follicle stimulating hormone(FSH)values before and after treatmentAfter paired t test,compared with before treatment,there was a significant difference in FSH after treatment in the control group(P=0.000<0.01),and a significant difference in FSH in the observation group(P=0.000<0.01).After treatment,the FSH in the control group and the observation group were tested by independent sample t’.There was a significant difference in FSH after treatment between the two groups of patients(P=0.008<0.01).The FSH difference between the control group and the observation group was tested by independent sample t test,and the results showed significant differences(P=0.006<0.01).3.Comparison of luteinizing hormone(LH)values before and after treatmentAfter paired t test,compared with before treatment,there was no signific ant difference in LH after treatment in the control group(P=0.555>0.05),and there was a significant difference in LH in the observation group(P=0.039<0.05).After treatment,the LH of the control group and the observation group were tested by independent sample t test.There was no significant difference between the two groups of patients(P=0.599>0.05).There was no significant difference in the LH difference between the control group and the observation group(P=0.276>0.05).4.Comparison of follicle stimulating hormone ratio to luteinizing hormone(FSH/LH)values before and after treatmentAfter paired t test,compared with before treatment,there was a significant difference in FSH/LH after treatment in the control group(P=0.003<0.01),and a significant difference in FSH/LH in the observation group(P=0.000<0.01).After treatment,the FSH/LH of the control group and the observation group were tested by independent sample t ’test,and there was a significant difference between the two groups of patients(P=0.018<0.05).The independent sample t test showed that there was a significant difference in the FSH/LH difference between the observation group and the control group(P=0.035<0.05).5.Comparison of estradiol(E2)values before and after treatmentAfter paired t test,compared with before treatment,there was no significant difference in E2 after treatment in the control group(P=0.090>0.05),and there was no significant difference in E2 in the observation group(P=0.057>0.05).After treatment,the E2 of the control group and the observation group were tested by independent sample t test.There was no significant difference in E2 between the two groups after treatment(p=0.728>0.005).There was no significant difference in E2 between the observation group and the control group(P=0.960>0.05).6.Comparison of sinus follicle count(AFC)values before and after treatmentAfter the paired rank sum test,compared with before treatment,the AFC in the control group after treatment was significantly different(P=0.018<0.05),and the AFC in the observation group was also significantly different(P=0.000<0.01).After treatment,the AFC in the control group and the observation group was tested by Mann-Whitney U test.There was a significant difference in the AFC after treatment between the two groups of patients(P=0.009<0.01).There was a significant difference in the AFC difference between the observation group and the control group(P=0.010<0.05).7.Comparison of menstrual points before and after treatmentAfter the paired rank sum test,compared with before treatment,there was a significant difference in menstrual scores in the control group after treatment(P=0.000<0.01),and there was also a significant difference in the menstrual scores in the observation group(P=0.000<0.01).Mann-Whitney U test of the control group and observation group after treatment showed that there was a significant difference between the two groups of menstrual points after treatment(P=0.006<0.01).There was a significant difference in the difference in menstrual score between the observation group and the control group(P=0.043<0.05).8.Comparison of kidney deficiency symptom scores before and after treatmentAfter paired t test,compared with before treatment,there was a significant difference in the scores of renal deficiency symptoms after treatment in the control group(P=0.004<0.01),and there was a significant difference in the scores of renal deficiency symptoms in the observation group(P=0.000<0.01).After treatment,the kidney deficiency symptom scores of the control group and observation group were tested by independent sample t test.There was a significant difference in the kidney deficiency symptom scores between the two groups of patients after treatment(P=0.000<0.01).There was a significant difference between the experimental group and the control group in the difference in the scores of renal deficiency symptoms(P=0.000<0.01).9.Safety monitoring and evaluationTwo routine blood tests were performed before and after treatment in the two groups of patients,suggesting no significant abnormalities in liver function,renal function,blood routine and other indicators.ConclusionIn the treatment of DOR patients,the simple use of Bujiale + progesterone capsule treatment and the combined treatment of traditional Chinese medicine on this basis can effectively improve the serum hormone levels of the patients in the follicular phase and increase the number of sinus follicles,and the combined treatment group is improving the patients FSH,FSH/LH levels in the follicular phase,increased AFC,improved menstrual conditions and some clinical symptoms of kidney deficiency in traditional Chinese medicine,etc.There are no obvious side effects during treatment,suggesting that conventional Western medicine artificial cycle combined with comprehensive Chinese medicine treatment can effectively improve DOR The clinical efficacy of the patient and further improvement of the patient’s clinical symptoms are worthy of clinical reference and promotion.Its long-term efficacy needs further follow-up and further evaluation after patient withdrawal. |
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