Clinical Study On The Treatment Of POI Infertility With Kidney Deficiency And Liver Depression By Tonifying The Kidney And Soothing The Liver Metho

Purpose:Based on the method of tonifying kidney to explore the clinical efficacy of Zhuluan Decoction combined with Zhuochuang Decoction in treating infertility patients caused by early ovarian insufficiency(POI)of liver depression and kidney deficiency syndrome,and to provide more treatment ideas and more effective treatment methods for clinical Chinese medicine in treating infertility caused by POI.Material and method:From December 2020 to September 2022,104 infertility patients with POI of liver depression and kidney deficiency syndrome who were treated by Professor Wang Xin from the gynecological clinic of the Affiliated Hospital of Liaoning Traditional Chinese Medicine University were selected.According to the random number table method,they were randomly divided into two groups and each group include 52 people.The therapeutic schedule of the control group: Fenmatong(2/10mg),1 tablet/day;the therapeutic schedule of the observation group: on the basis of the control group,Zhuovo Decoction and Implantation Decoction are taken orally for three months.Compare two groups’ before and treatment the TCM symptom score,menstruation,serum FSH,LH,E2,AMH levels,sinus follicle count(AFC),ovarian volume(OV),pregnancy rate and anxiety symptom score,and conduct statistical evaluation of safety to count the occurrence of adverse reactions.Results:1.Total efficiencyAfter treatment,the total effective rate of the control group could reach 70%,and the total effective rate of the observation group was 94%.The therapeutic effect of the observation group was significantly better than that of the control group,the difference was statistically significant(P < 0.05).2.TCM syndrome scoreAfter treatment,the TCM syndrome scores of both two groups showed a downward trend,and the decline was particularly obvious in the observation group,with statistical significance(P< 0.05).For individual symptom scores,intra-group comparison: after treatment,the observation group was lower than before treatment,the difference was statistically significant(P < 0.05).There was no statistically significant difference in marital infertility efficacy in the control group after treatment compared with before treatment(P > 0.05),and the remaining treatment was decreased compared with before treatment,the difference was statistically significant(P< 0.05).Comparison between the two groups: there was no statistical significance in the effects of hypolibido,hot flushes,sweating,chest tightness,irritability and irritability in the two groups(P > 0.05);The observation group was better than the control group in marital infertility,menstrual cycle,volume,blood quality,lumbosacral pain,dizziness,tinnitus,fatigue,thoracolecular distension pain,lower abdominal distension pain,the difference was statistically significant(P < 0.05).3.Serum hormone levelsAfter treatment,serum FSH and LH levels in 2 groups were decreased,and serum E2 level was increased,with statistical significance(P < 0.05),while serum AMH level was not significantly changed,with no statistical significance(P > 0.05).In the observation group,compared with the control group,the levels of FSH and LH decreased more significantly,and the levels of E2 increased more significantly,the difference was statistically significant(P <0.05),and the serum AMH level had no significant change,the difference was not statistically significant(P > 0.05).4.AFC and ovarian volumeAfter treatment,AFC and ovarian volume increased in both groups compared with before treatment,and the difference was statistically significant(P < 0.05).Compared with the control group,the AFC count and ovarian volume in the observation group increased significantly,and the difference was statistically significant(P < 0.05).5.Anxiety symptom scoreAfter treatment,the scores of anxiety symptoms in both groups decreased compared with those before treatment,and the difference was statistically significant(P < 0.05).The anxiety symptom score of the observation group decreased more significantly than that of the control group,and the difference was statistically significant(P < 0.05).6.Clinical pregnancy rateAfter 3 courses of treatment and 6 months of follow-up,the clinical pregnancy rates of the observation group and the control group were 26%(13/50)and 8%(4/50),respectively,and the indicators of the observation group were significantly higher than those of the control group,the difference was statistically significant(P < 0.05).Conclusion:1.The method of tonifying kidney and soothing liver(Zhuluan Decoction + Zhuochuang Decoction)can improve the TCM syndrome score and single TCM symptom score of infertility patients with kidney deficiency and liver depression syndrome POI.The effect is accurate,and the effect is better than that of monchunfen morong treatment;2.The method of tonifying kidney and soothing liver(Zhuluan Decoction + Zhuochuang Decoction)can improve serum hormone levels,increase AFC count and increase ovarian volume in infertile patients with POI syndrome of kidney deficiency and liver depression,so as to improve clinical pregnancy rate;3.The method of tonifying kidney and soothing liver(Zhuluan Decoction + Zhuochuang Decoction)can improve the anxiety state of POI infertility patients with high safety and non-toxic side effects.