Applied Study Of Tiankui Theory In On Perimenopause Symptoms

Part 1 Exploration of TiankuiThere have been several different explanations of Tiankui since the term first appeared in < The Medical Classic of the Yellow Emperor >; here we conclude these explanations into four recognitions as follow:A. 'Tiankui' is one sort of mobile Qi between kidneys;B. Tiankui is a sort of original yin or jin;C. Tiankui is a sort of Jin in male and blood in femaleD. Kind of jin inside kidneys.From < The Medical Classic of the Yellow Emperor > to nowadays, Chinese medical scholars have considered that Tiankui has physiological functions as following three aspects:A. Tiankui can promote and trigger sexual and reproductive behaviors, maintain sexual potential.B. Promote body development and maintain physical strength.C. Promote and maintain sexual difference in shape both in male and in female. Based on the description of Tiankui in < The Medical Classic of the Yellow Emperor >which indicated its' features connecting with body's changes and changes of Zangfu's functions with its' arriving and withdrawing, we infer that the functions of Tiankui should include hypothalamus-pituitary-gonada axis, pertaining to FSH, LH and GnRH. as well as estrogen, androgen; some TCM scholars think that kidney, Tiankui and Chongren channels constitute a Sexual-reproduction axis together with Baogong in TCM system, which is similar to hypothalamus-pituitary-gonada axis; This recognition is inspired by the depending relationship of Tiankui on kidney in TCM as well as their interactions among Tiankui, Chongren and Baogong when they take part in reproductive behaviors.There has been no much research on their interactions between Tiankui and other organs such as liver, heart and spleen, however, its relationships with these organs shouldn'tbe ignored; it is quite important and crucial for us to develop some new therapeutic principles for some diseases relative to Tainkui's dysfunction such as perimenopause symptoms due to supportive arguments in < The Medical Classic of the Yellow Emperor > and clinical clue. These papers will analysis sexual differences of Tiankui in function and in materials, and try to test new methods of therapeutic principles for perimenopause symptoms, on the basis of our theoretical exploratory hypothesis of Tiankui and perimenopause symptoms.Part 2 Clinical studies of selected Chinese herbs and acupuncture on perimenopause symptoms.A Perimenopause symptom is a group symptom, which affect on 2/3 women who are in their stage of reproductive transition. A large scale of reports both in lab and clinical trial indicate that withdrawing of estrogen as well as progesterone will result in hypothalamus-pituitary-ovary axis failure functionally; and this will influence on varied neuroendocrinal functions which are crucial to maintain the homeostasis of many important metabolisms; if the abnormal abilities of neuroendocrine aren't corrected, it will become the pathogenesis of some chronic diseases, such as AD, osteoporosis, coronary heart disease, metabolic syndromes, obesity etc.Although there is much progress in basic and preclinical studies, but few progress has been made in the therapeutic options on perimenopause symptoms. With the accumulated knowledge about adverse effects of Hormone Replacement Treatment (HRT), the majority of scholars and doctors intend to find a new safer therapeutic option instead of HRT.In TCM, perimenopause symptoms are named as varied symptoms before and after menopause. The majority of TCM Doctors hold that kidney deficiency, which could lead to decline of Tiankui, is the basic pathogenesis for perimenopause while other organs deficiencies were consequences of kidney deficiency. Because of this recognition, the methods of therapeutic principles are limited within toni kidney during TCM practice in the treatment of perimenopause symptoms.Most other methods of therapeutic principles In TCM, such as nourishing blood and promoting blood circulation, removing blood stasis, conducting QI and Xue, etc, are missed in the treatment of perimenopause. There is no much reports found on the methods of regulating interactions between QI and Xue through improving functions of liver, heart and spleen.According to the < The Medical Classic of the Yellow Emperor >, Some descriptions associated with relationships among Tiankui, women's menstruate, Zangfus' functions, combined with the factual clue from clinical signs, imply that females' reproductive behaviors and menstruate cycles are always pertaining to blood loss, blood stasis; therefore, blood deficiency and dislocation are basic pathogenesis for nearly all troubles relative to females' menstruate, discharge, pregnancy, labors. Also, evidences fromclinical epidemic investigations on the distributions of clinical types in TCM indicated that there are seldom simple kidney deficiency types on the perimenopause symptoms, but most common types of clinical syndromes are associated with disorders of Qixue which are connected with dysfunctions of liver, heart, spleen governing Qixue; So, by TCM methodology of inference on reasons and pathogenesis from symptoms and signs to particular fixed syndromes, we hypothesis that dryness of Xuehai and Blockage of Didao would be basic pathogenesis for menopause. Subsequently, the methods of nourishing blood, promoting blood circulation, removing blood stasis, should be applied to treat perimenopause symptoms; Respectively, regulating interactions of Qixue by improving dysfunctions of liver, heart and spleen should be used as an important method in the treatment of perimenopause symptoms.In order to test the hypothesis, we organize the herbal formula representing this therapeutic principles, make curative observation in the treatment of cases with perimenopause symptoms; E2 group and toning kidney herbal group are selected as controlled groups under comparable conditions. Simultaneously, acupuncture formula representing regulation of Chongren channel, reinforcing spleen and stomach, which produce blood and Ql-nutrition of body, is selected as acupuncture therapeutic group; the points associated with Qixue's movement, consoling mind (shen) are also added to. Acupuncture controlled group are designed under comparable conditions also ; Furthermore, this paper will analysis the influence of Chinese herbs on HPG and HPA axis, probe different curative mechanisms between Chinese herbs selected and HRT by the comparison of changes observed in blood pressure, blood rheology, C3, Ch50 etc.1. Curative effects of Chinese herbs and acupuncture on perimenopause symptomsBoth herbal therapeutic group and acupuncture therapeutic group have higher obvious total effective ratio (92%, 89%) than herbal controlled group and acupuncture group (84%, 80%) respectively; the total effect ratio of herbal therapeutic group is quite similar to that of estrogen group (88%); Furthermore, the herbal therapeutic group has a better effect on some particular symptoms such as insomnia, muscle strain, stress.2. Influence of Chinese herbs on the hypothalamus-pituitary-endocrine axis in patients with perimenopause symptoms.Herbal therapeutic group has considerable reduced circulating FSH, LH and elevated E2 level after treatment, the similar results is found in E2 group; E2 group has a remarkable increase of estrogen level and reasonable decrease of FSH and LH, while herbal therapeutic group has a quite noticeable decrease of LH, FSH comparable to the increase of its' estrogen level. These results hint that selected Chinese herbs may have some different mechanisms that work on hypothalamus-pituitary axis other than estrogen mechanism. Herbal therapeutic group has reduced evening salvia Cortisol level and circulating ACTH. E2 group shows same effect on ACTH and Cortisol. No similar effect is found in herbal...