| BackgroundHysterectomy is the most commonly used in gynecologic surgery, second only to Caesarean section. Literature shows that The hysterectomy of retaining ovarian can affect ovarian function, making a recession ahead. Removal of the uterus as a pre-menopausal women, the hormone replacement therapy is effective. But the important thing is how to resolve the problem of low hormone levels after long-term, and would not promote breast cancer, ovarian cancer, cardiovascular diseases. This is the one of the important issues to be studied currently. In recent years a large number of studies have shown that the method of Invigorating Kidney in the regulation of reproductive function and anti-aging significantly, and the side effects are small. And the Herbs are inexpensive and suitable for long-term use. So Patients would be more susceptible to accept it. In This study Capsule Yi Zhenâ… ,â…¡that made of under professor li li-yun's experience were used to delay the decline in ovarian function of the pre-menopausa women after hysterectomy, and we tried to explore the potential mechanism of action.ObjectiveThe research was that, Capsule Yi Zhenâ… ,â…¡are used alternately for treating the patients of pre-menopausa after uterus cutting because of uterine benign lesions, to observe the clinical efficacy and the security of TCM Treatment of Invigorating Kidney to the decline in ovarian function after hysterectomy, and to explore the method of Invigorating Kidney in the role of regulation of ovarian function, in order to provide a new control method for delaying the occurrence of menopausal symptoms.Methodnon-randomized concurrent control study was used. the cases of 75 patients that met the inclusion criteria were Included From April 2008 to October 2009, experimental group of 40 patients, control group 35 cases. The abdominal hysterectomys were completed by the doctors who had a full hysterectomy entry qualifications in Guangdong Provincial TCM Hospital, all done in the menstrual cycle follicular phase, no intraoperative complications. (1) experimental Group:the patients agreed to the treatment, taked capsules Yi Zhenâ… ,3 # tid, Yi Zhenâ…¡,4 # tid, alternately for 3 months after taking out stitches at the wound. (2) blank control group:the patients not agreed to the treatment, any treatment that might have preventive effects for the menopausal syndrome were not used in 3 months after hysterectomy. However, the control group that occured menopausal symptoms during the follow-up treatment and required treatment were also given capsules Yi Zhenâ… ,3# tid, Yi Zhenâ…¡,4 # tid, alternately until 3 months after hysterectomy, and detailed records must be made. Peripheral blood follicle-stimulating hormone (FSH), estradiol (E2) and the improved Kupperman score of the two groups were monitored before,1 month and 3 months after the surgery separately, and recorded the adverse reactions.Result1. The experimental group were included 40 cases, of which 4 cases were excluded because of the age less than 40,2 patients did not complete the treatment because of failure to visit, so the actual observation of 34 patients were treated for 3 months. The blank control group were included 35 cases, of which 5 cases did not complete treatment because of failure to visit, so 30 cases were observed actually. The postoperative FSH, E2 levels between the two groups had no statistically significant difference (P> 0.05), but the E2 level of the experimental group 3 months after the surgery was higher than the blank control group, The FSH levels of the experimental group were lower than the blank control group both 1 month and 3 months after the surgery. The FSH levels of the blank control group had upward trend compared with Preoperative level. The FSH levels of the experimental group had a downward trend after the first increase.2. The Kupperman score of The blank control group had a gradual upward trend from preoperative to 3 months after operation, and the differences were statistically significant (P<0.05).3. Kupperman score of the experimental group 1 month after the surgery compared with the score before the sugery was increased, and the score 3 months after the surgery compared with the score of before and 1 month after was decreased. All the differences were statistically significant (P<0.05).4. Kupperman scores of the experimental group were lower than the blank control group, and the Kupperman score of the experimental group after 3 months had a significant difference statistically (P<0.05), compared with the blank control group5. No adverse reaction was occurred in the experimental group.Conclusion1. Throughout this study, we could consider that taking capsules Yi Zhenâ… ,andâ…¡alternately more than 3 months could effectively delay the menopause symptoms.2. Menopause symptoms could occur after Hysterectomy within 3 months, and were aggravated with the passage of time. But during this period, the in vivo hormone levels did not change significantly, suggesting that changes in menopausal symptoms and hormone levels could be inconsistent. Chinese herbs of Invigorating Kidney might role in the decline of neuroendocrine-immune network after Hysterectomy, improve the function of ovarian reserve and stabilize Internal environment,and relieved menopausal symptoms onsequently by regulating the reproductive endocrine function,3. Chinese herbs of Invigorating Kidney was effective, and no adverse reaction was occurred in the experimental group. It showed that the treatment of Chinese herbs was safe and effective, and suggested that the method of Invigorating Kidney could delay the declining of ovarian function of pre-menopausal women after hysterectomy. The treatment could be put to use in clinical widely. |
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