The Study Of Clinical Effect Of Chinese And Western Medicine On Diminished Ovarian Reserve And Premature Ovarian Failure With Kidney-deficiency Syndrome

ObjectivePremature Ovarian Failure (POF) is the loss of function of the ovaries before age 40. A commonly cited triad for the diagnosis is amenorrhea, hypergonadotropinism, and hypoestrogenism. It has been estimated that POF affects 1% of the female population. Diminished ovarian reserve (DOR) is a condition of impaired ovarian function. DOR would develop into Premature Ovarian Failure (POF) in 1 to 6 years if not treated timely. As major problems in gynecological endocrinology, there are yet not definitive effective treatments for DOR and POF in western medicine. Meanwhile, TCM has been proven to be effective in improving ovarian function. Therefore, this study aimed to evaluate the clinical efficacy of kidney-tonifying and essence-replenishing prescription (KTER prescription) and the one of KTER prescription integrated with hormone replacement therapy (HRT) in DOR and POF, providing necessary clinical evidence for new drug research of KTER prescription.Methods20 cases of DOR or POF with Kidney-deficiency syndrome were randomly divided into two groups:10 cases in TCM group,10 cases in Integrative group. All subjects were treated with KTER prescription(including human placenta, Cistanche deserticola, Fructus Corni, Radix Rehmanniae Praeparata, medlar, cornu cervi degelatinatum, herba epimedii, morinda officinalis, etc). The prescription were taken orally,1 formula per day. Whereas, the subjects in integrated group were treated with Estradiol Valerate and progesterone at the same time. The course of treatment were three months. Menstrual cycle, symptom, serum hormones(FSH, LH and E2), AMH, INHB and B-ultrasonic examination before and after treatments were compared. SPSS 19.0 software were adopted in Statistical analysis. Data before and after treatment were compared using paired-samples t test or rank sum test within two groups, and independent-sample t test or rank sum test between two groups.ResultsThe total effective rate were 80% and 88.89% for TCM group and integrative group respectively. There was no statistical significance between the two groups (P>0.05). Both groups showed a improvement in menstrual disorder, and the p-value of integrated group was less than 0.05, while the one of TCM group was more than 0.05, and there was statistical significance between the two groups (P<0.05). In total TCM syndrome score, both groups showed a improvement (P<0.05), but there was no statistical significance between the two groups (P>0.05). In the two groups, basal FSH and LH decreased; E2 level increased in the integrated group, while lightly decreased in the TCM group, but the p-value of both were more than 0.05; and for above results there was no statistical significance between the two groups(P>0.05). Both groups showed a decrease in AMH level, and the p-value of integrated group was less than 0.05, while the one of TCM group was more than 0.05, but there was no statistical significance between the two groups (P>0.05). The integrated group showed a decrease in INHB level, while the TCM group showed a increase, but the p-value of both were more than 0.05; and there was no statistical significance between the two groups (P>0.05). Both groups showed a improvement in AFC, and the p-value of integrated group was less than 0.05, while the one of TCM group was more than 0.05; both groups showed a improvement in LOV, and the p-value of integrated group was more than 0.05, while the one of TCM group was less than 0.05; both groups showed a increase in ROV and EN, but there were no statistical significance (P>0.05); the integrated group showed a increase in the UV, while the TCM group showed a lightly decreased, but the p-value of both were more than 0.05; for above results, there was no statistical significance between the two groups(P>0.05).There was one cases of nausea reported in TCM group, and 2 cases in integrative group during the medication. No liver or kidney damage cased in both groups.Conclusion1.Both integrative medicine and Chinese medicine were effective in improving the DOR and POF patients’menstrual condition, relieving the clinical symptoms, and enhancing the quality of life.2. The integrative group were better than the TCM group in improving menstrual condition.3. After the treatment of KTER prescription, the ultrasound index changes of patients in the TCM group indicated an increase in the number of AFC, the left ovarian volume and the endometrial thickness. Therefore, we speculated the possible mechanism of KTER prescription was that it could promote blood circulation of ovary and uterus thus contributing to the recovery of ovarian function.