乌鳖口服液配合耳穴按压治疗阴虚火旺型卵巢早衰的临床研究
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摘要
目的：观察乌鳖口服液配合耳穴按压治疗卵巢早衰的临床疗效,探讨其机制,为临床应用提供客观依据。
方法：将40例符合纳入病例标准的患者,随机分为两组：其中治疗组20例,以乌鳖口服液配合耳穴按压治疗；对照组20例,单用乌鳖口服液治疗。两个疗程后(三个月经周期为一个疗程)观察两组患者治疗前后血清E2、FSH、LH和中医症状的变化情况,经评分及统计学方法处理后,综合评定疗效。
结果：治疗组与对照组总有效率分别为85.0%和70.0%；治疗组和对照组治疗前后自身对照血清E2、FSH、LH水平有显著性差异(P<0.05),治疗后组间比较E2有显著性差异(P <0.05), FSH、LH无显著性差异(P>0.05)；两组均能改善患者烘热汗出、心烦易怒、阴道干涩症状,有显著性差异(P<0.05),组间比较无显著性差异(P>0.05)；治疗组在改善忧郁、失眠上有显著性差异(P<0.05),对照组在改善忧郁、失眠上无显著性差异(P>0.05)。
结论：乌鳖口服液配合耳穴按压治疗卵巢早衰,可以提高患者血清E2值、降低FSH、LH水平,对患者中医症状亦有明显改善；特别是患者忧郁的缓解治疗组较对照组有明显的优势,推测可能是由于在耳穴贴压过程中与患者的交流可使患者心理放松,有利于病情的治疗。
Purpose:Observed side the method of WuBie oral to auricular points pressing on premature ovarian failure caused by deficiency of yin and excess of fire of the clinical efficacy, to provide an objective basis for a clinical treatment of the diseas.
Methods:40 patients with premature ovarian failure were randomly divided into treatment group and the control group. The treatment group was given WuBie oral to auricular points pressing; the control sub-group was only given WuBie oral. After two treatment courses (around three menstrual cycles comprising one treatment course),observed before and after treatment of the change in E2, FSH, LH blood serum levels and the clinical symptoms. Finally through the scoring and statistical analyzing methods, wholly evaluate the curative effect.
Results:the total effective rate of the treatment group and the control group was 85.0% and 70.0%; During the treatment course the statistical difference in blood serum E2, FSH and LH levels between the treatment and control group was significant (P<0.05), after the treatment the statistical difference in E2 blood levels was also significant (P<0.05), while the FSH and LH levels showed no statistically significant difference (P>0.05); both test groups significantly improved the patients reheat sweating, upset irritability as well as symptoms of vaginal dryness (P<0.05), between the two groups no statistically significant difference for these symptoms (P>0.05). The treatment group showed a statistically significant difference (P<0.01)for melancholy and insomnia, while the control group showed no statistically significant difference (P>0.05).
Conclution:The WuBie oral to auricular points pressing can effectively treat premature ovarian failure and improve the patient's blood serum E2 level and reduce FSH, LH levels; this treatment significantly releases TCM symptoms, especially the alleviation of melancholy which had a statistically significance. One putative mechanism is the communication between patients and doctor during the acupuncture point stimulation, which could ease pressure, to improve the patients' recovery.
方法：将40例符合纳入病例标准的患者,随机分为两组：其中治疗组20例,以乌鳖口服液配合耳穴按压治疗；对照组20例,单用乌鳖口服液治疗。两个疗程后(三个月经周期为一个疗程)观察两组患者治疗前后血清E2、FSH、LH和中医症状的变化情况,经评分及统计学方法处理后,综合评定疗效。
结果：治疗组与对照组总有效率分别为85.0%和70.0%；治疗组和对照组治疗前后自身对照血清E2、FSH、LH水平有显著性差异(P<0.05),治疗后组间比较E2有显著性差异(P <0.05), FSH、LH无显著性差异(P>0.05)；两组均能改善患者烘热汗出、心烦易怒、阴道干涩症状,有显著性差异(P<0.05),组间比较无显著性差异(P>0.05)；治疗组在改善忧郁、失眠上有显著性差异(P<0.05),对照组在改善忧郁、失眠上无显著性差异(P>0.05)。
结论：乌鳖口服液配合耳穴按压治疗卵巢早衰,可以提高患者血清E2值、降低FSH、LH水平,对患者中医症状亦有明显改善；特别是患者忧郁的缓解治疗组较对照组有明显的优势,推测可能是由于在耳穴贴压过程中与患者的交流可使患者心理放松,有利于病情的治疗。
Purpose:Observed side the method of WuBie oral to auricular points pressing on premature ovarian failure caused by deficiency of yin and excess of fire of the clinical efficacy, to provide an objective basis for a clinical treatment of the diseas.
Methods:40 patients with premature ovarian failure were randomly divided into treatment group and the control group. The treatment group was given WuBie oral to auricular points pressing; the control sub-group was only given WuBie oral. After two treatment courses (around three menstrual cycles comprising one treatment course),observed before and after treatment of the change in E2, FSH, LH blood serum levels and the clinical symptoms. Finally through the scoring and statistical analyzing methods, wholly evaluate the curative effect.
Results:the total effective rate of the treatment group and the control group was 85.0% and 70.0%; During the treatment course the statistical difference in blood serum E2, FSH and LH levels between the treatment and control group was significant (P<0.05), after the treatment the statistical difference in E2 blood levels was also significant (P<0.05), while the FSH and LH levels showed no statistically significant difference (P>0.05); both test groups significantly improved the patients reheat sweating, upset irritability as well as symptoms of vaginal dryness (P<0.05), between the two groups no statistically significant difference for these symptoms (P>0.05). The treatment group showed a statistically significant difference (P<0.01)for melancholy and insomnia, while the control group showed no statistically significant difference (P>0.05).
Conclution:The WuBie oral to auricular points pressing can effectively treat premature ovarian failure and improve the patient's blood serum E2 level and reduce FSH, LH levels; this treatment significantly releases TCM symptoms, especially the alleviation of melancholy which had a statistically significance. One putative mechanism is the communication between patients and doctor during the acupuncture point stimulation, which could ease pressure, to improve the patients' recovery.
引文
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[2]Van Kasteren YM, Schoemaker J. Premature ovarian failure:asystematic review on therapeutic interventions to restore ovarianfunction and achieve pregnancy[J]. Hum Rep rod Update,1999,5 (5): 48323891
[3]Lachlan KL,Youings S,Costal T,et al.A clinical and molecular study of 26 females with Xp deletions with special emphasis on inherited deletions[J]. Hum Genet,2006,118:640-651.
[4]Portno MF,Aboura A, Tachdjian G,et al. Molecular cytogenetic studies of Xq critical regiongs in premature ovarian failure patiens[J]. Hum Reprod,2006,21,(9):2329-2334.
[5]Prueitt RL, Chen H, Barnes R I, et al. Most X; autosome translocations associated with premature ovarian failure do not interrup tX-linked genes[J]. Cytogenet Genome Res,2002,97 (122):32-38.
[6]Shimasaki S, Moore RK, Otsuka F,et al. The bone morphogenetic protein system in mammalian reproduction[J]. Endocr Rev,2004,25:72-101.
[7]Dixit H, Rao KL, Padamalatha VV,et al.Missense mutations in the BMP 15 gene are associated with ovarian[J]. Hum Genet,2006,119:408-415.
[8]Laissue P,Christin-Maitre S, Touraine P, et al,Mutations and sequence variants in GDF9 and BMP15 in patients with premature ovarian failure[J]. Eur J Endocrinol,2006,154:4739-744.
[9]Luoh SW, Bain PA, Polakiewicz RD, et al. Zfxmutation results in small animal size and reduced germ cell number in male and female mice[J]. Development,1997,124 (11):2275-2284.
[10]De Felici M, Klinger FG,Farini D,et al.Establishment of oocyte populationg in the fetal ovary;primordial germ cell proliferation and oocyte programmed cell death[J]. Reprod Biomed Online,2005,10:182-191.
[11]Lepp ig KA, Disteche CM. Ring X and other structural X chromosome abnormalities:X inactivation and phenotype[J]. SeminRep rodMed,2001,19 (2):145-157.
[12]Satok K,Uehera S, Hashiyada M, et al. Genetic significance of skewed X-chromosome inactivation in premature ovarian failure[J]. Am J Med Genet,2004,130A (3):240-244.
[13]Allen EG, He W, Yadav-Shah M, et al. A study of the distributional characteristics of FMR1 transcript levels in 238 individuals. Hum Genet,2004,114(5):439-47.
[14]Gersak K, Meden-Vrtovec H, Peterlin B. Fragile X permutation in women with sporadic premature ovarian failure in Slovenia.Hum Reprod,2003,18(8):1637-40.
[15]Miano MG, Laperuta C, Chiurazzi P, et al. Ovarian dysfunction and FMR1 alleles in a large Italian family with POF and FRAXA disorders:case report. BMC Med Genet,2007 8:18.
[16]Bione S, Sala C, Manzini C, et al. A human homologue of the Drosophila melanogaster diaphanous gene is disrup ted in a patient with premature ovarian failure:evidence for conserved function in oogenesis and implications for human sterility[J]. Am J HumGenet,1998,62 (3):533-541.
[17]Marozzi A, Manfredini E, TibilettiMG, et al. Molecular definition of Xq common-deleted region in patients affected by premature ovarian failure[J]. Hum Genet,2000,107 (4):304-311.
[18]Caburel S,Laissue P,Beysen D,et al.Premature ovarian failure and forkhead transcription factor FOX2;blepharophimosis-ptosis-epicanthus inversus syndrome and ovarian dysfunction[J]. Pediatr Endocrinol Rev,2005,2 (4):653-660.
[19]Harris SE, Chand AL, Winship IM, et al. Identification of novel mutations in FOXL2 associated with premature ovarian failure. Mol Hum Reprod,2002,8(8):729-33.
[20]Nallathambi J, MoumneL, de Baere E, et al. A novel polyalanine expansion in FOXL2:the first evidence for a recessive form of the blepharophimosis syndrome (BPES) associated with ovarian dysfunction. Hum Genet,2007,121(1):107-12.
[21]Aittomaki K, Lucena JL, Pakarinen P, et al. Mutation in the follicle-stimulatinghormonereceptor gene causeshereditary hypergonadotropic ovarian failure. Cell,1995,82(6):959-68.
[22]陈新娜陈贵安李美芝.卵巢早衰患者卵泡刺激素受体基因突变的检测[J].中华妇产科杂志,2006,41(5)：315-317.
[23]Shelling AN, Burton KA, Chand AL, et al. Inhibin:a candidate gene for premature ovarian failure. Hum Reprod,2000,15(12):2644-9.
[24]Marozzi A, Porta C, Vegetti W, et al. Mutation analysis of the inhibin alpha gene in a cohort of Italian women affected by ovarian failure. Hum Reprod,2002,17(7):1741-5.
[25]Aaltonen J, Laitinen MP, Vuojolainen K, et al. Human growth differentiation factor 9 (GDF-9) and its novel homolog GDF-9B are expressed in oocytes during early folliculogenesis. J Clin Endocrinol Metab, 1999,84(8):2744-50.
[26]Liu L, Rajareddy S, Reddy P, et al. Infertility caused by retardation of follicular development in mice with oocyte-specific expression of Foxo3a. Development,2007,134(1):199-209.
[27]Gallardo TD, John GB, Bradshaw K, et al. Sequence variation at the human FOX03 locus:a study of premature ovarian failure and primary amenorrhea. Hum Reprod,2008,23(1):216-21.
[28]Kim JG, Moon SY, Chang YS et al1Autoimmune p remature ovarian failure1 J Obstet Gynaecol,1995, 21(1):59
[29]Smith SA & Hosid S. Premature ovarian failure associated with autoantibodies at the zona pellucida.Int J Fertil,1994,39(6):316-319.
[30]孙晓溪,李大金,王明雁,等.自身免疫性卵巢功能损伤与TH1/TH2型细胞因子表达关系的研究[J].中国免疫学杂志,2001,17(2)：96-98.
[31]谢梅青.卵巢早衰的病因[J].实用妇产科杂志,2003,19(4)：193-194.
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