Clinical observation of Bushen Huoxue decoction in the treatment of premature ovarian failure and its influence on ANA-ACA-AOA pathway 

DONG Yalan; DONG Li

doi:10.16305/j.1007-1334.2020.08.011

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Clinical observation of Bushen Huoxue decoction in the treatment of premature ovarian failure and its influence on ANA-ACA-AOA pathway 

更新时间：2022-08-31

- Clinical observation of Bushen Huoxue decoction in the treatment of premature ovarian failure and its influence on ANA-ACA-AOA pathway 
- Shanghai Journal of Traditional Chinese Medicine Vol. 54, Issue 8, Pages: 61-65(2020)
- 作者机构：
  
  1. 河南省信阳市中心医院中医科,河南,信阳,464000
  2. 上海中医药大学附属岳阳中西医结合医院妇科,上海,200437
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2020.08.011
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DONG Yalan, DONG Li. Clinical observation of Bushen Huoxue decoction in the treatment of premature ovarian failure and its influence on ANA-ACA-AOA pathway . [J]. Shanghai Journal of Traditional Chinese Medicine 54(8):61-65(2020)
DOI：

DONG Yalan, DONG Li. Clinical observation of Bushen Huoxue decoction in the treatment of premature ovarian failure and its influence on ANA-ACA-AOA pathway . [J]. Shanghai Journal of Traditional Chinese Medicine 54(8):61-65(2020) DOI： 10.16305/j.1007-1334.2020.08.011.

摘要

目的：观察补肾活血方治疗卵巢早衰患者的临床疗效,并探讨其对患者相关免疫抗体的影响。方法：纳入82例卵巢早衰患者,随机分为中药组和西药组,每组41例。中药组给予补肾活血方口服,西药组给予口服戊酸雌二醇片结合醋酸甲羟孕酮片序贯疗法治疗,两组治疗周期均为6个月。治疗前后,比较两组患者的中医证候评分；检测患者的卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E,2,)、催乳素(PRL)、孕酮(P)、睾酮(T)、抗苗勒氏管激素(AMH)、抗核抗体(ANA)、抗心磷脂抗体(ACA)、抗卵巢抗体(AOA)水平；采用超声检查,比较两组患者的子宫体积、卵巢体积及两侧卵巢基质内血流的收缩期峰值流速(PSV)和阻力指数(RI)。结果：治疗过程中,中药组剔除或脱落4例、西药组剔除2例,最终中药组37例、西药组39例纳入统计分析。①治疗后,两组患者的中医证候评分均显著降低(P,<,0.01),且中药组患者的评分低于西药组(P,<,0.01)。②治疗后,中药组患者的FSH水平及FSH/LH比值明显降低(P,<,0.05),西药组患者的FSH水平亦降低(P,<,0.05)；两组患者的各项性激素水平比较,差异均无统计学意义(P,>,0.05)。③治疗后,两组患者的AMH水平均升高(P,<,0.05),ANA、AOA水平均降低(P,<,0.05),且中药组患者的AMH水平高于西药组、ANA水平低于西药组(P,<,0.05)。④治疗后,两组患者的卵巢体积及卵巢血流PSV较治疗前均升高(P,<,0.05),中药组患者的RI较治疗前降低(P,<,0.05),且中药组患者的RI低于西药组(P,<,0.05)。结论：补肾活血方能有效改善卵巢早衰患者的中医证候,下调患者的FSH水平及FSH/LH比值,上调AMH水平,调节ANA-ACA-AOA通路,从而平衡患者的生殖内分泌轴,减缓卵巢颗粒细胞及卵泡的损伤,缓解卵巢早衰。

Abstract

Objective:To observe the clinical efficacy of Bushen Huoxue decoction in the treatment of premature ovarian failure(POF)and explore its influence on the relevant immune antibody. MethodsEighty-two patients of POF were enrolled and randomly divided into the Chinese medicine group and the western medicine group,41 cases in each group.The patients in the Chinese medicine group were orally treated with Bushen Huoxue Decoction,and the patients in the western medicine group were orally treated with sequential therapy of progynova combined with medroxyprogesterone acetate.The treatment course of the two groups was 6 months. Before and after treatment, the Chinese medical syndrome scores of the two groups were compared; the levels of follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E,2,), prolactin(PRL), progesterone(P), testosterone(T), anti-mullerian hormone(AMH), antinuclear antibody(ANA), anticardiolipin antibody(ACA)and anti-ovarian antibody(AOA)were detected; the uterine volume, ovarian volume, and the peak systolic velocity(PSV)and resistance index(RI)of ovarian stromal blood flow in the two groups were measured and compared through ultrasonic examination. Results:In the course of treatment, 4 cases in the Chinese medicine group and 2 cases in the western medicine group were eliminated, and finally 37 cases in the Chinese medicine group and 39 cases in the western medicine group were included in the statistical analysis.①After treatment, the Chinese medical syndrome scores of the two groups were significantly decreased(P,<,0.01), and the scores of the Chinese medicine group were lower than those of the western medicine group(P,<,0.01).②=2\*GB3After treatment, the level of FSH and the radio of FSH/LH in the Chinese medicine group were significantly decreased(P,<,0.05), the level of FSH in the western medicine group was also decreased(P,<,0.05), and there were no statistical differences on the levels of sex hormones between the two groups(P,>,0.05).③=3\*GB3After treatment, the levels of AMH in the two groups were increased(P,<,0.05), the levels of ANA and AOA were decreased(P,<,0.05), and the level of AMH in the Chinese medicine group was higher than that in the western medicine group and the level of ANA in the Chinese medicine group was lower than that in the western medicine group(P,<,0.05).④=4\*GB3After treatment, the ovarian volume and the PSV of ovarian stromal blood flow in the two groups were increased compared with treatment before(P,<,0.05), the RI in the Chinese medicine group was decreased compared with treatment before(P,<,0.05), and the RI in the Chinese medicine group was lower than that in the western medicine group(P,<,0.05). Conclusion:Bushen Huoxue decoction can effectively improve the Chinese medical syndrome of the patients with POF, down-regulate the level of FSH and the ratio of FSH/LH, up-regulate the level of AMH, regulate the ANA-ACA-AOA pathway, thereby balance the hypothalamus-hypophysis-gonad axis, alleviate the damages of ovarian granulosa cells and follicle, and relieve POF.

关键词

卵巢早衰中医药疗法补肾活血方ANA-ACA-AOA通路

Keywords

premature ovarian failuretraditional Chinese medicine therapyBushen Huoxue DecoctionANA-ACA-AOA pathway

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