Cov txiaj ntsig ntawm Western Tshuaj Pab Los ntawm Bushen Tiaojing Decoction hauv Kev Kho Cov Ntaub Ntawv Nrog Polycystic Ovary Syndrome Vim Lub raum Tsis Txaus Thiab Ntshav Stasis

Abstract:

Lub Hom Phiaj: Los tshawb txog cov txiaj ntsig ntawm cov tshuaj sab hnub poob tau pab los ntawm Bushen Tiaojing's decoction hauv kev kho cov neeg mob Infertility nrogpolycystic zes qe menyuam syndrome(PCOS) vimlub raum tsis muaj peev xwmthiabntshav stasis. 

Cov txheej txheem: Cov ntaub ntawv kho mob ntawm 81 tus neeg mob lub raum tsis txaus thiab ntshav stasis hom PCOS tsis muaj menyuam tau kho hauv Zhuhengzhouhou Daqiao Tsev Kho Mob txij xyoo 2019 txog Lub Ob Hlis 2021 tau txheeb xyuas rov qab. Raws li txoj kev kho mob, lawv tau muab faib ua pawg kawm (40cases, kho nrog cov tshuaj sab hnub poob) thiab pawg tswj hwm (41 tus neeg mob, kho nrog kev kho mob sab hnub poob.Bushen Tiaojing Kev txiav txim siab).

Kev ua haujlwm ntawm zes qe menyuam,kev sib deev cov tshuaj hormones, ovulation, thiab cev xeeb tub tau muab piv ntawm ob pawg ua ntej thiab tom qab kho. Cov txiaj ntsig Tom qab kev kho mob, tus naj npawb ntawm cov follicles nrog ib txoj kab uas hla ntawm {{0}} hli hauv ob pawg Txo, thiab qhov ntim ntawm zes qe menyuam txiav txim siab (P < 0.05).="" lub="" mount="" ntawm="" 2="" -="" 8="" hli="" follicles="" nyob="" rau="" hauv="" kev="" kawm="" pawg="" yog="" tsawg="" tshaj="" li="" nyob="" rau="" hauv="" pawg="" tswj,="" thiab="" lub="" zes="" qe="" menyuam="" ntim="" nyob="" rau="" hauv="" kev="" kawm="" pab="" pawg="" neeg="" yog="" tsawg="" tshaj="" li="" nyob="" rau="" hauv="" pawg="" tswj="" (p="">< 0.05).="" tom="" qab="" kev="" kho="" mob,="" qib="" ntawm="" follicle-stimulating="" hormone="" (fsh)="" thiab="" estradiol="" (e2)="" hauv="" ob="" pawg="" tau="" nce,="" thaum="" qib="" ntawm="" luteinizhormone="" (lh)="" thiab="" testosterone="" (t)="" txo="" qis="" (p=""><0.05). cov="" theem="" ntawm="" fsh="" thiab="" e2="" hauv="" pab="" pawg="" kawm="" tau="" siab="" dua="" cov="" hauv="" pawg="" tswj="" hwm,="" thaum="" qib="" ntawm="" lh="" thiab="" tin="" pawg="" kawm="" tau="" qis="" dua="" cov="" pawg="" tswj="" hwm="" (p=""><>

ovulation tus nqi [85. 00 feem pua ​​(34 / 40)] thiab cev xeeb tub [42. 50 feem pua ​​(18 / 40)] ntawm pawg kawm tau siab dua cov pawg tswj hwm [60. 98 feem pua ​​(24/41)], 21.95 feem pua ​​(9/41)])] (P <0.05). kev="" xaus="" qhov="" sib="" ntxiv="" ntawm="" bushen="" tiaojing="" decoction="" rau="" lub="" hauv="" paus="" ntawm="" pas="" western="" tshuaj="" nyob="" rau="" hauv="" lub="" adjuvant="" kev="" kho="" mob="" ntawm="" pcos="" cov="" ntaub="" ntawv="" yuav="" zoo="" dua="" tswj="" cov="" theem="" ntawm="" cov="" tshuaj="" hormones="" poj="" niam="" txiv="" neej,="" thiab="" zes="" qe="" menyuam="" muaj="" nuj="" nqi,="" thiab="" txhawb="" ovulation="" thiab="" cev="" xeeb="">

Ntsiab lus:polycystic zes qe menyuam syndrome; tsis muaj menyuam;raum tsis txaus thiab ntshav stasis hom;Cistanche

Polycystic zes qe menyuam syndrome(PCOS) yog ib hom kab mob hauv cov poj niam uas muaj hnub nyoog yug me nyuam, feem ntau tshwm sim raws li mob plab, thiab anovulation.

Qhov kev pheej hmoo ntawm gestational diabetes thiab nchuav menyuam yog siab dua tom qab ovulation induction, uas cuam tshuam rau lub cev thiab lub hlwb noj qab haus huv ntawm cov poj niam ntawm cov me nyuam muaj hnub nyoog [1]. Cov tshuaj sab hnub poob feem ntau yog siv rau hauv kev kho mob ntawm PCOS.Cov tshuaj suav tshuajkuj muaj nws tus kheej tshwj xeeb syndrome sib txawv kev kho rau infertility [2]. Cov tshuaj suav tshuaj suav hais tias PCOS infertility yog ib qho mob ntawm qhov tsis txaus thiab ntau dhau, uas yog raws li lub raum tsis txaus thiab phlegm-dampness raws li tus qauv. ].

Raws li qhov no, qhov kev tshawb fawb no tau txheeb xyuas cov ntaub ntawv kho mob ntawm 81 tus neeg mob ntawm PCOS infertility cov neeg mob uas muaj lub raum tsis muaj zog thiab ntshav stasis hom, thiab tshawb nrhiav cov tshuaj siv tshuaj ntawm Bushen Tiaojing Decoction.

1 Cov khoom siv thiab cov txheej txheem ntawm TCM khoPolycystic Ovary Syndrome

1. 1 Cov ntaub ntawv dav dav Cov ntaub ntawv kho mob ntawm 81 tus neeg mob ntawmPCOS infertility cov neeg mob diagnosed and treated in Zhengzhou Daqiao Hospital from January 2019 to February 2021 were retrospectively analyzed, and they were divided into study group (40 cases) and control group (41 cases) according to the treatment method. . The age of the control group was 21-34 (26.59 ± 2.35) years, the duration of PCOS was 1-10 (5.31 ± 1.95) a, and the infertility time was 1-7 (3.82 ± 1.15) a; The age of the study group was 20-33 (27.14 ± 2.54) years old, PCOS The course of disease was 1 to 9 (5.24 ± 1.73) a, and the time of infertility was 1 to 8 (4.23 ± 1.26) a. There was no statistically significant difference in the baseline data between the two groups (P >0.05).

1. 2 Cov txheej txheem kuaj mob

(1) Diagnostic cov txheej txheem ntawm Western tshuaj: Xa mus rau qhov kev kuaj mob ntawm PCOS nyob rau hauv Suav Cov Lus Qhia rau Kev Ntsuas thiab Kev Kho MobPolycystic Ovary Syndrome[4], muaj cov tsos mob xws li anovulation mus sij hawm ntev, kev hloov pauv ntawm zes qe menyuam zoo li, thiab nce qib androgen.

(2) TCM Syndrome txawv tus qauv: xa mus rau tus qauv sib txawv ntawm lub raum tsis muaj peev xwm thiab cov ntshav stasis hom hauv "Cov Lus Qhia rau Kev Tshawb Fawb Txog Kev Tshawb Fawb Tshiab Suav Tshuaj" [5]. Cov tsos mob tseem ceeb: oligomenorrhea, amenorrhea, rog rog. Cov tsos mob thib ob: ntub dej turbidity, ua daus no hauv nqua, puv hauv siab thiab plab, xim dull ntawm kev coj khaub ncaws thiab pw tsaug zog, thiab lwm yam. Tus nplaig pulse: tus nplaig txheej yog xim dawb thiab muaj roj, thiab lub plawv dhia qeeb. 2 cov tsos mob tseem ceeb ua ke nrog 3 cov tsos mob thib ob ua ke nrog tus nplaig thiab mem tes tau kuaj pom.

1. 3 Cov txheej txheem xaiv

(1) Cov txheej txheem suav nrog: ua tau raws li cov txheej txheem kuaj mob saum toj no ntawm cov tshuaj suav tshuaj suav thiab sab hnub poob; tsis txhob siv lwm yam tshuaj uas yuav cuam tshuam cov txiaj ntsig ntawm txoj kev tshawb no; ua raws li kev kho mob.

(2) Cov txheej txheem cais tawm: cov uas muaj menyuam tsis taus los ntawm lwm yam laj thawj; cov neeg uas muaj lwm yam kab mob endocrine; cov neeg uas muaj cov kab mob organic ntawm cov kab mob hauv lub cev; cov neeg uas ua xua rau cov tshuaj hauv qhov kev tshawb fawb no.

1. 4. Txoj kev kho mob (1) Pab pawg tswj hwm: tau txais kev kho mob sab hnub poob. Clomiphene citrate ntsiav tshuaj (CODAL SYNTO LTD, tus naj npawb pom zoo H20140688) tau noj qhov ncauj ntawm hnub 5 ntawm kev coj khaub ncaws, 1 ntsiav tshuaj ib hnub rau 21 hnub; ethinyl estradiol cyproterone ntsiav tshuaj (Jenapharm GmbH & Co. KG, Kev Pom Zoo No. H20170210) tau pib hais lus rau hnub 5 ntawm kev coj khaub ncaws, 50 mg ib hnub, thiab txuas ntxiv rau 21 hnub.

(2) Pab pawg kawm: ua ke nrog Bushen Tiaojing Decoction raws li pawg tswj hwm. Cov tshuaj suav tshuaj suav tshuaj: Amethyst, Salvia miltiorrhiza, Dodder, 15g txhua,Cistanche, 12g txhua Pinellia, 10g txhua ntawm Morinda officinalis, Dannanxing, Saponin, Cyperus officinalis, Rehmannia glutinosa. ntxiv dej

Soak thiab decoct 2 zaug, noj tag nrho ntawm 400 mL ntawm concoction, thiab coj nws ob zaug thaum sawv ntxov thiab yav tsaus ntuj. nyiam

Yog tias koj tsis xeeb tub, noj tsis tu ncua rau 3 lub hlis.

1. 5 Kev soj ntsuam ntsuas

(1) Lub zes qe menyuam muaj nuj nqi: Kev kuaj ultrasound (Samsung Disson ultrasound diagnostic apparatus, qauv HS70A) tau ua, lub zes qe menyuam ntim tau xam los ntawm cov qauv yooj yim ellipse, thiab cov ntim ntawm cov follicles nrog txoj kab uas hla ntawm 2-8 hli ntawm ob sab tau sau tseg.

(2) Kev sib deev cov tshuaj hormones: suav nrog testosterone (T), estradiol (E2), luteinizing hormone (LH) thiab follicle stimulating hormone (FSH). (3) Tus nqi ovulation thiab cev xeeb tub ntawm ob pawg tom qab 6 lub hlis ntawm kev kho mob.

1. 6 Cov txheej txheem txheeb cais

Cov ntaub ntawv raug tshuaj xyuas nrog SPSS 23.0 software. Cov ntaub ntawv ntsuas tau ua raws li qhov kev faib tawm ib txwm thiab tau hais tias txhais tau tias ± tus qauv sib txawv (x ± s). Kev sib piv hauv pab pawg tau ua los ntawm kev sib tw t-test, thiab kev sib piv ntawm pab pawg tau ua los ntawm cov qauv ywj pheej t-test. Cov ntaub ntawv suav sau tau piav qhia los ntawm tus lej ntawm tus lej thiab tus lej, thiab qhov kev xeem χ2 tau siv. P < 0.05="" tau="" suav="" tias="" yog="" qhov="" tseem="">

2 Cov txiaj ntsig ntawm TCM TreatPolycystic Ovary Syndrome

2. 1 Ovarian muaj nuj nqi

Ua ntej kev kho mob, tsis muaj qhov sib txawv loj ntawm cov follicles nrog txoj kab uas hla ntawm {{0}} mm thiab zes qe menyuam ntim ntawm ob pawg (P > 0.05). Cov 2-8 hli follicles hauv pawg kev tshawb fawb tau tsawg dua li hauv pawg tswj hwm, thiab lub zes qe menyuam ntim me dua li hauv pawg tswj hwm (P <>

2. 2 theem kev sib deev

Ua ntej kev kho mob, tsis muaj qhov sib txawv tseem ceeb ntawm qib FSH, E2, LH thiab T ntawm ob pawg (P > 0.05); Tom qab kev kho mob, theem ntawm FSH thiab E2 nyob rau hauv ob pawg tau nce, thaum theem ntawm LH thiab T txo qis, thiab theem ntawm FSH thiab E2 hauv pawg kawm tau nce siab dua li cov hauv pawg kawm. Cov qib siab dua li ntawm pawg tswj hwm, thiab qib LH thiab T tau qis dua cov pawg tswj hwm (P <>

2. 3 Ovulation thiab cev xeeb tub

Tus nqi ovulation [85.00 feem pua ​​(34/40)] thiab cev xeeb tub [42.50 feem pua ​​(18/40)] ntawm pawg kawm tau siab dua cov pab pawg tswj [60.98 feem pua (24/41)] thiab cev xeeb tub [21.95 feem pua ​​(9/41)] (P <0.05).

3 Kev Sib Tham ntawm TCM Kev Kho MobPolycystic Ovary Syndrome

Ntawm cov poj niam ntawm lub hnub nyoog yug me nyuam, qhov tshwm sim ntawm PCOS yog 5 feem pua ​​​​rau 10 feem pua, thiab qhov kev rho menyuam tawm ntawm cev xeeb tub yog 70 feem pua ​​​​rau 80 feem pua, uas muaj kev cuam tshuam loj rau poj niam lub cev thiab lub hlwb [6].

. Lub pathogenesis ntawm PCOS tseem tsis tau paub meej, tab sis feem ntau ntseeg tau tias nws muaj feem xyuam rau cov metabolism hauv endocrine, thiab hypothalamus-pituitary-ovarian axis raug rhuav tshem, uas ua rau ovulation teeb meem thiab kev xeeb tub. Tam sim no, kev kho mob ntawm PCOS infertility feem ntau yog ua raws li cov tshuaj sab hnub poob, uas tuaj yeem tswj hwm kev txhawb nqa ntawm kev xeeb tub.

Txawm li cas los xij, kev siv mus sij hawm ntev tuaj yeem ua rau muaj ntau yam tsis zoo xws li kev loj hlob ntawm lub mis, kev ua rau lub plab zom mov thiab lub paj hlwb [7].

Nrog rau kev sib sib zog nqus ntawm lub tswv yim ntawm TCM kev kho mob, cov kev tshawb fawb tau pom tias hauv kev kho mob ntawm PCOS infertility los ntawm TCM syndrome sib txawv, cov kev kho mob zoo tuaj yeem ua tiav los ntawm kev ua kom lub raum thiab tswj cov meridians, dissolving phlegm thiab dredging collaterals, thiab txhawb cov ntshav ncig. thiab tshem tawm cov ntshav stasis [8].

Hauv TCM, PCOS infertility yog muab faib ua pawg "infertility" thiab "amenorrhea", thiab cov tsos mob ntawm lub raum tsis txaus thiab ntshav stasis yog feem ntau. Lub raum yog lub hauv paus ntawm qi thiab lub hauv paus ntawm cov ntshav. Lub raum tsis txaus, qhov tsis txaus ntawm Yuan yin, tsis muaj cov khoom pov thawj txaus, cov ntshav stasis thiab stasis, tsis muaj kev txhaj tshuaj uterine, tuaj yeem ua rau amenorrhea [9-10]. "Plain Questions" hais tias: "Ib tug poj niam muaj xya xyoo, nws lub raum qi yog kev vam meej, nws cov hniav muaj plaub hau, nws cov hniav yog elongated, thiab thaum nws muaj hnub nyoog ob los yog xya xyoo, lub ntuj ceeb tsheej guile los txog, lub Ren mem tes. qhib, lub Taichong mem tes muaj zog, thiab lub caij nyoog poj niam yog nyob rau hauv lub sij hawm tam sim no, yog li ntawd nws muaj ib tug me nyuam. " Lub raum yog lub hauv paus ntawm fertility. , qhov chaw khaws cov ntsiab lus tseem ceeb, kev loj hlob tseem ceeb, qhov tsis txaus ntawm lub raum qi tuaj yeem cuam tshuam rau kev loj hlob ntawm follicles thiab ovulation. Bushen Tiaojing Decoction yog ib hom tshuaj ntsuab siv hauv Suav teb rau kev kho mob raum tsis txaus thiab ntshav stasis syndrome. Nuan Gong soothe cov hlab ntsha, feem ntau yog siv rau qhov tsis muaj qhov txias thiab tsis muaj menyuam; Dodder tonifies lub raum thiab ntxiv cov ntsiab lus, thiab tuaj yeem txo qis qis;Cistanche, Morinda officinalis, thiab Ciconia yog tag nrho cov tshuaj yang-tonifying, uas tuaj yeem ua rau lub raum-yang, ntxiv dag zog rau cov leeg thiab pob txha; Phlegm; Pinellia txo qis inversion thiab nres ntuav; Saponin pos kom ntws cov kua paug thiab txo qhov o; Ua cov tswm ciab los daws qhov stagnation thiab txo qhov mob; Kev sib xyaw ntawm ntau yam tshuaj tuaj yeem ua rau lub raum thiab tus po, tshem tawm cov ntshav stasis thiab txo qhov mob, tswj qi thiab tswj yin. Kev tshawb fawb tshuaj niaj hnub tau pom tias amethyst tuaj yeem txhim kho zes qe menyuam hauv cov neeg mob;Cistanchethiab Dodder tuaj yeem tswj hwm kev ua haujlwm ntawm gonadal axis thiab txhim kho lub xeev endocrine txawv txav; kev cuam tshuam tsis tu ncua tuaj yeem tswj hwm lub cev tsis muaj zog thiab tiv thaiv kev rho menyuam ntxov ntxov; Salvia miltiorrhiza tuaj yeem txhim kho lub raum ua haujlwm thiab ua rau lub siab ua haujlwm qeeb. Nws tuaj yeem txhawb cov ntshav ncig thiab txhim kho cov tsos mob ntawm cov ntshav stasis hauv cov neeg mob[11-12].

Tau ib qho qauv ntawm

Cistanche thiab Dodder Mixed Tablets

Txoj kev tshawb no qhia tau hais tias tom qab kev kho mob, cov hauv paus hniav thiab zes qe menyuam ntim nrog ib txoj kab uas hla ntawm 2-8 mm nyob rau hauv ob pab pawg tau zoo dua piv nrog rau cov ua ntej kev kho mob, thiab kev txhim kho nyob rau hauv pab pawg neeg txoj kev tshawb no tseem ceeb dua. Qhov no qhia tau hais tias Bushen Tiaojing Decoction ua ke nrog cov tshuaj sab hnub poob yog siv los kho PCOS infertility, thiab tuaj yeem txhawb kev txhim kho ntawm zes qe menyuam ua haujlwm hauv cov neeg mob. Yog vim li cas yog tias cov tshuaj raum tonifying muaj txiaj ntsig zoo rau kev txhim kho ntawm zes qe menyuam, thiab cov ntshav ua kom lub cev thiab kev coj khaub ncaws tuaj yeem ua rau lub plab zom mov tsis zoo, txo qhov tuab ntawm lub zes qe menyuam, txo lub sijhawm pib ntawm lub raum- tonifying tshuaj, thiab txhawb kev rov ua haujlwm ntawm zes qe menyuam. Txoj kev tshawb no tseem qhia tau hais tias cov theem ntawm FSH, E2, LH, thiab T hauv ob pawg tau txhim kho tom qab kev kho mob, thiab pab pawg tshawb fawb tau muaj txiaj ntsig zoo dua, uas yog qhov tseem ceeb raws li kev tshawb fawb ntawm Zhang Chunling li al.[13 ]. Kev sib deev cov tshuaj hormones xws li LH thiab FSH tuaj yeem tswj hwm kev loj hlob thiab kev loj hlob ntawm cov qe qe, thiab yog tias lawv txawv txav, lawv tuaj yeem ua rau muaj kev loj hlob tsis zoo. Cov qib LH ntau dhau tuaj yeem txhawb nqa androgen secretion, thiab tom qab hloov dua siab tshiab rau hauv estrone, nws tuaj yeem cuam tshuam rau lub cim ntawm LH peaks hauv kev coj khaub ncaws, yog li cuam tshuam qhov kev loj hlob thiab excretion ntawm follicles. FSH tuaj yeem ua rau muaj kev loj hlob thiab kev loj hlob ntawm primordial follicle hlwb, thiab yog tias qib qis dhau lawm, nws yuav cuam tshuam rau mitosis thiab ua rau cov follicles tsis tuaj yeem txhim kho ib txwm [14]. Tus nqi cev xeeb tub thiab ovulation tus nqi hauv pawg kawm tau siab dua li cov hauv pawg tswj hwm, qhia tias Bushen Tiaojing Decoction ua ke nrog cov tshuaj sab hnub poob hauv kev kho mob ntawm PCOS infertility tuaj yeem txo qis kev xeeb tub thiab txhim kho cev xeeb tub los ntawm kev tswj hwm cov tshuaj hormones. Txhawm rau ua kom tiav, ntxiv Bushen Tiaojing Decoction rau kev kho mob ntawm PCOS infertility raws li cov tshuaj sab hnub poob tuaj yeem tswj hwm cov tshuaj hormones poj niam txiv neej zoo dua, txhim kho zes qe menyuam ua haujlwm, thiab txhawb ovulation thiab cev xeeb tub.

Yog tias koj muaj lus nug, thov xa email rau kuv ntawm: wallence.suen@wecistanche.com