Kev Tshawb Fawb Kev Tshawb Fawb Ntawm Phenylethyl Cawv GlycosidesinCistanche Deserticola Ntawm Perimenopausal Syndrome Tsiaj Qauv

Discussion Perimenopause occupies txog ib feem peb mus rau ib nrab ntawm ib tug poj niam lub neej. Nws yog lub sijhawm hloov pauv thaum lub zes qe menyuam ua haujlwm maj mam poob los ntawm lub xeev muaj zog kom ploj mus tag. Xws li 2 mus rau 5 xyoo ua ntej amenorrhea, thawj xyoo ntawm amenorrhea tsis tu ncua, 15 xyoo tom qab amenorrhea rau hnub nyoog laus. Covperimenopausal syndromeyog ib tug txo nyob rau hauvqib tshuaj estrogen, uas cuam tshuam rautswj kev ua haujlwm ntawm hypothalamusthiab pituitary caj pas.Kev poob qis hauv zes qe menyuam ua haujlwmNws yog lub hauv paus pathogenesis, thiab kev ua haujlwm thiab kev hloov pauv pathological tshwm sim hauv ntau lub cev thoob plaws lub cev. Nws ua rau endocrine ntshawv siab, tsis muaj kev tiv thaiv thiab autonomicpaj hlwb tsis zoo, feem ntau ua rau kub kub, ntxhov siab, kev nyuaj siab lossis kev xav tsis zoo, thiab mob pob txha. Raws li IDF cov qauv, 55% ntawm cov poj niam postmenopausal thiab 45% ntawm cov poj niam premenopausal tau pom tias muaj tus mob perimenopausal [20]. Feem ntau ntawm kev nyuaj siab nyob rau hauv cov poj niam perimenopausal yog qhov tseem ceeb, nrog rau cov ntaub ntawv qhia tawm txawv teb chaws yog 20% ​​thiab domestically yog 46.5%. Nws feem ntau tshwm sim thaum muaj hnub nyoog 45 thiab 55 [21].Cov poj niam Perimenopausalua lub luag haujlwm tseem ceeb hauv zej zog thiab tsev neeg, thiabperimenopausal syndrometau dhau los ua ib qho tseem ceeb cuam tshuam rau kev sib raug zoo thiab tsev neeg kev sib haum xeeb.

Nws yuav siv sij hawm ntev npaum li cas rau CISTANCHE ua haujlwm?

1 Cov tshuaj suav tshuaj suav nrog kev nkag siab ntawm perimenopausal syndrome

1.1 Lub ntsiab txhais ntawm perimenopausal syndrome nyob rau hauv tsoos suav tshuaj

Cov manifestations thiab cov yam ntxwv ntawm lubperimenopausal syndromeNyob rau hauv cov phau ntawv kho mob thaum ub feem ntau yog tawg nyob rau hauv cov lus piav qhia ntawm "lily kab mob", "zang mania", "kev nyuaj siab syndrome", "irregular menstruation", "relapse ntawm menstruation nyob rau hauv lub hnub nyoog laus", thiab lwm yam. Raws li cov ntaub ntawv nyob rau hauv ancient phau ntawv kho mob, Cov kws tshaj lij gynecological tau ua ke ntau xyoo ntawm kev kho mob los qhia "pre- thiab postmenopausal syndromes." "Su Wen·Zhenzhen Lun" hais tias: "Rau ib tug poj niam nyob rau hnub 17, lub raum qi muaj zog, nyob rau hnub 27th ntawm lub hli, lub Ren meridian yog qhov tseeb, thiab Taichong mem tes muaj zog, Hnub 77, lub Ren pulse tsis muaj zog, lub Taichong mem tes tsis muaj zog, thiab Tiangui yog qaug zog, uas yog qhov tseeb "tsis tsim nyog" qhia meej tias cov poj niam cev xeeb tub muaj feem cuam tshuam rau lub raum "Synopsis of the Golden Chamber: Treatment of Women's Miscellaneous Diseases thiab Pulse Syndrome" hais tias: "Tus poj niam lub cev sab hauv yog qhuav, nws tu siab thiab xav quaj, nws cov duab zoo li cov vajtswv tsim, thiab nws cov lej tsis ncav cuag." Cov kab mob hauv lub cev yog Yin, thiab thaum twg. Yin yog tsis txaus thiab hluav taws kub heev, nws txhais tau hais tias "dryness". tshwm." "Suwen · Yin thiab Yang Yingxiang Dalun" hais tias: "Thaum muaj hnub nyoog plaub caug, lub zog yin yog ib nrab ntawm lub cev, thaum ib tug poj niam muaj plaub caug xyoo, nws Yin Qi yuav puv ib nrab, nws Heavenly Gui yuav qaug zog, Nws lub raum Qi yuav maj mam poob qis, nws Yin essence yuav tsis txaus, nws Yin thiab Yang yuav tsis txaus, nws ob lub raum yuav tsis txaus thiab nws lub siab yuav muaj zog, dej yuav tswj tsis tau hluav taws, thiab lub plawv hluav taws yuav o, ua rau lub plawv. thiab cov tsos mob ntawm lub raum tsis txaus muaj xws li kev ua poj niam cev xeeb tub lossis cov tsos mob menopausal xws li tawm hws kub, khaus khaus, nyob tsis tswm, kub hnyiab, palpitations thiab insomnia, mob nraub qaum thiab lub ntsej muag, o ntawm lub ntsej muag thiab ceg ceg, kiv taub hau, tinnitus, thiab zoo li kab laug sab. daim tawv nqaij "Song Dynasty Qi Zhongfu Cov Poj Niam Cov Lus Nug" cov ntaub ntawv: "Tus lej hexagram ntawm Qiqi dhau lawm", uas qhia tau hais tias tus kab mob tshwm sim vim muaj kev cuam tshuam ntawm lub zog phem vim qhov tsis txaus ntawm tib neeg lub cev meridians, thiab qhov tsis txaus ntseeg ntawm lub cev. Chong thiab Ren meridians hauv cov poj niam. Innately, lub raum yog leej niam ntawm daim siab nyob rau hauv lub Tsib Elements.Lub raum tsis ua haujlwmyuav inevitably cuam tshuam rau daim siab thiab ua rau lub physiological yam ntxwv ntawm lub siab poob. Yog li, daim siab ua haujlwm tsis zoo kuj yog lub ntsiab pathogenesis ntawm perimenopausal syndrome, tab sis nws lub hom phiaj tseem cuam tshuam rau lub raum. Cov ntaub ntawv qub saum toj no qhia txog qhov tseem ceeb ntawm kev tiv thaiv raum qi hauv kev kho mob perimenopausal syndrome. Qhov nce thiab poob ntawm lub raum qi yog qhov ua rau ua rau mob khaub thuas thiab mob khaub thuas. Cov tshuaj suav niaj hnub ntseeg hais tias qhov ua rau thiab qhov tshwm sim ntawm tus kab mob no yog "lub raum tsis muaj peev xwm." ", Tshuaj suav suav suav kev nkag siab txog kev nyuaj siab perimenopausal: Cov tshuaj suav tshuaj suav hais tias lub raum tsis txaus ua rau mob raum thiab mob hlwb, encephalopathy cuam tshuam rau lub raum, thiab lub raum tsis txaus, Yi Gui muaj tib lub hauv paus chiv keeb, ua rau lub siab poob. kev noj haus, thiab daim siab kev nyuaj siab thiab qi stagnation. Rov ua dua, qhov no ua raupoj niam kev nyuaj siab.Qhov pib ntawm perimenopausal kev nyuaj siab.

1.2 TCM etiology, pathogenesis, thiab kev kho mob ntawm perimenopausal syndrome

1.2.1 TCM etiology thiab pathogenesis ntawm perimenopausal syndrome

Deficiency ntawm yin thiab ntshav,kev tsis sib haum xeeb ntawm yin thiab yang, kev tsis sib haum xeeb ntawm qi, thiab nyob tsis tswm ua rau qhov tshwm sim ntawm perimenopausal syndrome. Cov tshuaj suav tshuaj suav tshuaj ntseeg tau hais tias perimenopausal syndrome yog tshwm sim los ntawm lub raum tsis muaj zog, lub siab stagnation, endogenous phlegm thiab ntshav stasis, spleen thiab plab tsis muaj zog, Chong thiab Ren pulse deficiency, thiab lwm yam, tab sis lub hom phiaj tsis yog cais los ntawm lub raum tsis txaus. Piv txwv li: "kev xav tsis zoo, ntau lub cev tsis ua haujlwm" thiab "phlegm qaug zog ua rau muaj kab mob" yog vim tsis muaj cov ntsiab lus hauv lub raum, kev hloov pauv tsis zoo qi, tsub zuj zuj ntawm dampness thiab phlegm, tsis txaus ntawm ob lub raum yin thiab yang, kev puas tsuaj loj heev. daim siab qi, stagnation ntawm daim siab qi, thiab congestion. Yog tias muaj qhov tsis txaus ntseeg, qaug zog thiab ntshav txhaws ntawm ntau yam kabmob hauv nruab nrog cev, thiab phlegm syndrome, ntau cov tsos mob ntawm tus kab mob no yuav tshwm sim. Lub siab stagnation yog thawj zaug ntawm tag nrho cov kev nyuaj siab, thiab congenital deficiency ntawm lub raum essence yog lub ntsiab pathogenesis ntawm stagnation. Physiologically, lub raum yog dej-derived ntoo. Yog tias lub raum essence txaus, cov ntshav siab yuav tau txais. Nyob rau tib lub sijhawm, lub siab cov ntshav thiab lub raum essence tuaj yeem noj ib leeg, thiab lub siab thaum cov ntshav txaus, cov ntshav tuaj yeem hloov mus ua cov ntsiab lus; thaum lub raum essence puv, lub essence yuav tig mus rau hauv cov ntshav. Thaum qi thiab ntshav sib haum xeeb, txhua yam kab mob yuav raug tiv thaiv.

1.2.2 Suav tshuaj kho mob perimenopause

Kev kho mob los ntawm hom: "Cov qauv kev kuaj mob thiab kev ua tau zoo ntawm cov tshuaj suav tshuaj suav tshuaj" tau muab faib ua ob yam mob rau kev kho mob: daim siab thiab lub raum yin deficiency thiab raum yang deficiency; thiab "Cov Ntsiab Cai ntawm Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Cov Tshuaj Suav Tshiab Tshiab" tau muab faib ua ob yam mob: yin deficiency thiab sab hauv tshav kub, yin deficiency thiab essence deficiency, thiab yin deficiency. Nws tuaj yeem kho nrog xya tus mob:daim siab tsis muaj peev xwm, daim siab thiab lub raum yin deficiency, yin deficiencythiabntshav qhuav, lub plawv thiab lub raum disarmony, thiab spleen thiab raum yang deficiency. Qhov thib tsib thiab thib rau ntawm "TCM Gynecology" ob leeg kho raum yin deficiency thiab raum yang deficiency, thiab lub xya tsab kho raum yin deficiency, raum yang deficiency, thiab raum yin thiab yang deficiency. Txawm hais tias qhov kev faib tawm thiab kev kho mob yog qhov nyuaj, lub hom phiaj yog txhawb nqa lub raum. Feem ntau siv Suav tshuaj patent suav nrog Longfengbao Capsules, Wujia Mengnian Tablets, thiab lwm yam.

Ntxiv thiab rho tawm cov ntawv sau yooj yim: Nws yog ib txoj hauv kev siv ntau dua hauv kev kho tshuaj suav tshuaj. Raws li cov tsos mob sib txawv, txoj hauv kev xws li kev noj qab haus huv raum thiab nourishing yin, sov lub raum thiab nourishing yang, nourishing lub raum thiab nourishing lub siab, nourishing lub raum thiab spleen, los yog nourishing lub raum thiab calming lub plawv yog ntxiv raws li lub syndrome. . Txhawm rau txo cov tsos mob ntawm perimenopausal syndrome.

Kev kho mob tshwj xeeb: Cov tshuaj noj yin thiab tu lub raum lossis ua kom lub siab thiab ua kom lub siab muaj zog feem ntau yog siv los ua tshuaj ntsiav, tshuaj, granules, lossis txhaj tshuaj rau kev kho mob.

Kev kho mob acupuncture: Los ntawm kev txhawb nqa HPO axis, qib tshuaj hormones, thiab qib neurotransmitter raug hloov kho, cov kab mob endocrine tsis raug kho, thiab cov teeb liab intracellular tau rov qab los, yog li rov ua kom lub cev tsis ua haujlwm thiab cov ntaub so ntswg thiab lub cev ua haujlwm [22].

Lwm yam kev kho mob: kho ko taw massage, kho acupoint txhaj tshuaj, pob ntseg acupuncture, thiab lwm yam. Lawv txhua tus muaj qee yam kev kho mob, tab sis tsis muaj cov tshuaj siv tau zoo thiab yooj yim.

Txoj kev tshawb xav neurotransmitter tuav tias cov ntsiab lus thiab feem ntawm monoamine neurotransmitters hauv hypothalamus ntawm cov neeg mob perimenopausal cuam tshuam. Cov kev hloov pauv hauv cov tshuaj neurotransmitters zoo sib xws rau perimenopausal syndrome, uas tau nyiam ntau ntxiv. DA thiab 5-HT yog ob qho tib si monoamine neurotransmitters hauv lub hlwb thiab muaj feem cuam tshuam nrog perimenopausal syndrome. 5-HT feem ntau cuam tshuam nrog kev coj tus cwj pwm, kev xav, thiab kev xav. Kev nyuaj siab yog tshwm sim los ntawm 5-hydroxytryptamine (5-HT) deficiency. Cov theem ntawm monoamine neurotransmitters 5-HT thiab DA hauv cov kua cerebrospinal ntawm cov neeg mob uas muaj kev nyuaj siab txo qis [4]. Raws li ib tug neurotransmitter nyob rau hauv lub synaptic cleft, 5-HT yuav tsum khi rau nws cov receptor sib raug rau cov ntaub ntawv kis tau tus mob. Yog li ntawd, 5-HT receptors kuj tseem muaj feem cuam tshuam nrog qhov pib ntawm kev nyuaj siab rau kev mob ntshav qab zib [29]; DA txhawb kev tsim cov tshuaj endorphin. [2], kev tso tawm thiab kev ua haujlwm ntawm hypothalamic -EP txo qis, ua rau muaj kev nce hauv NE / DA piv, ua rau qhov tshwm sim ntawm kub flashes [7]. Yog li ntawd, tom qab cov poj niam nkag mus rau perimenopause, ntxiv rau qhov ua rau cov tsos mob thaum ntxov xws li kub hnyiab thiab hmo ntuj tawm hws, thiab atrophy ntawm cov urinary thiab reproductive systems nyob rau hauv nruab nrab lub sij hawm, nws kuj yuav ua rau neurological tsos mob thiab nco tsis tau nyob rau hauv lub lig theem.

Txoj kev xav ntawm lub cev tiv thaiv kab mob tuav tau tias txo qis cov tshuaj estrogen (E2) ntau dhau los tiv thaiv lub cev tiv thaiv kab mob los ntawm kev ua kom lub cev tiv thaiv kab mob estrogen, ua rau txo qis hauv cov tshuaj estrogen receptors (ER), uas ua rau muaj kev cuam tshuam tsis zoo ntawm cov tshuaj estrogen, thiab tom qab ntawd tiv thaiv kab mob. active cells tsis tuaj yeem tsim cov tshuaj tiv thaiv kab mob txaus txaus tuaj yeem ua rau muaj qhov tshwm sim ntawm perimenopausal syndrome, atrophy thiab qhov txhab ntawm lub cev tiv thaiv kab mob, thiab kev tiv thaiv qis.

Peb txoj kev xav loj sib tshooj sib tshooj, tab sis qhov teeb meem ntawm estrogen thiab receptors khiav los ntawm peb txoj kev xav. Qhov tsis txaus ntawm cov tshuaj estrogen thiab cov qib receptor sib raug yog ib qho tseem ceeb tshwm sim ntawm qhov teeb meem. Kev tshawb fawb txog kev kho mob niaj hnub no qhia tau hais tias neurotransmitters tuaj yeem tswj cov kab mob endocrine, cov kab mob endocrine tuaj yeem tswj hwm lub cev tiv thaiv kab mob thiab cov lus pom tsis zoo neurotransmitter system, thiab lub cev tiv thaiv kab mob tuaj yeem cuam tshuam rau cov kab mob neurotransmitter, nrog rau kev sib txuas ntawm ntau thiab ze. Piv txwv li: estrogen tuaj yeem tswj cov qib ntawm cov neurotransmitters hauv hypothalamus rau cov ntsiab lus ruaj khov thiab qhov sib piv, yog li txhim kho kev ua haujlwm ntawm hypothalamus, tsis ncaj qha tswj kev tso tawm thiab tso tawm ntawm GnRH, txo qhov tso tawm ntawm pituitary LH thiab FSH, thiab txo cov dej kub. cov tsos mob. Ntxiv nrog rau cov kev tswj xyuas tsis zoo, GnRH kuj tseem cuam tshuam txog kev tswj hwm ntawm ntau yam neurotransmitters thiab paj hlwb: dopamine (DA), gamma-aminobutyric acid (GABA) thiab -endorphin (-EP), thiab lwm yam. Kev tso tawm ntawm GnRH feem ntau ua lub luag haujlwm inhibitory, thaum norepinephrine (NE), 5-hydroxytryptamine (5-HT) thiab excitatory amino acids tuaj yeem txhawb kev tso tawm ntawm GnRH, thiab cov neurotransmitters cuam tshuam nrog estrogen. [30]. Kev tswj hwm ntawm lub cev tiv thaiv kab mob los ntawm neurotransmitters thiab endocrine system yog tsuas yog ua tiav los ntawm kev sib xyaw ntawm cov neurotransmitters, cov tshuaj hormones thiab cov receptors sib xws ntawm cov ntaub so ntswg thiab cov kabmob. Lub cev tiv thaiv kab mob paub txog kev tawm tswv yim kev tswj hwm ntawm neuroendocrine los ntawm ntau yam bioactive molecules uas tsim los ntawm lub cev tiv thaiv kab mob. Ntawd yog, peb lub tshuab loj yog sib txuas nrog ib leeg los ntawm neurotransmitters, cov tshuaj hormones thiab lub cev tiv thaiv kab mob kom tswj tau lub cev lub cev ua haujlwm ntawm lub cev tag nrho. Lub holistic saib ntawm tsoos suav tshuaj tuaj yeem txhais los ntawm qib molecular biology [31]. Lub pathogenesis ntawm kev nyuaj siab yog nyuaj, thiab qhov feem ntau pom pom yog qhov txo qis hauv monoamine neurotransmitters, feem ntau suav nrog 5-HT thiab DA. Tshwj xeeb tshaj yog 5-HT, 5-hydroxytryptamine tseem hu ua indole alkylamine. 5-HT feem ntau muaj ntau yam haujlwm xws li tswj kev xav, pw tsaug zog, ceev faj, nco, qab los noj mov, kev ntshaw kev sib deev, lub cev kub, hypothalamus-pituitary-endocrine, thiab lwm yam.[32] . Lub 5-HT neurotransmitter hypothesis ntseeg tias qhov tshwm sim ntawm kev nyuaj siab yog vim qhov txo qis hauv 5-HT tso tawm hauv nruab nrab paj hlwb thiab txo qis hauv cov ntsiab lus synaptic. 5-HT depleting agents tuaj yeem ua rau cov tsos mob nyuaj siab, thiab qib ntawm 5-HT txo qis yog cuam tshuam nrog cov tsos mob. Qhov hnyav yog ncaj qha proportional [33] Serotonin (5-HT) thiab dopamine (DA) ua lub luag haujlwm tseem ceeb hauv kev pib thiab kho mob hlwb. Kev siv 5-hydroxytryptamine (5-HT) thiab dopamine (DA) hauv kev kho mob rau kev nyuaj siab mus sij hawm ntev muab cov lus xaus zoo. Piv txwv li, kev tswj hwm ntawm dopamine precursors tuaj yeem txhim kho lub hlwb ntawm qee cov neeg mob kev nyuaj siab lossis ua tiav cov tshuaj tiv thaiv kev ntxhov siab los ntawm inhibiting DA metabolism thiab thaiv DA reuptake [34-35].

2.3 Kev kho mob niaj hnub ntawm perimenopausal syndrome

Rau cov neeg mob uas muaj mob me me thiab cov tsos mob hnyav, tuaj yeem muab kev sab laj txog kev puas siab puas ntsws thiab cov tshuaj vitamin tuaj yeem muab tau zoo; Cov tshuaj hormone hloov kho (HRT) feem ntau siv cov tshuaj estrogen: estrone, estradiol, estriol, estradiol, thiab lwm yam. Ntawm lawv, estradiol yog cov tshuaj lom neeg lom neeg thiab siv dav hauv cov tshuaj estrogen hauv lub cev. Nws tuaj yeem txo ntau yam tsos mob ntawm perimenopause, txo cov pob txha pob txha, thiab txhim kho poj niam lub neej zoo. Txawm li cas los xij, nws ua rau muaj kev pheej hmoo ntawm mob qog noj ntshav endometrial. Yog li ntawd, nws tsuas yog tsim nyog rau cov poj niam uas tau txais hysterectomy. Progestins yog siv ua ke nrog cov tshuaj estrogen los tiv thaiv kev loj hlob ntawm endometrium los ntawm estrogen. Tab sis cov kab mob stroke, plawv nres, thiab venous thrombosis tau nce. Xaiv cov tshuaj estrogen receptor modulators: yog cov tshuaj zoo li tshuaj estrogen uas xaiv ua rau cov ntaub so ntswg rau kev ua haujlwm estrogenic. Lawv feem ntau siv los ua lwm txoj hauv kev rau HRT. Txawm li cas los xij, lawv muaj kev pheej hmoo ua rau mob qog noj ntshav thiab nce cov kab mob thromboembolic, thiab muaj kev cuam tshuam tsis zoo rau lub siab. thiab kev txawj ntse tsis raug cuam tshuam. Phytoestrogen therapy: Qee cov khoom siv tooj dag muaj nyob hauv cov taum pauv, alfalfa thiab lwm yam nroj tsuag muaj cov tshuaj estrogen zoo li thiab tuaj yeem siv los kho cov mob perimenopausal. Nws tuaj yeem tiv thaiv osteoporosis zoo thiab muaj kev tiv thaiv ntawm cov hlab plawv.

Tam sim no, ob qho tib si tsiaj estrogens thiab phytoestrogens ua rau muaj kev hem thawj. Qhov no tau tsa cov lus nug tshiab thiab cov teeb meem rau cov neeg ua haujlwm kho mob, thiab tseem coj tau lub cib fim tshiab thiab cov nyom rau cov tshuaj suav tshuaj muaj kev nyab xeeb dua. Cov tshuaj suav tshuaj rau tonifying raum yang muaj cov nyhuv zoo li estrogen, uas tuaj yeem kho cov haujlwm ntawm txhua qhov txuas ntawm hypothalamus-pituitary-ovary axis, nce qib tshuaj estrogen, thiab muaj txiaj ntsig zoo hauv kev kho kev nyuaj siab thiab osteoporosis hauv perimenopausal syndrome. Piv txwv li, cov rog-soluble tivthaiv estradiol nyob rau hauv velvet antler yog lub active tivthaiv ntawm velvet antler nrog estrogen-zoo li cov teebmeem; chorionic gonadotropin yog lub luag haujlwm ntawm Ziheche uas txhawb nqa lub raum, ntxiv dag zog rau yang, thiab muaj cov tshuaj estrogen zoo li; epimedium tuaj yeem txhim kho txoj haujlwm ntawm HPO axis endocrine system; Morinda officinalis muaj cov tshuaj adrenocorticotropic zoo li cov nyhuv; Psoralen muaj cov tshuaj estrogen zoo li tswj cov hlab ntsha thiab cov ntshav, txhawb cov pob txha pob txha hematopoiesis, txhim khu kev tiv thaiv kab mob thiab endocrine zog, thiab muaj kev tiv thaiv kev laus. Epimedium tag nrho cov flavonoids tuaj yeem ua rau cov ntshav E2 nce ntxiv thiab txo cov ntshav FSH thiab LH qib hauv perimenopausal qauv tsiaj, qhia tias nws tuaj yeem tswj cov qib tshuaj hormones hauv perimenopausal qauv tsiaj; Nws tuaj yeem txhim kho pob txha thiab kev tiv thaiv kab mob los ntawm kev txo qis hauv cov tshuaj estrogen thaum lub sijhawm perimenopause. lub zog poob [36] Icariin tuaj yeem ua kom cov ntshav siab testosterone ntau ntau hauv cov qauv nas [37]. Morinda officinalis, psoralen, cnidii, thiab lwm yam tuaj yeem tiv thaiv cov tsos mob ntawm perimenopausal osteoporosis. Erxian decoction tuaj yeem ua rau nce qib E2 ntawm cov neeg mob [38], qhia tias qhov tseem ceeb ntawm cov tshuaj suav tshuaj los txhawb lub raum feem ntau yog nyob rau hauv kev rov qab los ntawm lub cev lub cev ua haujlwm. Txhawm rau kom ua tiav cov txiaj ntsig zoo thiab ua tiav lub hom phiaj ntawm kev kho cov tsos mob thiab cov hauv paus hniav. Clinically, nws tau pom tias feem ntau cov tshuaj uas txhawb lub raum yang muaj kev kho mob zoo ntawm perimenopausal syndrome. Raws li kev nkag siab ntawm perimenopausal syndrome los ntawm cov tshuaj suav tshuaj suav tshuaj thiab kev sib tham hauv cov ntaub ntawv ntawm qee cov tshuaj suav tshuaj uas muaj cov tshuaj estrogen zoo li thiab noj rau lub raum yang, Cistanche deserticola, ib txwm siv tshuaj suav tshuaj suav tshuaj rau kev kho mob perimenopausal syndrome, raug xaiv.