ADVANCES OF EXPERIMENTAL RESEARCH ON ACUPUNCTURE AND MOXIBUSTION FOR TREATMENT OF WOMEN'S CLIMACTERIC SYNDROME

To introduce the advances of experimental research on acupuncture and moxibustion for treatment of Women＇s Climacteric Syndrome.The recent years experimental research literature of acupuncture and moxibustion for treatment of Women＇s Climacteric Syndrome were reviewed.The research literatures on acupuncture treatment were major,focusing on the field of acupuncture and moxibustion regulating hypothalamic-pituitary-gonad axis and nerval-endocritic-immune net.Acupuncture and moxibustion could regulate the endocrine environment of menopausal women.Taking advantage of combination biomedicine with multi-sciences,to improve the acupuncture and moxibustion curative effct and probe the mechanism of menopausal pathology and acupuncture and moxibustion function to Women＇s Climacteric Syndrome,is the research direction afterward.

Acupuncture for Treatment of Climacteric Syndrome—A Report of 35 Cases

To evaluate the effects of acupuncture for treatment of climacteric syndrome.Methods:The 65 cases in this series were randomly assigned to the acupuncture group (N=35) and the control group (N=30), with the former treated by acupuncture and the latter by medication respectively.The therapeutic effects were evaluated by means of the clinical outcome,improvement in the symptom scores and the results of radioimmunoassays.Results:In the acupuncture group,12 cases were cured,16 cases markedly effective,and 6 cases improved,the total effective rate being as high as 97.14%.The decrease in the symptom scores,and especially the elevation of the decreased E_2 level and the decrease of the increased FSH and LH levels, demonstrated that acupuncture therapy was superior to medication.Conclusion:Acupuncture for regulating the mental activities and reinforcing the kidney is an effective therapy for climacteric syndrome.

CLINICAL STUDY ON CLIMACTERIC SYNDROME TREATED WITH AURICULAR PLUS BODY ACUPUNCTURE

Aim: To search for the best therapeutic method for climacteric syndrome. Methods: A total of 190 cases of climacteric syndrome participants were randomly divided into auricular plus body acupuncture group (treatment group, n=96) and simple body acupuncture group (control group, n=94). Serum sexual hormone (FSH, LH and E2) and blood lipid (TC, LDL C, HDL C and TG) levels were detected before and after treatment. Results: After 30 sessions of treatment, the total effective rates of treatment and control groups were 82.29% and 76.02% respectively, with the former being significantly higher than the later (P<0.01). In comparison with pre treatment of each group, serum follicle stimulating hormone (FSH) and luterotropic hormone (LH) levels lowered significantly; serum estradiol (E 2) increased remarkably (P<0.05-0.01); serum high density lipoprotein cholesterol (HDL C) of two groups raised significantly (P<0.05-0.01), and low density lipoprotein (LDL) C of treatment group decreased evidently (P<0.05). In addition, the improvement of complaints of hot flushes, sweating, paresthesia, insomnia and emotional irritability in treatment group is significantly better than that of control group. Conclusion: Auricular acupuncture combined with body acupuncture has a better therapeutic effect than that of simple body acupuncture in the treatment of climacteric syndrome.

Female Climacteric Syndrome Treated by Ear Embedding

Female climacteric syndrome is a common disease occurring before and after menopause. The author has treated the disease with ear embedding therapy, and achieved satisfactory therapeutic results. The following is a report of the clinical observation.

Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.

Menopausal Status and Metabolic Syndrome in Women in Climacteric Period Treated at a Clinic in Southern Brazil

Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syn- drome according to sample characteristics. Methods: A cross-sectional study was conducted with 551 women treated at a clinic in southern Brazil. MetS and its components were defined according to NCEP-ATP III and menopausal status as pre, peri, and post-menopause. Prevalences of menopausal status and of MetS and its components were calculated. Estimates of prevalence ratios crude and adjusted with confidence intervals of 95% were calculated by Poisson Regression with robust variance. Demographic, socioeconomic, behavioral, and reproductive characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of MetS determination. Results: The prevalence of Metabolic Syndrome in the sample was 56.1% (CI95%: 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche 11 years old, with three or more pregnancies and in the post-menopausal period. In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause;however, the confidence intervals include the unit. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%;CI95%: 81.7 to 87.8), waist circumference (66.4%;CI95%: 62.5 to 70.4) and HDL cholesterol (51.7%;CI95%: 47.5 to 55.9). There was a linear increase on mean blood glucose through menopausal status. Conclusions: Our study indicates variation on the distribution of MetS and each component according to menopausal status and other women characteristics. Future studies on MetS should also have foresight to use this type of approach to improve understanding and targeting of actions and programs focusing on women in this period of life.

Advances in the Pathogenesis of Perimenopausal Syndrome

Perimenopause syndrome refers to the syndrome of the disorders of multiple systems of women around menopause caused by the reduction in secreted estrogen and is also known as menopause syndrome.Its pathogenesis involves increasing age,the abatement of ovarian function,and psychological change caused by the increasing life pressure.The above factors lead to physical and mental changes in postmenopausal women.This paper summarizes the pathogenesis of perimenopause from the perspective of gene studies and existing experimental studies and provide some ideas for clinical treatment and research.

Effect of the Ginseng extractive E on experimental climacteric disturbance in rats

Objective To search the effects of the extractive E of Ginseng(EG)on experimental climacteric syndrome in rats.Methods Extirpating the both sides of ovary of rats to turbulence estrogen secretion,induce climacteric syndrome.The weight,bite and sup,substance of bone,blood lipid,calcium urine biochemistry,estrodiol,behavior perfomance were also observed.Results The body weight of ovariotomied rat was controlled,bone density was increased,estradiol level increased,the weight of bone increased.Conclusions EG ameliorated climacteric syndrome.Increase bone density and bone mine content,enhanced the level of estradiol.

Clinical efficacy of anti-Mullerian hormone inspection in supporting diagnosis for climacteric disorders

The diagnosis of climacteric disorders in gynecology is performed on the basis of symptoms rather than hormonal levels. Generally, the follicle-stimulating hormone (FSH) level increases when the 17β-estradiol (E2) level decreases in menopause. However, the problem of these hormones should be determined by strict timing of sampling, and there are individual specificities of decreases of hormone levels. We considered that anti-Mullerian hormone (AMH) can be measured at any time of the menstrual cycle and that it shows ovary functional decline earlier than FSH/E2, and we examined whether AMH would possibly become a good index for climacteric disorders. The subjects were 163 healthy females and 21 patients with climacteric disorders between 20 and 59 years old. We examined AMH, FSH and E2 at the same time. It is understood that in healthy females, AMH decreases with age and a decline in ovary function occurs at a relatively early age. Patients visiting clinics for climacteric disorders often have normal-range serum FSH/E2 levels, and it is clear that these values could not serve as indices of menopause at these inspections. Upon measurement of AMH in patients with climacteric disorders, most showed less than normal range (< 14 pmol/L), suggesting a decline in ovarian function. In addition, AMH was low in females with climacteric disorders compared with those without them. In conclusion, AMH was suggested as an objective index for climacteric disorders and possibly as a new diagnostic marker.

Artificial Intelligence and Network Pharmacology Reveal the Medication Rules of Professor Wang Yu-Ying in the Treatment of Climacteric Syndrome

Objective: The objective of this study was to explore the medication rules and academic ideas of Professor Wang Yu-Ying in the treatment of climacteric syndrome(CLS) and to predict new prescriptions. Materials and Methods: The characteristics of frequency, clustering, four properties, and five flavors were analyzed, and new prescriptions were predicted through an artificial intelligence(AI)-based method. The potential pathways of new prescriptions were explored through network pharmacology-based analysis. Results: The top 16 medicinals used by Professor Wang Yu-Ying in the treatment of CLS included Danggui, Longgu, Muli, Fuling, Chuanxiong, Gancao, Xiangfu, and Tusizi. The AI method was applied to predict the basic prescription for treating CLS: Danggui 15 g, Duanlonggu 30 g, Duanmuli 30 g, Fuling 28 g, Chuanxiong 10 g, Gancao 6 g, Xiangfu 12 g, Tusizi 14 g, etc., Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses showed that the pathogenesis of CLS might be related to the estrogen pathway, involving typical steroid responses. Conclusions: This study summarized Professor Wang's medication experience in the treatment of CLS based on the data mining of clinical diagnoses and treatment cases. The AI method was used to predict the new prescription of CLS treatment, which was found to be reasonable by network pharmacology studies on its multi-target and multi-pathway mechanisms.

Changes of Leucocytic Estrogen Receptor Levelsin Patients with Climacteric Syndrome andthe Therapeutic Effects of LiuweiDihuang Pills (六味地黄丸)

he levels of estrogen receptor (ER) in human peripheral leucocytes in 22 women withclimacteric syndrome were measured by radioligand method. The results were compared with those of 12healthy women of child-bearing age. It was found that the contents of leucocytic ER in patients with cli-macteric syndrome were significantly lower than healthy women of child-bearing age (372±149 vs 1143±255 Rs binding sites/cell). The authors used a Chinese prescription---Liuwei Dihuang Pills (LDP) totreat the patients for 2 months. The levels of leucocytic ER were increased affer treatment. The data indi-cate a decrease of ER Ievels in leucocytes may be involved in the pathogenesis of climacteric syndrome.LDP not only increase plasma estradiol levels , but also increase the leucocytic ER levels. This may be thebasis of the therapeutic effect of LDP on climacteric syndrome.

李轩主任运用补肾疏肝法治疗男性更年期综合征

男性更年期综合征(PADAM)是男性在由中年向老年过渡的阶段,由于内分泌紊乱而出现的以性能力下降为主要症状的生物学过程,归属于中医学的“脏燥、虚劳、郁证”等范畴。李轩主任中医师认为此病的病因主要为肾虚,肝郁是此病病理机枢,治疗上强调补肾疏肝,同时健脾养心以调和脏腑机能。在机制研究方面,已经证实了补肾疏肝中药可以通过调整垂体-下丘脑-性腺轴功能,或调控脱氢表雄酮(DHEA)、胰岛素样生长因子(IGF-1)等分泌,从而促进睾酮合成及分泌发挥治疗作用;而对于雄激素水平正常的患者,补肾疏肝法则可通过调控性激素结合蛋白等机制提升血清睾酮水平而发挥治疗作用。

温经汤在肾虚型更年期综合征患者中的应用效果观察

目的 探究温经汤在肾虚型更年期综合征患者中的应用效果。方法 59例肾虚型更年期综合征患者为研究对象,以随机数字表法分为对照组(29例)和观察组(30例)。对照组接受常规西药治疗,观察组在此基础上给予温经汤治疗。比较两组临床疗效、中医证候积分、生殖内分泌激素指标水平、植物神经功能紊乱情况。结果 观察组临床治疗总有效率为93.33%,高于对照组的72.41%(P<0.05)。两组治疗前月经紊乱、烘热汗出、五心烦热、腰膝酸冷积分及总分比较,差异无统计学意义(P>0.05);观察组治疗后月经紊乱、烘热汗出、五心烦热、腰膝酸冷积分及总分分别为(1.92±0.68)、(1.89±0.73)、(1.84±0.64)、(1.83±0.65)、(7.48±2.61)分,均低于对照组的(2.36±0.69)、(2.43±0.74)、(2.24±0.63)、(2.19±0.67)、(9.22±2.52)分(P<0.05)。两组治疗前雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)水平比较,差异无统计学意义(P>0.05);观察组治疗后E2水平(49.37±3.48)pmol/L高于对照组的(46.89±3.13)pmol/L, FSH水平(33.93±8.67)U/L、LH水平(18.67±3.34)U/L均低于对照组的(41.89±8.94)、(21.76±3.09)U/L(P<0.05)。两组治疗前总植物神经功能紊乱发生率比较,差异无统计学意义(P>0.05);观察组治疗后总植物神经功能紊乱发生率6.67%低于对照组的31.03%(P<0.05)。结论 采用温经汤治疗肾虚型更年期综合征可以调节患者生殖内分泌激素水平及植物神经功能,缓解临床症状,提高治疗效果。

中医药辨治妇人更年期综合征的研究进展

更年期综合征是妇人在绝经前后常见的一种疾病,主要症状包括月经紊乱、烦躁易怒、热潮红、出汗、失眠、焦虑、抑郁等,这些症状会对患者的身心健康造成影响,给患者的生活和工作带来不便和痛苦。随着医疗技术和保健意识的提高,女性对于自身健康的重视程度也在逐渐提高,越来越多的女性开始关注自身的身体和心理健康,积极采取措施预防和治疗更年期综合征。中医药治疗更年期综合征的经验丰富,传统中医认为本病之本在肾,常累及心、肝、脾等多个脏腑,致使本病证候复杂。因此,治疗该病需要根据个体情况辨证论治,中医药治疗更年期综合征的优点在于不仅能调节人体阴阳平衡,激活身体自身调节机制,缓解症状,而且还具有较好的长期疗效和预防复发的效果。中医药也因此受到越来越多的关注和认可。文章现从更年期综合征的病因病机和治疗进展入手,结合现代实验研究,对中医药治疗本病的现状和经验作一综述。文章阐述了中医药治疗更年期综合征的理论基础和临床实践,包括中药、药膳、针灸等中医药治疗手段,总结了中医辨证论治妇人更年期综合征的经验,为临床治疗本病提供了理论依据,同时也为中医药在妇科疾病治疗方面的应用提供一定的参考。

芍药苷针对围绝经期综合征的作用机制研究进展

围绝经期综合征(climacteric syndrome,CMS)是绝经前后女性因其卵巢功能衰退、雌激素水平波动或下降,而出现的烦躁易怒、失眠多梦、潮热汗出等一系列症状。现代医学治疗CMS是以激素替代疗法(hormone replacement thera-py,HRT)为主要手段,存在不良反应大、长期使用危害性大影响疗效等问题。中医以肝郁气滞为CMS的主要病因,而白芍养血柔肝、养阴润燥,具有疏肝解郁的功效,是近代中医临床上治疗CMS的高频用药。芍药苷(paeoniflorin,PF)是中药白芍的主要活性成分,已知具有抗抑郁、保肝、保护神经、镇静催眠等多种药理作用。对国内外相关文献进行梳理归纳,就PF在肝郁气滞所致CMS中情绪障碍、睡眠障碍、认知障碍、骨质疏松症、血管舒缩症状5个方面的药理作用及机制进行综述,发现PF通过调节下丘脑-垂体-肾上腺轴活性,保护海马神经、抑制海马炎症反应,调整肠道中的炎症因子表达发挥抗抑郁作用可改善CMS的情绪障碍;PF可通过调节海马脑源性神经营养因子(BDNF)/酪氨酸蛋白激酶受体B(TrkB)通路等途径来缓解睡眠障碍;PF能通过提高海马神经因子水平、缓解神经元损伤,激活腺苷A受体来起到改善CMS认知障碍的作用;PF可以促进成骨生成、抑制成骨细胞凋亡和破骨细胞的生成,从而改善骨质疏松症。此外,还讨论了PF药物动力学中生物利用度低及PF低毒性的特点。综上,PF的临床应用提供借鉴依据,促进对其进一步深入研究。

雌二醇片/雌二醇地屈孕酮片在女性围绝经期综合征患者中的应用

目的 探讨雌二醇片/雌二醇地屈孕酮片在女性围绝经期综合征患者中的应用价值。方法 非随机选取2022年2月—2023年12月长沙市第四医院收治的围绝经期综合征患者80例为研究对象。按治疗方法分为两组,每组40例。对照组给予坤泰胶囊治疗,观察组给予雌二醇片/雌二醇地屈孕酮片治疗。比较两组性激素水平、性生活质量评分及临床症状改善时间。结果 观察组卵泡刺激素(33.5±3.5)U/L、黄体生成素水平(31.5±6.0)U/L低于对照组的(41.2±2.9)U/L、(37.1±2.9)U/L,雌二醇水平(25.6±3.1)mg/L高于对照组的(16.6±2.4)mg/L,差异有统计学意义(t=10.714、7.972、14.519,P均<0.05)。观察组性生活质量评分高于对照组,临床症状改善时间短于对照组,差异有统计学意义(P均<0.05)。结论 雌二醇片/雌二醇地屈孕酮片治疗女性围绝经期综合征,可有效维持机体性激素水平平衡,改善性生活质量,缓解不适症状。

性激素替代疗法联合常规保健治疗更年期综合征的效果分析

目的:分析性激素替代疗法联合常规保健治疗更年期综合征的效果。方法:选取2020年2月—2022年2月烟台市芝罘区妇幼保健收治的70例更年期综合征患者作为研究对象,根据随机数字表法分成两组,各35例。对照组采用常规保健治疗,研究组在对照组基础上采用性激素替代疗法。比较两组治疗效果。结果:治疗后,研究组焦虑自评量表、抑郁自评量表、睡眠质量指数、自我症状评定量表评分及卵泡雌激素、黄体生成素水平低于对照组,雌二醇水平高于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率高于对照组,差异有统计学意义(P=0.023)。结论:性激素替代疗法联合常规保健治疗更年期综合征的效果显著,能够缓解患者负性情绪,提高睡眠质量,改善雌激素水平与临床症状。

常规西药联合益肾养心舒肝汤与针灸治疗更年期综合征的效果分析

目的:分析常规西药联合益肾养心舒肝汤与针灸治疗更年期综合征的效果。方法:选取2022年4月—2023年3月上海中医药大学附属龙华医院收治的110例女性更年期综合征患者作为研究对象,依据随机数字表法分为观察组与对照组,各55例。对照组采用常规西药治疗,观察组在对照组基础上加用益肾养心舒肝汤与针灸治疗。比较两组治疗效果、焦虑及抑郁情况、睡眠质量。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.001)。治疗后,两组汉密尔顿焦虑量表、汉密尔顿抑郁量表评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组匹兹堡睡眠质量指数各项评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:常规西药联合益肾养心舒肝汤与针灸治疗更年期综合征的效果较好,改善患者焦虑、抑郁症状,提升睡眠质量。

养肾舒肝方联合艾灸治疗肝肾阴虚型更年期综合征临床效果

目的 探讨养肾舒肝方联合艾灸应用于肝肾阴虚型更年期综合征的治疗效果。方法 选取2020年1月至2022年10月成都市双流区中医医院收治的更年期综合征患者86例,采用随机数表法分为对照组(43例)和研究组(43例),对照组给予常规西药治疗,研究组给予养肾舒肝方联合艾灸治疗,比较两组治疗前及治疗1、2、3个月的中医证候积分、Kupperman评分,治疗前后的性激素指标以及临床治疗效果。结果 两组治疗1、2、3个月中医证候积分、Kupperman评分低于治疗前(P<0.05),且研究组低于对照组(P<0.05)。两组治疗后雌二醇(E_(2))、孕激素(P)较治疗前均升高,黄体生成素(LH)、促卵泡激素(FSH)较治疗前均降低(P<0.05),且研究组治疗后E_(2)、P高于对照组,LH、FSH低于对照组(P<0.05)。研究组的治疗总有效率为93.02%,高于对照组的76.74%(P<0.05)。结论 养肾舒肝方联合艾灸治疗更年期综合征,可有效改善中医证候和临床症状,调节性激素指标,提高临床治疗疗效。

坤泰胶囊联合唑吡坦治疗肾虚肝郁型更年期综合征睡眠障碍的效果研究

目的探究肾虚肝郁型更年期综合征睡眠障碍患者应用坤泰胶囊联合唑吡坦治疗的效果。方法选取60例肾虚肝郁型更年期综合征睡眠障碍患者,按照随机数字表法分为对照组(30例,予以唑吡坦治疗)与治疗组(30例,予以唑吡坦联合坤泰胶囊治疗)。比较两组治疗效果、睡眠质量、检测指标及不良反应发生情况。结果治疗组总有效率96.67%高于对照组的76.67%(P<0.05)。治疗后治疗组匹兹堡睡眠质量指数量表(PSQI)评分低于对照组(P<0.05)。治疗组雌二醇(E_(2))水平高于对照组,卵泡刺激素(FSH)、促黄体生成素(LH)水平低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论肾虚肝郁型更年期综合征睡眠障碍患者应用坤泰胶囊联合唑吡坦治疗效果突出,能够改善睡眠质量,调节性激素水平,安全系数高。