The Efficacy and Safety of Modified Xiaoyao San for Perimenopausal Syndrome (PMS): A Systematic Review and Meta-Analysis

Objectives: To assess the efficacy and safety of modified Xiaoyao San (XYS) for treating Perimenopausal syndrome (PMS). Methods: Literature searches were carried out on PubMed, Cochrane Library, CNKI Database, Chinese Biomedical Literature Database, Wan Fang Database, and VIP Database up to December 2018. Hand search for further references was conducted. Study selection, data extraction, quality assessment, and data analyses were performed as request of the Cochrane standards. Results: Nine publications in total were suitable for inclusion. There was evidence that modified XYS was tested to be more effective in improving overall symptoms compared with HRT (odds ratio 3.50, 95% CI 2.56 to 4.78). Whereas HRT was more sensitive and direct in decreasing FSH (WMD 6.69, 95% CI 5.60 to 9.52) and LH (WMD 7.00, 95% CI, 5.75 to 8.25) in comparison with XYS group. It was also strongly supported that XYS had less adverse effect than HRT (odds ratio 0.07, 95% CI 0.05 to 0.10). Conclusion: Modified XYS might be more effective and safer in treatment of perimenopausal syndrome. However, due to poor methodological quality in the majority of included studies, the potential benefit and safety about XYS need to be confirmed in rigorously designed, multi-centre, and large-scale trials.

Clinical efficacy of gamma-oryzanol combined with Femoston for perimenopausal syndrome

BACKGROUND Perimenopausal syndrome(PMS)is a chronic disease associated with estrogen deficiency.Because of the unsatisfactory outcomes of current conventional treatments for this condition,its treatment must be continuously explored and optimized.AIM To assess the clinical effectiveness ofγ-oryzanol in combination with Femoston for PMS.METHODS A total of 119 patients with PMS were selected from June 2023 to December 2023,which included 59 and 60 patients in the control and observation group,respectively.The control and observation groups were treated with Femoston andγ-oryzanol+Femoston,respectively.Comparative analyses were performed in terms of clinical effectiveness,safety(dizziness and headache,nausea and vomiting,and breast tenderness),sex hormones[estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)],lumbar spine(L1-4)and bilateral femoral bone mineral density(BMD),and sleep quality(sleeping time and frequency of awakenings from sleep).RESULTS Compared with the control group,the observation group had statistically higher total effective rates of treatment;lower overall incidence of adverse events;higher post-treatment E2 levels and L1-4 and bilateral femoral BMD;and lower LH and FSH levels,sleeping time,and frequency of awakenings from sleep after treatment.CONCLUSION Therefore,for the treatment of PMS,γ-oryzanol combined with Femoston is significantly better than Femoston alone in terms of clinical effectiveness,exhibiting more pronounced clinical advantages in improving safety,sex hormone levels,BMD,and sleep quality.

经前舒颗粒对PMS肝气郁证模型大鼠下丘脑MAOA和MAOB表达水平的影响

目的通过研究PMS肝气郁证模型大鼠下丘脑MAOA和MAOB基因的表达,探讨PMS肝气郁证的微观发病机制及中药经前舒颗粒的作用靶点。方法束缚法制备PMS肝气郁证模型大鼠,用经前舒颗粒干预治疗,运用半定量RT-PCR和Western Blotting方法检测正常组、模型组、给药组大鼠下丘脑区MAOA、MAOB mRNA及其蛋白表达水平;通过单因素方差分析及LSD法统计数据。结果与正常组相比,PMS肝气郁证模型组大鼠MAOA mRNA在下丘脑表达显著升高(P<0.05),蛋白表达极显著升高(P<0.01);MAOB mRNA及蛋白在下丘脑表达均无统计学差异(P>0.05);给药组与模型组相比,MAOA mRNA在下丘脑表达降低(P<0.05),蛋白表达显著降低(P<0.01);MAOB mRNA及蛋白在下丘脑表达均无统计学差异(P>0.05);给药组与正常组相比,MAOA、MAOB mRNA及蛋白在大鼠下丘脑中表达均无统计学差异(P>0.05)。结论模型组大鼠与正常组大鼠相比,下丘脑MAOA基因表达升高,通过经前舒颗粒干预后,恢复正常。说明MAOA基因与PMS肝气郁证相关,并且可能是经前舒颗粒治疗该证的作用机制之一。

依据“患者自评表”制定PMS肝气逆证疗效评价参考标准的研究

目的:针对临床缺乏经前期综合征(PMS)肝气逆证疗效评价标准的情况,建立PMS肝气逆证疗效评价参考标准。方法:采用随机双盲对照多中心的原则,依据"PMS肝气逆证症状严重程度患者自评表"初步建立PMS肝气逆证疗效评价参考标准。结果:"经前平颗粒"和安慰剂对于PMS肝气逆证患者均具有治疗效果,经前平组疗效明显优于安慰剂组;"患者自评表"可以作为疗效评价指标。结论:初步建立PMS肝气逆证疗效评价参考标准,为PMS肝气逆证疗效评价行业标准的建立提供了参考。

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.

Effects of Soy Isoflavones on the Sex Hormone Level and Pathological Changes in the Perimenopausal Syndrome Animal Model

[Objectives] To observe the effect of soy isoflavones on the perimenopausal syndrome model of female rats,and to find its mechanism,in order to provide experimental evidence for the clinical treatment of menopausal syndrome. [Methods]50 female SD rats were randomly divided into five groups,with 10 rats in each group,respectively,for the normal control group,sham operation group,model group,diethylstilbestrol group,soy isoflavone treated group,except the normal control group and sham operation group,the other groups were ovariectomized rats,the formation model of perimenopausal rats treated with normal saline,diethylstilbestrol,soy isoflavone by gavage,normal control group and sham operation group were given the same dose of normal saline and soy isoflavone by gavage. After 6 weeks of continuous treatment,abdominal aorta was taken blood,the serum was isolated,and radioimmunoassay method to measure E_2( Eestradiol),P( Progesterone),T( Testosterone). And removal of the pituitary gland,uterine and adrenal prepared pathological section,experimental effect was observed by light microscopy,using immunohistochemical method to observe the brain pituitary FSH( Follicle-Stimulating Hormone) and LH( Luteinizing Hormone) levels. [Results] Radiation immune analysis results showed that soy isoflavone could significantly improve serum E_2 level in ovariectomized rats,compared with the model group,the statistical analysis showed significant difference( P < 0. 05),but the serum P and T level had little effect. The pathological results showed that( i) uterus: the uterine wall and endometrial thickness of soy isoflavone group was between that of model group and sham operation group,the surface epithelium was columnar,glands increased;( ii) pituitary gland: soy isoflavone ovariectomized group cells were between model group and normal group;( iii) adrenal gland: soy isoflavone group adrenal tissue did not change significantly. Immunohistochemical results showed that soy isoflavone group pituitary tissues of FSH and LH cells compared with the model group decreased significantly. [Conclusions] The soy isoflavones could make the uterus wall and endometria of perimenopausal syndrome animal model thicken,improve the serum level of E_2 in ovariectomized rats,and decrease the level of FSH and LH,but had little effect on the adrenal tissues,level of T and P.

Study on the Molecular Mechanism of Danggui Buxue Decoction in Intervention of Perimenopausal Syndrome Based on Network Pharmacology and Molecular Docking

[Objectives]This study was conducted to explore the intervention mechanism of Danggui Buxue Decoction in perimenopausal syndrome based on network pharmacology and molecular docking.[Methods]The chemical components and targets of Danggui Buxue Decoction were acquired through the TCMSP database,and the main targets of perimenopausal syndrome were obtained through the GeneCards database.The component targets and disease targets were intersected,and combining with active components and Chinese herbs in the decoction,a traditional Chinese medicine-component-target network was constructed using Cytoscape 3.7.1 software.The STRING platform was employed for protein-protein interaction analysis.The DAVID analysis platform was used to conduct target GO and KEGG enrichment analysis,so as to predict the action mechanism Danggui Buxue Decoction.Finally,an active component-disease target-signal pathway network diagram was constructed.[Results]Twenty two components in Danggui Buxue Decoction related to perimenopausal syndrome and 120 corresponding targets were obtained,including active components such as 1,7-dihydroxy-3,9-dimquercetin and kaempferol,and key targets such as TNF,ESR1 and PPARG.The results of GO analysis and KEEG analysis indicated that Danggui Buxue Decoction might regulate the transcription of RNA polymerase II promoter,DNA templating,gene expression,signal transduction,hypoxia response and other biological processes by regulating multiple signal pathways such as chemical carcinogenesis-receptor activation,cancer pathways,lipid and atherosclerosis,tryptophan metabolism,malaria,steroid hormone biosynthesis and chemical carcinogenesis-DNA adduct.[Conclusions]Danggui Buxue Decoction intervenes in perimenopausal syndrome through multiple components,targets and pathways,providing a basis for elucidating the intervention mechanism of Danggui Buxue Decoction and expanding its clinical application.

抗PM-Scl抗体检测对结缔组织病重叠综合征的诊断和鉴别诊断价值

目的探讨抗PM-Scl抗体检测对结缔组织病重叠综合征的诊断和鉴别诊断价值。方法采用酶联免疫吸附试验法对624例结缔组织病患者和100例体检健康者(对照组)血清进行抗PM-Scl抗体定量检测,采用间接免疫荧光法进行抗核抗体(ANA)检测,采用免疫印迹法进行ANA谱检测。结果624例结缔组织病患者抗PM-Scl抗体检出水平为6.57(2.31~10.02)RU/mL,检出率为3.5%;在90例多发性肌炎/系统性硬化症重叠综合征患者中,其抗体检出水平为11.34(6.48~16.32)RU/mL,其中有20例抗PM-Scl抗体水平明显升高,其检出水平为118.92(100.22~156.83)RU/mL,阳性率为22.2%(20/90)。多发性肌炎/系统性硬化症重叠综合征患者抗PM-Scl抗体水平和阳性率明显高于非多发性肌炎/系统性硬化症重叠综合征患者(P<0.01)。22例抗PM-Scl抗体水平升高患者ANA谱抗体检测阴性,用间接免疫荧光法筛查ANA,均为核仁抗体阳性。结论抗PM-Scl抗体主要出现在多发性肌炎/系统性硬化症重叠综合征患者中,抗体水平升高标志着重叠综合征的可能,有助于重叠综合征等结缔组织病的诊断和鉴别诊断。

Research on the Effects of the Extract of Polygala fallax Hemsl on Sex Hormones andβ-EP in Perimenopausal Rat Models

Objective:To study the effects of the ethnic medicine Polygala fallax Hemsl with Guangxi characteristics on the sex hormones andβ-EP in research objective perimenopausal rat models.Methods:40 female SPF rats were randomly divided into 4 groups,including the normal,model,high-dose and lowdose groups.Rats of three groups except for the normal one were treated with perimenopausal modelling through the method of subcutaneous injection of compound 4-VCD for 15 consecutive days.Rats of the normal and model group were normally fed without any treatment.Rats of the high-dose and low-dose groups were administered by high-and low-dose intragastric administration of the extract of Polygala fallax Hemsl.According to the menstrual cycle of the vaginal smear of the rat,each menstrual cycle is a course of treatment and 6 consecutive courses of treatment would be given.The indexes of serum sex hormones(E2,FSH,LH)andβ-EP of rats in each group were observed after treatment.Results:After the treatment of 6 cycles,for the levels ofβ-EP and E2,the model group was lowest(P<0.05),the normal group was highest(P<0.05);and the high-dose group was higher than the low-dose group;For the levels of FSH and LH,the normal group was lowest(P<0.05),the model group was highest(P<0.05),and the high-dose group was lower than the low-dose group.Conclusion:Guangxi characteristic national medicine Polygala fallax Hemsl can effectively improve the levels of serum sex hormones andβ-EP in perimenopausal rat models and relieve the related symptoms with a certain dose-effect relationship.

Constitutional Mismatch Repair-Deficiency Syndrome Is a Rare Cause of Cancer Even in a Highly Consanguineous Population

Biallelic germline mutations in the mismatch repair genes, including MLH1, MSH2, MSH6 or PMS2, lead to a recessive constitutional mismatch repair-deficiency (CMMR-D) syndrome characterized by early onset malignancies in children and young adults. Because consanguinity unmasks autosomal recessive disorders, we hypothesized that the frequency of CMMR-D is inflated in the highly consanguineous population of Saudi Arabia. In this study, 371 pediatric and young adult?patient samples from Saudi Arabia that cover the tumor spectrum of CMMR-D syndrome were analyzed for biallelic germline mutations in the MLH1, MSH2, MSH6 and PMS2 with the use of direct genomic sequencing. However, none of the 371 patients involved in the study was found to have biallelic pathological mutations of MLH1, MSH2, MSH6 or PMS2. This result indicates that CMMR-D is exceptionally rare among pediatric cancer patients and adult early onset cancer patients, even in the highly consanguineous Saudi population. Our findings suggest that larger cohorts will be needed, particularly in outbred populations, to determine the frequency of CMMR-D and that routine screening for this syndrome among cancer patients is not warranted.

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.

Chief Physician Defen Wang’s Clinical Experience in Dialectical Treatment with Mediation Method of Perimenopausal Sweating

The objective of this paper is to outline Chief Physician Defen Wang’s clinical experience in perimenopausal sweating syndrome differentiation and treatment,to inherit Mr.Gao’s academic concept of mediation technique,and to integrate multiple prescriptions under Mr.Gao’s thinking.The deficiency is based on the deficiency of liver and kidney Yin,the weakness of spleen and stomach,and the standard is the imbalance of Ying and Wei,the imbalance of Qi,blood and body fluid,and the main method of treatment is nourishing liver and kidney,soothing liver and invigorating spleen,regulating Ying and Wei,as well as tonifying Qi and absorbing fluid.

关黄母颗粒治疗围绝经期综合征患者的临床疗效及对其内分泌紊乱、睡眠质量的影响

目的探讨关黄母颗粒治疗围绝经期综合征(Perimenopausal syndrome,PMS)患者的临床疗效及对其内分泌紊乱、睡眠质量的影响。方法选取2021年2月—2023年1月期间江苏省苏北人民医院收治的192例PMS患者,采用随机数字表法分为对照组和观察组,每组各96例。对照组给予小剂量激素替代疗法(Hormone replacement therapy,HRT),观察组给予关黄母颗粒治疗,连续治疗8周。观察比较两组患者治疗效果、不良反应,同时检测治疗前后外周血性激素雌二醇(Estradiol,E_(2))、黄体生成素(Luteinizing hormone,LH)与促卵泡激素(Follicle-stimulating hormone,FSH)水平变化,评价中医证候评分、女性更年期综合征自我诊断评定表(Kupperman)评分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)和围绝经期综合征生存质量量表(Menopause-specific quality of life,MENQOL)评分,测量子宫内膜厚度及腰椎骨密度(Bone mineral density,BMD)。结果治疗后两组患者中医证候各症状及总分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候各症状及总分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者Kupperman、PSQI和MEN-QOL评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组Kupperman、PSQI和MEN-QOL评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者内分泌指标E_(2)水平较治疗前升高,LH和FSH水平较治疗前降低,差异有统计学意义(P<0.05);但两组间比较,差异无统计学意义(P>0.05)。治疗后两组患者子宫内膜厚度及BMD均较治疗前升高,差异有统计学意义(P<0.05);但两组间比较,差异无统计学意义(P>0.05)。治疗后观察组总有效率94.62%(88/93)明显高于对照组76.09%(70/92),差异有统计学意义(P<0.05)。治疗期间,观察组无明显不良反应,与对照组的不良反应率10.87%比较,差异有统计学意义(P<0.05)。结论关黄母颗粒治疗PMS疗效显著且副作用少,能够有效纠正内分泌紊乱、减轻临床症状,并可改善睡眠质量及生活质量。

柴胡四物汤对围绝经期综合征模型大鼠血清E_(2)水平、子宫形态及ERα表达的影响

目的:通过观察柴胡四物汤对围绝经期综合征模型大鼠血清E_(2)水平、子宫形态及子宫、下丘脑ERα表达的影响,初步探讨柴胡四物汤治疗围绝经期综合征的作用机制。方法:将75只雌性SD大鼠随机分为假手术组、模型组、西药组、柴胡四物汤高、中、低剂量组,采用双侧卵巢切除法造模,选取符合条件的60只大鼠纳入实验,每组10只。从术后第14天开始,连续给药28 d。给药结束后,观察各组大鼠子宫指数及形态学的改变;采用ELISA法检测血清E_(2)水平;采用RT-PCR法及Western Blot法检测子宫、下丘脑ERα的表达水平。结果:与假手术组比较,模型组血清E_(2)水平明显下降(P<0.01),子宫湿重、子宫指数显著下降(P<0.01),子宫体积明显缩小,宫腔变窄,腺体数量较少,内膜及肌层萎缩,子宫ERαmRNA及蛋白的表达水平明显下降(P<0.01),下丘脑ERαmRNA及蛋白的表达水平显著升高(P<0.01)。与模型组比较,西药组、柴胡四物汤高、中剂量组血清E_(2)水平明显升高(P<0.01),西药组、柴胡四物汤高、中、低剂量组的子宫指数明显上升(P<0.01),子宫腺体数量增加,内膜及肌层的萎缩程度有所缓解,西药组、柴胡四物汤高、中剂量组子宫ERαmRNA表达水平增加(P<0.01),西药组、柴胡四物汤高剂量组子宫ERα蛋白表达水平增加(P<0.01),西药组、柴胡四物汤高、中、低剂量组下丘脑ERαmRNA及蛋白的表达水平降低(P<0.01)。结论:柴胡四物汤可改善围绝经期的各类症状,其作用机制可能与升高围绝经期综合征模型大鼠血清E_(2)水平,改善子宫指数及萎缩程度,提高子宫ERα的表达并同时下调下丘脑ERα的表达有关。

双侧卵巢切除大鼠下丘脑⁃垂体的转录组学特征及二仙汤的调节效应

目的利用RNA测序技术研究围绝经期综合征模型大鼠下丘脑-垂体的转录组学特征及二仙汤的作用。方法以大鼠双侧卵巢切除术模拟围绝经期综合征雌激素骤然下降状态。48只雌性SD大鼠,随机取假手术组12只,其余36只大鼠双侧卵巢切除术后再随机分为双侧卵巢切除组、17β-雌二醇组、二仙汤组,每组12只。大鼠双侧卵巢切除术后第7天,17β-雌二醇组灌胃17β-雌二醇(0.1 mg·kg^(-1)·d^(-1)),二仙汤组灌胃二仙汤提取液(8 g·kg^(-1)·d^(-1)),每日灌胃1次,持续6周;假手术组与双侧卵巢切除组均灌胃等量的灭菌水。采用酶联免疫吸附测定(ELISA)法检测血清雌二醇(E2)、促性腺激素释放激素(GnRH)与β-内啡肽(β-EP)含量。采用mRNA转录组测序技术检测下丘脑与垂体,根据FPKM值与edgeR算法筛选组间差异表达基因,进行基因本体(GO)与京都基因与基因组百科全书(KEGG)富集分析,并以实时荧光定量逆转录聚合酶链式反应(RT-qPCR)法验证下丘脑雌激素受体α(Esr1)与线粒体编码的NADH脱氢酶亚基4(Mt-nd4)、垂体钙/钙调素依赖性蛋白激酶Ⅱα(Camk2a)与甲状腺激素受体α(Thra)共4个差异表达基因。结果①与假手术组比较,双侧卵巢切除组大鼠血清E2与β-EP显著下降(P<0.05);与双侧卵巢切除组比较,二仙汤组E2与β-EP水平显著升高(P<0.05)。②大鼠下丘脑与垂体可检测基因数量均为30957个。③与假手术组比较,双侧卵巢切除大鼠下丘脑上调基因135个、下调基因348个,垂体上调基因409个、下调基因82个。与双侧卵巢切除组比较,17β-雌二醇治疗后大鼠下丘脑上调基因126个、下调基因225个,垂体上调基因93个、下调基因273个;二仙汤治疗后大鼠下丘脑上调基因91个、下调基因92个,垂体上调基因390个、下调基因376个。④GO分析表明,下丘脑与垂体差异表达基因富集于细胞过程、生物学调控、代谢过程等。⑤KEGG呈现了下丘脑与垂体的差异表达基因富集前30个信号通路,其中二仙汤调节尼古丁成瘾、氮代谢、突触囊泡循环等信号通路。⑥RT-qPCR所验证的二仙汤显著调节的Esr1、Mt-nd4、Camk2a基因表达变化与转录测序结果一致。结论双侧卵巢切除大鼠下丘脑与垂体的神经内分泌系统处于紊乱状态,17β-雌二醇侧重于调节下丘脑基因,二仙汤对垂体调节更广、更深。

宁夏南部山区围绝经期女性围绝经期综合征特点分析

目的分析宁夏南部山区围绝经期女性围绝经期的影响因素,为宁夏农村围绝经期女性预防保健提供依据。方法采取多阶段抽样方法,选择宁夏南部山区2个县,每个县2个乡,每个乡2个村,对40~55岁女性395人进行问卷调查,根据改良Kuppermonn量化评分表对其症状进行评分,并对围绝经期综合征的影响因素进行分析。结果395名女性中检出围绝经综合征162人,绝经期综合征患病率为41.0%。其中,轻度63人,占15.9%;中度91人,占23.1%;重度8人,占2.1%。年龄、产次、吃甜食、吃奶类豆类及其制品成为围绝经期综合征的影响因素。结论针对农村围绝经期女性围绝经期综合征特点,对此类人群进行健康教育和重点干预,以提高农村女性自我保健意识。

坤泰胶囊联合地屈孕酮治疗围绝经期综合征的临床效果

目的:探讨坤泰胶囊联合地屈孕酮治疗围绝经期综合征(PMS)的临床效果.方法:选取2022年7月—2023年6月沈阳维康医院收治的PMS患者78例为研究对象,依据随机数字表法分为对照组和观察组,各39例.对照组采用地屈孕酮治疗,观察组在对照组基础上联合坤泰胶囊治疗.比较两组治疗效果、女性雌激素指标水平、康复相关指标.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=0.042);治疗后,两组促卵泡生成素、促黄体生成素水平均低于治疗前,雌二醇水平高于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05);治疗后,两组窦卵泡数量、卵巢体积、子宫内膜厚度水平均高于治疗前,观察组窦卵泡数量、子宫内膜厚度优于对照组,差异有统计学意义(P<0.05),两组卵巢体积比较,差异无统计学意义(P>0.05).结论:坤泰胶囊联合地屈孕酮治疗PMS的临床效果显著,可促进患者的卵巢功能恢复,调节女性激素水平.

坤泰胶囊对围绝经期综合征治疗作用的研究

目的探讨坤泰胶囊对围绝经期综合征(peripheral menopause syndrome,PMS)的治疗作用。方法共收集60例患PMS的志愿者,随机分为治疗组和对照组,每组30例。治疗组服用坤泰胶囊,对照组则为替勃龙。坤泰胶囊,饭后0.5 h口服,每次2 g,1日3次。替勃龙,晚饭后0.5 h口服,每次2.5 mg,1次/d。所有患者均服药3个月。检测两组志愿者服药前后血清激素(FSH、LH、E2)浓度和改良后Kupperman评分(mKMI),判断坤泰胶囊对的治疗作用。结果mKMI比较:组间治疗前后有改善(P<0.05);服用药物3个月后,治疗组比对照组治疗和改善患者症状的效果更好(P<0.05)。性激素方面:与对照组相比,治疗组E2上升(P<0.05);治疗后FSH、LH两组均下降(P<0.05)。临床疗效治疗组疗效更好。结论坤泰胶囊治疗PMS的总疗效上更好。

全国名中医尤昭玲基于“以胞宫为中心的五脏一体观”诊治绝经前后诸证

绝经前后诸证对应西医学围绝经期综合征,或多种因素致卵巢功能衰竭而出现围绝经期综合征临床表现的患者。全国名中医尤昭玲基于《黄帝内经》“五脏一体观”,提出“以胞宫为中心的五脏一体观”,认为“五脏失调”为绝经前后诸证的主要病机,以“调和五脏”为治则,创制经验方更年方。以胞宫为中心,顺应胞宫藏泻有序的特点,绝经前分经期、排卵前、排卵后辨证施以耳穴辅助治疗,绝经后顺应胞宫藏而不泻的生理特性,辅以耳穴静养阴阳。分年龄配合药膳养巢煲或养生安神煲,临证中收获佳效。