基于"乙癸同源"理论针药联合治疗肾虚肝郁型卵巢储备功能减退的临床研究OA

Objective:To observe the clinical efficacy of combined acupuncture and medication in treatment of diminished ovarian reserve(DOR)with Kidney deficiency and Liver depression syndrome,based on'shared origin of Yi and Gui'theory.Methods:A total of 94 DOR patients with Kidney deficiency and Liver depression syndrome were randomly assigned into the medication group and the combined group,with 47 patients in each group.The medication group received sequential estrogen-progesterone therapy and Biantong Zishiying Decoction;on which basis,the combined group was also treated with acupuncture.Both groups underwent treatment for three menstrual cycles and were followed up three months after the end of treatment.TCM symptom scores and Self-Rating Anxiety Scale(SAS)scores were compared before and after treatment.Serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),and anti-Müllerian hormone(AMH)were measured,and antral follicle count(AFC)was assessed via ultrasound.Pregnancy outcomes of both groups were also followed up three months after the end of treatment.Results:After treatment,compared with pre-treatment values,the scores of TCM symptoms and SAS,as well as the levels of FSH and LH were significantly decreased,whereas the levels of AMH and AFC were significantly increased(P＜0.05)in the two groups;in which the combined group demonstrated significantly greater improvements compared with the medication group(P＜0.05).The total effective rate was 97.73％(43/44)in the combined group,which was significantly higher than 81.82％(36/44)in the medication group(P＜0.05).Conclusion:Combined acupuncture and medication have a clear therapeutic effect on DOR with Kidney deficiency and Liver depression syndrome.It can alleviate TCM clinical symptoms and anxiety,regulate serum sex hormone levels,increase AFC,and demonstrates superior efficacy compared with medication therapy alone.