卵巢早衰PPT课件.pptx

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,#,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,#,POF,卵巢早衰的中医临床治疗及研究,（,Study of TCM on Premature Ovarian Failure,）,朱玲,广州中医药大学第一附属医院妇科,Dr.ling Zhu,Department of,Gynecology,.the First Affiliated Hospital;Guangzhou University of TCM,Mar/22/2009,New York.USA,广州中医药大学中医妇科学简介,国家级重点学科（,2002,年,-,今）,国家级重点专科（,2002,年,-,今）,国家级精品课程（,2005,年）,中医妇科学博士点（,1986,年，首批）,中医妇科学硕士点（,1981,年，首批）,广东省重点学科（,2000,年,-,今）,广东省“,211,工程”建设重点学科（,2003,年,-,今）,“,全国最佳医院排名,妇产科,”中,名列第,8,，居,全国,中医妇科之首,（卫生部医疗产业调研中心及美国斯路塞恩公司,2005,年发布的调研结果）,广州中医药大学中医妇科学简介,第一代学科带头人,、首任教研室主任,罗元恺教授,是全国首批中医妇科学博士生导师。,第二代学科带头人,:,欧阳惠卿教授,是广东省名中医，全国第三批名老中医药专家学术继承工作的导师。,第三代学科带头人,、现任教研室主任,罗颂平教授,是罗元恺教授的学术继承人，,国务院学位委员会第,5,、,6,届,学科评议组成员，,国家级“有突出贡献的中青年专家”。,卵巢早衰相关研究基金来源,Correlated study funds sources of POF,国家自然科学基金（,No,：,30400607,）（,2005.1-2007.12,）,项目负责人,National Natural Science Foundation of China,（,No,：,30400607,）（,2005.1-2007.12,）,广东省中医药局基金（,No,：,403021,）（,2004.1-2005.12,）,项目负责人,Fund by,Bureau of TCM,GuangDong province,（,No,：,403021,）（,2004.1-2005.12,）,卵巢早衰,概述,卵巢早衰,是指女性在,40,岁之前,出现,闭经,，卵泡刺激素,(,FSH,),及黄体生成素,(,LH,),水平升高,(,FSH40IU/L,），雌激素水平降低的一种综合征。,卵巢早衰的发病率为,0.3%,3%,，占原发性闭经的,20%,25%,，继发性闭经的,10%,20%,。无遗传因素、无医源性因素的,POF,在青少年中也不少见。,The term premature ovarian failure,（,POF,）,describes a stop in the normal functioning of the ovaries in a woman younger than age 40.It is also known as hypergonadotropic hypogonadism.Amenorrhea is a frequent syndrome.The characterstics of the patients hormone are high follicle stimulating hormone(FSH40IU/L,）,and luteotrophic hormone(LH),but low estrogen.,The disease rate is 0.3%,3%,，,occupy 20%,25%in primary amenorrhea,，,10%,20%in secondary amenorrhea,。,卵巢早衰,病因学研究,study of,etiology on POF,(1),医源性因素,iatrogenic factor,心理因素,psychologic factor,遗传因素,hereditary factor,免疫学因素,immunology factor,抗卵,巢,抗体。,代谢因素,metabolism,factor,高半乳糖血症,环境因素和感染因素,environmental factor and,affectoi,吸烟、腮腺炎以及严重的化脓性、结核性和淋菌性盆腔炎也可能造成,POF,。,特发性,unknown,factor,卵巢早衰病因学研究,study of,etiology on POF,(2),我们的研究表明：,POF,患者较之正常妇女外周血,CD8+T,细胞增高、,CD4+/CD8+,比值下降，二者相比有显著性差异（,P0.05,）。,Our study indicate:the serum CD8+T cells with POF increase than normal one,the ratio of CD4+/CD8+decrease.,卵巢早衰病因学研究,study of,etiology on POF,(3),七情致病,seven modes of emotions,六淫,six exopathogens,先天不足,inherent deficiency,金刃、药食所伤,surgery,medicines,其中：,七情,seven modes of emotions,(38,例,/122,例,占,31.15%),药物、疾病因素,medicines and diseases(39,例,/122,例,占,31.97%),情志及药物、疾病双重因素,both,seven modes of emotions and,medicines and diseases(6,例,/122,例,占,4.92%),无因可查,no cause can be find(39,例,/122,例,占,31.97%),（滕秀香，,2008,年,4,月）,卵巢早衰的病机特点,Pathogenetic characteristic of POF,肾虚，气血不足，肝郁血瘀,renal deficiency,insufficiency of qi and blood,stagnation of liver-qi and blood stasis,卵巢早衰,证候特点,characteristic of,syndrome,of POF,(1),证候,syndrome,病例数,Case number,百分率,(%),percentage,证候,syndrome,病例数,Case number,百分率,(%),percentage,肝郁肾虚,stagnation of liver-QI and renal deficiency,41,33.61,肾虚血瘀,renal deficiency and,blood stasis,10,8.20,肝肾阴虚,hepatic and renal yin deficiency,22,18.03,肝郁脾虚,stagnation of liver-QI with deficiency of the spleen,9,7.38,（滕秀香，,2008,年,4,月）,卵巢早衰,证候特点,characteristic of,syndrome,of POF,(2),证候,syndrome,病例数,Case number,百分率,(%),percentage,证候,syndrome,病例数,Case number,百分率,(%),percentage,脾肾阳虚,asdthenic splenonephro-yang,19,15.57,心肾不交,carduonephric cisharmony,1,0.82,热盛伤津,consumption of body-fluid,caused by excessive heat,19,15.57,脾虚湿困,splenasthenic fluid-retention,1,0.82,（滕秀香，,2008,年,4,月）,卵巢早衰,证候特点,characteristic of,syndrome,of POF,(2),症状由高到低依次为：,闭经,amenorrhea,（,105,例,/122,例，,86.07%,）,潮热汗出,hectic fever and sweating,（,83,例,/122,例，,68.03%,）,性欲淡漠,sexual desire indifference,（,52,例,/122,例，,42.62%,）,心慌,flustered,（,47,例,/122,例，,38.52%,）,眠欠安,insomnia,（,42,例,/122,例，,34.43%,）,烦躁,restlessness,（,37,例,/122,例，,33.03%,）,阴道干涩（,29,例,/122,例，,23.77%,）,大便干（,22,例,/122,例，,18.03%,）,带下量少（,13,例,/122,例，,10.66%,）,阴毛脱落（,13,例,/122,例，,11.02%,）,（滕秀香，,2008,年,4,月）,症状由高到低依次为：,闭经,menorrhea,（,19,例,/20,例，,100%,）,多梦,dreamful sleep,（,18,例,/20,例，,90%,）,阴道干涩,vaginal unsmooth,润滑（,17,例,/20,例，,85%,）,腰膝酸软（,16,例,/20,例，,80%,）,烦燥,r,estlessness,（,6,例,/122,例，,80%,）,精神抑郁,ademosyne,（,13,例,/20,例，,65%,）,心悸（,8,例,/20,例，,40%,）,潮热（,7,例,/20,例，,35%,）,（朱玲、罗颂平，,2004,年,7,月）,卵巢早衰治疗,Treatment on POF,辨证：,肾虚为本，气血亏虚为主，兼肝郁血瘀。,differentiation of symptoms and signs:,renal deficiency,insufficiency of qi and blood,stagnation of liver-qi and blood stasis,治疗大法,：补肾调阴阳，益气养血，兼疏肝活血。用药注意阴阳转化的关系。,Method of treatment:Tonifying kidney and balance yin and yang,nourishing qi and blood,disperse the depressed liver-energy and promoting blood flow,滋补肝肾（阳中求阴），兼疏肝活血（,1,）,invigorate the liver and kidney,disperse the depressed liver-energy and promoting blood flow,蔡某，女，,36,岁，已婚，,2008,年,5,月,10,日初诊。,停经半年余,Menolipsis more than 6 months.,患者既往月经规则。于,2003,年始因压力较大，情绪波动较大出现月经频发，一月两行，未曾在意，后出现,月经推后，量少,，经人提醒，于,2005,年,8,月外院检查,内分泌,：,FSH,：,53.1IU/L,，,LH,：,37.8 IU/L,，,E2,：,140.12 pmol/L,，,PRL,：,10.3ug/L,。予补佳乐治疗。,2007,年,10,月外院复查内分泌：,FSH,：,78.3IU/L,，,LH,：,56.2 IU/L,，,E2,：,220.12 pmol/L,。,LMP,：,2007,年,11,月,2,日。,The womans menstruation was regular before 2003.Since then her menstruation was irregular because of stronger stress and instable emotions.After,polymenorrhea,oligomenorrhea occurred.She went to hospital to check serum hormones.Her hormones were:,FSH,：,53.1IU/L,，,LH,：,37.8 IU/L,，,E2,：,140.12 pmol/L,，,PRL,：,10.3ug/L,。,She was treated by,Progynova,(,estradiol valerate,),。,She rechecked hormones on Oct.2007,：,FSH,：,78.3IU/L,，,LH,：,56.2 IU/L,，,E2,：,220.12 pmol/L,。,LMP,：,Nov-2-2007,。,已育一女。体型较瘦，眠差梦多，较烦燥。眼眶黯。舌尖红边有瘀点，薄白苔，细脉。,体格检查：第二性征正常，外阴已产式，阴道畅，宫颈光，宫体前，常大，无压痛，质中，活动，双附件无及明显异常。,G1P1,Thin,insomnia,dreamful sleep,restlessness,eye sockets,dim,.red tip of tongue with edge petechia,thin and whitish fur,small puls,.,滋补肝肾（阳中求阴），兼疏肝活血（,2,）,invigorate the liver and kidney,disperse the depressed liver-energy and promoting blood flow,滋补肝肾（阳中求阴），兼疏肝活血（,3,）,invigorate the liver and kidney,disperse the depressed liver-energy and promoting blood flow,诊断,：,卵巢早衰,Diagnose:POF.,辨证：阴虚内热，兼肝郁血瘀,differentiation of symptoms and signs:,yin asthenia generating intrinsic heat,congestion of the liver.,治法,：滋补肝肾（阳中求阴），兼疏肝活血,Method of treatment:,invigorate the liver and kidney,disperse the depressed liver-energy and promoting blood flow,左归丸加减,Zuogui Pill,生地,ShenDi 15g,山茱萸,ShanZhuYu 12g,黄精,HuangJing 20g,菟丝子,TuSiZi 15g,鹿角胶,luJiao glue 9g,（烊化,melting,）,龟板胶,GuiBan glue 9g,（烊化,melting,）川牛膝,NiuXi 15g,郁金,YuJin 15g,柴胡,CaiHu 10g,白芍,BaiShao 10g,夜交藤,YeJiaoTen 15g,甘草,GanChao 6g,2008,年,5,月,24,日二诊：烦燥好转，仍未经潮，仍梦多易醒，大便较烂，舌黯红苔白脉略细，于前方去鹿角胶、黄精之滋腻，加合欢皮,15g,川芎,10g,增强宁心安神，解郁活血之功。,returned visit on May-24-2008:,Less Restlessness,insomnia,dreamful sleep,no menstruation,，,Loose stools.Dark and red tip of tongue,thin and whitish fur,small puls.Removed,鹿角胶,luJiao glue 9g,（烊化,melting,）,黄精,HuangJing 20g,added,合欢皮,HeHuanPi 15g,川芎,Chuan Xiong 10g in order to calm the nerves and disperse the depressed liver-energy and promoting blood flow.,生地,ShenDi 15g,山茱萸,ShanZhuYu 12g,菟丝子,TuSiZi 15g,龟板胶,GuiBan glue 9g,（烊化,melting,）川牛膝,NiuXi 15g,郁金,YuJin 15g,柴胡,CaiHu 10g,白芍,BaiShao 10g,夜交藤,YeJiaoTen 15g,甘草,GanChao 6g,合欢皮,HeHuanPi 15g,川芎,Chuan Xiong 10g,滋补肝肾（阳中求阴），兼疏肝活血（,4,）,invigorate the liver and kidney,disperse the depressed liver-energy and promoting blood flow,滋补肝肾（阳中求阴），兼疏肝活血（,5,）,invigorate the liver and kidney,nourishing qi and blood,disperse the depressed liver-energy and promoting blood flow,2008,年,6,月,7,日三诊,：睡眠好转，二便调，但仍未经潮，略烦燥，乳房胀。舌暗红苔薄黄脉略滑。,returned visit on June-7-2008:,sleep better.Normal urine and stool.No menstruation restlessness,spargosis.Dark red tongue,thin and yellow fur,slippery pulse,治法：行气活血，补肾疏肝，宁心安神,Method of treatment:,promoting qi to activate blood,，,invigorate the kidney and disperse the depressed liver-energy.,桃仁,TaoRen 15g,益母草,YiMuChao 15g,川芎,ChuanXiong 10g,当归,DangGui 10g,生地,ShenDi 15g,菟丝子,TuSiZi 15g,川牛膝,NiuXi 15g,郁金,YuJin 15g,柴胡,CaiHu 10g,白芍,BaiShao 10g,夜交藤,YeJiaoTen 15g,合欢皮,HeHuanPi 15g,甘草,GanChao 6g,2008,年,6,月,13,日四诊：服药第,5,天，月经来潮，但量少，色鲜红，无痛经，乳胀缓解，感腰酸不适。舌尖红苔白脉滑。前方去川牛膝、郁金、夜交藤、合欢皮,15,，加路路通,15g,，水蛭,3g,、女贞子,15g,、旱莲草,15g,活血通络，养阴填精，三剂。服药后月经量增多，,5,天净,.,returned visit on June-13-2008:menstruation came after taking medicine,but less.Removed,川牛膝,NiuXi 15g,郁金,YuJin 15g,夜交藤,YeJiaoTen 15g,合欢皮,HeHuanPi 15g,add,路路通,LuLuTong 15g,，水蛭,ShuiZhi 3g,女贞子,NvZhenZi 15g,旱莲草,HanLianChao 15g.Taking the medicine,her,menstrual blood volume became more.,桃仁,TaoRen 15g,益母草,YiMuChao 15g,川芎,ChuanXiong 10g,当归,DangGui 10g,生地,ShenDi 15g,菟丝子,TuSiZi 15g,柴胡,CaiHu 10g,白芍,BaiShao 10g,甘草,GanChao 6g,路路通,LuLuTong 15g,，水蛭,ShuiZhi 3g,女贞子,NvZhenZi 15g.,旱莲草,HanLianChao 15g,滋补肝肾（阳中求阴），兼疏肝活血（,6,）,invigorate the liver and kidney,disperse the depressed liver-energy and promoting blood flow,继予左归丸调经至今，月经,40-50,天一行。,2008,年,11,月,30,日复查,FSH,：,13.6IU/L,，,LH,：,10.7 IU/L,，,E2,：,289.43 pmol/L,。,up to now,she is taking ZuoGui pill to regulate menstruation.Her cycle is 40-50 days.,She rechecked hormones on 30-Nov-2008:,FSH,：,13.6IU/L,，,LH,：,10.7 IU/L,，,E2,：,289.43 pmol/L,。,滋补肝肾（阳中求阴），兼疏肝活血（,7,）,invigorate the liver and kidney,disperse the depressed liver-energy and promoting blood flow,滋阴降火，养血活血通络（,1,）,nourishing yin to lessen fire,，,tonifying blood and promoting blood circulation to remove meridian obstruction,吴某，女，,39,岁，,2003,年,8,月,13,日初诊。,停经,5,月余,2002,年,9,月因经期延长（,10-15,天）行取环术，术后经期,6-7,天，周期正常，今年三月突然月经停闭不行，,LMP,：,2003,年,3,月,19,日，内分泌：,FSH,：,97.27IU/L,，,LH,：,32.44IU/L,，,E2,：,20 pmol/L,，,P:0.35nmol/L,PRL:6.78ug/L,。现潮热眠差，肢麻，纳差。舌淡苔白脉细关滑。,诊断,：,卵巢早衰,辨证：阴虚火旺，血虚血瘀,治法,：滋阴降火，养血活血通络,熟地,15g,菟丝子,20g,山萸肉,12g,女贞子,15g,麦冬,12g,地骨皮,12g,杜仲,15g,丹参,20g,赤芍,15g,郁金,15g,鸡血藤,30g,牛膝,15g,25/8,二诊：潮热肢麻缓解，仍眠差。舌淡苔白脉略弦。,菟丝子,20g,熟地,15g,仙灵脾,10g,丹参,20g,赤芍,15g,郁金,15g,珍珠母,30g,菖蒲,10g,茯苓,15g,甘草,6g,滋阴降火，养血活血通络（,2,）,nourishing yin to lessen fire,，,tonifying blood and promoting blood circulation to remove meridian obstruction,17/9,三诊：,LMP,：,8/9-13/9,，量不多，色鲜红。,菟丝子,20g,熟地,15g,仙灵脾,10g,郁金,15g,丹参,20g,赤芍,15g,当归,10g,牛膝,15g,鸡血藤,30g,珍珠母,30g,石菖蒲,10g,远志,6g,13/10,四诊：,LMP,：,13/10-17/10,，腹胀纳差，白带多，梦多易醒，夜尿,2-3,次，时有心慌，舌边尖红苔白脉细数。,菟丝子,20g,熟地,15g,山萸肉,12g,女贞子,15g,麦冬,12g,杜仲,15g,牛膝,15g,鸡血藤,30g,丹参,20g,赤芍,15g,郁金,15g,滋阴降火，养血活血通络（,3,）,nourishing yin to lessen fire,，,tonifying blood and promoting blood circulation to remove meridian obstruction,23/10,五诊：,LMP,：,13/10-17/10,，量中，色鲜红，小腹隐痛，偶心慌，头晕，眠差，舌红少苔脉细。,菟丝子,20g,熟地,15g,山萸肉,12g,制首乌,15g,黄精,30g,白芍,15g,丹参,15g,郁金,15g,石菖蒲,10g,茯苓,15g,牛膝,15g,鸡血藤,30g,22/11,六诊：,LMP,：,10/11-13/10,，时头晕，无心慌，无烦燥，纳眠可，二便调，舌淡苔白脉细两关略滑。,12/11,内分泌：,FSH,：,6.66IU/L,，,LH,：,6.08 IU/L,，,E2,：,256 pmol/L,，,P:4.35nmol/L,T:0.88nmol/L,。,菟丝子,20g,山萸肉,12g,杜仲,15g,枸杞子,15g,山药,15g,丹参,15g,赤芍,15g,郁金,15g,鸡血藤,30g,当归,10g,制首乌,15g,川芎,10g,相关研究（,1,）,Related study(1),加味左归丸治疗卵巢早衰继发性闭经,30,例,基本方,:,熟地,15g,淮山药,15g,山茱萸,10g,枸杞子,15g,菟丝子,15g,川牛膝,20g,鹿角胶,10g,炙龟板,10g,阿胶,6g,女贞子,15g,当归,15g,柴胡,10g,。,面色萎黄,神疲乏力,脉细弱者,加黄芪,30g,党参,15g;,胸胁胀闷,脉弦细者,加制香附,15g,广郁金,15g;,纳食不香,脾运不健者,加焦山楂,15g,六神曲,15g,茯苓,15g,。,3,个月为,1,个疗程。,1,个疗程后,痊愈,15,例,好转,13,例,无效,2,例,总有效率,93.33%,。,30 patients with secondary amenorrhea were treated by Zuogui pill.One course of treatment every 3 months.15 patients were recovery after One course of treatment,13 cases were improved and 2 ones useless.Its total effective rate is 93.33%.,(,朱也君,2008),相关研究（,2,）,Related study(2),免疫性,POF,小鼠卵巢间质可见淋巴细胞浸润,外周血,FSH,升高,E2,下降,AoAb,阳性,卵母细胞生长分化因子,-9,（,growth and differentiation factor-9,GDF-9,）,mRNA,阳性细胞数减少,生长卵泡及成熟卵泡数减少。左归丸能减缓,POF,小鼠外周血,FSH,升高,提高体内,E2,水平,抑制,AoAb,产生,提高卵母细胞,GDF-9 mRNA,阳性细胞数,使生长卵泡及成熟卵泡数增加,早期用药比后期用药作用显著。,Ovarian interstitial of the immune POF(growth and differentiation factor-9,GDF-9)mice occurred lymphocytes infiltration.The positive cell number of GDF-9 mRNA of oocytes decreased.The growing follicles and mature follicles decreased obviously.ZuoGui Pill could normal the increase of FSH and the decrease of E2,，,inhibit the produce of AoAb,rise the positive cell number of GDF-9 mRNA of oocytes,increase the number of growing follicles and mature follicles,release the damages of ovarian inflammation.It can treat immune premature ovarian failure.,相关研究（,3,）,Related study(3),免疫性,POF,小鼠卵巢小卵泡、间质,FasL,表达均明显增强,Bcl-2,表达减弱，,Bax,表达增强，卵泡颗粒细胞凋亡率增高，颗粒细胞线粒体嵴排列紊乱、空泡化，卵泡膜细胞形态失常，颗粒细胞凋亡，卵母细胞透明带厚薄不匀，卵泡凋亡过度，卵巢衰竭。左归丸小鼠小卵泡,FasL,表达减弱，卵泡过度凋亡受到抑制，卵巢功能得以保护。,The,expression of Fas,protein,in great,folliculus,and small ones decreased obviously in POF mice.,The,expression of,FasL,protein,in small,folliculus,and stroma increased obviously in model mice.,The,expression of Fas,protein,in great,folliculus,and small ones increased obviously in the mice of different dosage ZGP.,The,expression of Fas,protein,increased in stroma but the,expression of FasL,protein,decreased in small,folliculus,in the mice of low dosage ZGP.,The,expression of Fas,protein,in stroma also increased obviously in the mice of high dosage ZGP.,The difference,s,were significant,compared with the model mice.,温肾补脾（阴中求阳），疏肝养血活血,Warming the kidney and spleen,disperse the depressed liver-energy(,tonifying and promoting blood flow,钟某，,30,岁，已婚，,2003,年,4,月,18,日初诊。,月经稀发,1,年余，停经,2,月。患者,1,年前因怀孕,50,天行人工流产，术后出现月经稀发，经用西药行人工周期后月经来潮，停人工周期,2,月则停经，末次月经为,2,月,17,日，孕,2,产,1,人流,1,。现症见腰膝酸软，怕冷，阴道干涩，性欲淡漠，纳差，二便调，舌质淡红、苔白，脉弦细。,内分泌示,:FSH,：,47.7IU/L,，,LH,：,23.14IU/L,，,PRL,：,5.8p,g/L,，,E2,：,230pmoL/L,P,：,3.879nmoL/L,T,：,1.09nmoL/L,。,诊断,：卵巢早衰。,辨证：脾肾亏虚，肝郁血疲，胞宫失养,.,治法,：补肾健脾，疏肝养血活血。,党参,30g,菟丝子、何首乌各,20g,，仙灵脾、当归、川芎、仙茅、柴胡各,1Og,，肉苁蓉、熟地黄、黄芪、白芍各,15g,。,守方加减治疗,4,月后，月经来潮、量少，自觉阴道分泌物渐增多，性欲较前好转。,复查,:FSH 22.87IU/L,LH 9.10IU/L,E2 399pmoL/L,，继续治疗,2,月，月经规律来潮，量可，,4-5,天干净。检测,BBT,呈双相。,二仙汤加味治疗卵巢早衰,42,例临床观察,42 patients with secondary amenorrhea were treated by Erxian soup,药物组成,:,仙茅、仙灵脾、巴戟天、知母、当归、黄柏、牡丹皮、黄精各,15g,紫草,30g,。,服药,3,月为,1,个疗程,治疗结束,3,个月后作内分泌检查,(FSH,、,E2,、,LH,等,),及阴道超声。,治愈,14,例,好转,19,例,未愈,9,例,总有效率为,78.5%,。,E2,、,FSH,、,LH,治疗后明显改善,与治疗前相比,差异有显著意义,(P0.05),。治疗后临床症状总改善率为,77%,差异有显著意义,(P0.05),（段玮玮等，,2008,年）,One course of treatment every 3 months.14 patients were recovery after treatment,19cases were improved and 2 useless.Its total effective rate is 78.5%.,二仙汤加味治疗卵巢早衰,42,例临床观察,42 patients with secondary amenorrhea were treated by Erxian soup,加减,:,烦躁、焦虑者：加柴胡、郁金、莲子，,失眠者：加酸枣仁、合欢皮、夜交藤,记忆力减退者：加石菖蒲,头晕者：加天麻、钩藤、石决明、白芍,头痛：加川芎、白芷,汗出尤剧者：加浮小麦、糯稻根、生牡蛎,五心烦热者：加生地黄、龟板、地骨皮,气短乏力者：加党参、黄芪,心悸者可：加龙骨、丹参、茯神。,相关研究,Related study,现代药理 研究表明,the study at now indicate,：,仙茅,中含有的仙茅苷成分,能增强机体的免疫机能；,There is curculigoside in curculiginis rhizoma,which can increase the immune ability.,淫羊藿（仙灵脾）,具有雌激素样作用,可使雌性大鼠卵巢、子宫增重,使雄性大鼠睾酮分泌增加,;,Epimedium has the function like estrogen.This weight ovaries and uterum.Promoting the secrete of testosterone,相关研究,Related study,巴戟天,含有维生素,E,而有增强卵巢功能、抗衰老的作用,;,There is vitamin E in morinda root,which promotes the functions of ovaries and antidotal.,当归,具有兴奋子宫及抗维生素,E,缺乏的作用,并能增加肝组织的耗氧量,;,angelica root can excite uterum and normal low vitamin E.,紫草,虽为凉血之品,但具有抑制脑垂体促性腺激素分泌的作用,对妇女围绝经期由于卵巢功能减退,失去对脑垂体功能的反馈抑制,导致促性腺激素分泌增加所出现的围绝经期综合征具有较好的疗效。,Lithospermi radix normal the secretion of Gn.,针灸,(1)acupuncture and moxibustion,主穴,：,关元、中极、大赫、子宫、肾俞,及胸,5-,腰,4,夹脊穴,肝肾阴虚者：加三阴交、,阴陵泉、肝,俞,、,阴郄、复溜、太溪。,脾肾阳虚,者：加脾俞、命门、地机。,手法,：补法,先用指弹进针,得气后留针,20,分钟。脾肾阳虚者温针灸，出针后背俞及夹脊穴拔火罐,5,10,分钟。,疗程,：,20,次为,1,疗程、休息,5,7,天进行下,1,疗程，,6,个疗程为限。,结果,：,84,例,POF,患者总有效率达,90.4%,。,main point,：,Guanyuan,，,Zh