Objective: To observe the effect of electroacupuncture (EA) combined with Yuyin pill on clinical symptoms, levels of serum sex hormone and Th2 cytokines in patients of decreased ovarian reserve function (DOR) with liver-kidney yin deficiency, and to compare the efficacy between EA combined with Yuyin pill and Yuyin pill alone.
Methods: Sixty patients with DOR were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 1 case dropped off). The patients in the control group were treated with Yuyin pill, 1 pill each time, 3 times a day. Based on the treatment of the control group, the patients in the observation group were additionally treated with acupuncture at Guanyuan (CV 4), Zhongji (CV 3), Guilai (ST 29), Zigong (EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3); EA was applied at bilateral Zusanli (ST 36) and Sanyinjiao (SP 6), with continuous wave, in frequency of 20 Hz and current intensity of 1 to 4 mA, for 20 min. The treatment was given 3 times a week. All the patients terminated treatment during menstrual period, and the treatment was given for 3 continuous menstrual cycles. The menstrual condition score and systemic symptom score were compared between the two groups before and after treatment. The levels of serum sex hormones on 2nd to 3rd day of menstruation, including follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), and the serums levels of interleukin (IL) -4 and IL-10 secreted by Th2 cytokines were compared between the two groups before and after treatment.
Results: After the treatment, the menstruation condition scores and systemic symptom scores in the two groups were reduced (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). After the treatment, the levels of serum FSH, LH and FSH/LH were reduced (P<0.05), and the E2 levels were increased in the two groups (P<0.05), and the levels of FSH, LH in the observation group were lower than those in the control group (P<0.05), and the E2 level was higher than that in the control group (P<0.05). After the treatment, the levels of serum IL-4 and IL-10 in the two groups were increased (P<0.05), and the levels of IL-4 and IL-10 in the observation group were higher than those in the control group (P<0.05).
Conclusion: EA combined with Yuyin pill could significantly improve menstruation, systemic symptoms and serum sex hormone levels in patients of decreased ovarian reserve function with liver-kidney yin deficiency, which may restore ovarian function by up-regulating the expression of Th2 cytokines.
目的：观察电针联合育阴丸对肝肾阴虚型卵巢储备功能下降（DOR）患者临床症状、血清性激素水平及Th2型细胞因子水平的影响，比较电针联合育阴丸与单纯育阴丸的疗效。方法：60例DOR患者随机分为观察组（30例，脱落2例）和对照组（30例，脱落1例）。对照组口服育阴丸治疗，每次1丸，每日 3次。观察组在对照组的基础上加用针刺治疗，穴取关元、中极、归来、子宫、足三里、三阴交、太溪、太冲，双侧足三里、三阴交连接电针仪，连续波，频率20 Hz，电流强度1~4 mA，留针20 min，每周治疗3次。两组患者均经期停止治疗，连续治疗3个月经周期。比较两组患者治疗前后月经情况评分及全身症状评分，月经来潮第2~3天血清性激素包括卵泡刺激素（FSH）、黄体生成素（LH）和雌二醇（E2）水平，及Th2型细胞分泌的白介素（IL）-4、IL-10水平变化。结果：两组患者治疗后月经情况及全身症状评分均较治疗前降低（P<0.05），且治疗后观察组评分均低于对照组（P<0.05）。两组患者治疗后血清FSH、LH、FSH/LH水平均较治疗前降低（P<0.05），E2水平较治疗前升高（P<0.05）；且观察组治疗后FSH、LH低于对照组（P<0.05），E2水平高于对照组（P<0.05）。两组患者治疗后血清IL-4、IL-10水平均较治疗前升高（P<0.05），且观察组IL-4、IL-10水平高于对照组（P<0.05）。结论：电针联合育阴丸可显著改善肝肾阴虚型卵巢储备功能下降患者月经情况、全身症状及血清性激素水平，疗效优于单纯育阴丸，其可能通过提升患者血清Th2型细胞因子的表达而恢复卵巢功能。.
Keywords: decreased ovarian reserve function (DOR); electroacupuncture; interleukin-10 (IL-10); interleukin-4 (IL-4); sex hormone.