Study on Addition and Subtraction Syndrome Differentiation Method of Huanglian Ejiaotang and Baihe Dihuangtang in Regulation of Neuroendocrine Network for Menopausal Syndrome / 中国实验方剂学杂志

ABSTRACT

Objective:To observe the clinical efficacy of addition and subtraction syndrome differentiation method of Huanglian Ejiaotang and Baihe Dihuangtang in the treatment of menopausal syndrome （MPS） and symptoms of deficiency of yin and hyperactivity of fire， and investigate its regulation effects on neuroendocrine network. Method:One hundred and forty-eight patients were divided into control group （74 cases） and observation group （74 cases） according to the random number table method. The patients in control group received estradiol/norethisterone acetate tablets， 3 mg/time， 1 time/day， while the patients in observation group received addition and subtraction of Huanglian Ejiaotang and Baihe Dihuangtang based on the same western medicine treatment as control group， orally 1 dose/day， with a treatment course of 3 months in both groups. Kupperman index （KI） score was evaluated before treatment and at 1 month， 2 months and 3 months after treatment. The Menopausal Quality of Life （MENQOL）， self-rating depression scale （SDS）， Self-rating Anxiety Scale （SAS）， Pittsburgh Sleep Quality Index （PSQI） and score of deficiency of yin and hyperactivity of fire were evaluated before and after treatment. The levels of serum estradiol （E2）， follicle stimulating hormone （FSH）， luteinizing hormone （LH）， norepinephrine （NE）， 5-hydroxytryptamine （5-HT）， nitric oxide （NO）， endothelin-1 （ET-1） and calcitonin gene-related peptide （CGRP） were detected before and after treatment. Result:The clinical efficacy in observation group was better than that in control group （Z=2.115， P<0.05）， and the KI scores in observation group at 1 month， 2 months and 3 months after treatment were lower than those in control group （P<0.01）， and the decrease of KI score in observation group after treatment was larger than that in control group （P<0.01）. The scores of various dimensions of MENQOL scale in observation group were lower than those in control group （P<0.01）. The scores of deficiency of yin and hyperactivity of fire， SAS， SDS and PSQI in observation group were all lower than those in control group （P<0.01）， and the level of E2 in observation group after treatment was higher than that in control group （P<0.01） ，while the levels of FSH and LH were lower than those in control group （P<0.01）.The levels of 5-HT and NE in observation group were higher than those in control group （P<0.01）.The NO level in observation group was higher than that in control group （P<0.01）， while the levels of CGRP and ET-1 were lower than those in control group （P<0.01）. During the study period， there were 5 drop-out cases， 2 excluded cases， and 67 completed cases in the control group. There were 7 drop-out cases， 1 excluded case， 66 completed cases in the observation group. Conclusion:On the basis of hormone replacement therapy， addition and subtraction of Huanglian Ejiaotang and Baihe Dihuangtang for patients with MPS （with symptom of deficiency of yin and hyperactivity of fire） can improve clinical symptoms， relieve depression and anxiety， improve sleep quality and enhance quality of life， and its clinical efficacy is superior to hormone replacement therapy alone. It can also regulate endocrine hormones， vasomotor factors and monoamine neurotransmitters， thereby improving clinical symptoms.