1、,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 ZhuDepartment 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
2、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 f
3、unds 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
4、(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 freque
5、nt 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 iatrogen
6、ic 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
7、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
8、.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
9、, stagnation of liver-qi and blood stasis,卵巢早衰证候特点characteristic of syndrome of POF (1),（滕秀香，2008年4月）,卵巢早衰证候特点characteristic of syndrome of POF (2),（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s
10、exual 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
11、干涩vaginal unsmooth 润滑（17例/20例，85%）腰膝酸软（16例/20例，80%）烦燥restlessness（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-
12、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 prom
13、oting 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 woman
14、s 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。S
15、he 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。G1P1Thin, insomnia, dreamful sleep ,restlessness, eye sockets dim.
16、 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
17、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
18、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:
19、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
20、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-ener
21、gy 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 restl
22、essness, 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
23、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. Re
24、moved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
25、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
26、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 less
27、en 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，
28、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15g25/8二诊：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：LM
29、P：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6g13/10 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 blo
30、od 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30g22/11六诊：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
31、/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
32、。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）Rela
33、ted 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,
34、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 o
35、f 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
36、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 follicu
37、lus 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 o
38、f high dosage ZGP. The differences 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
39、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 9.10
40、IU/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
41、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
42、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
43、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;
44、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：
45、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510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，Zhongji， Dahe，uterus，Shenshu, hepatic and renal yin deficiency: add Sanyinjiao, Yinlingquan, Ganshu(Liver Shu), Yinxi, Fuliu. Taixiasdthenic splenonephro-yang: add Pishu, Mingmen,
46、 Dijireinforcing method. Keeping 20 minutes. Every 20 is a course of treatment. Take a rest for 5-7days between two course of treatment. Not exceed 6 course of treatment.（沙桂娥等，1998年）,针灸（2-1） acupuncture and moxibustion,取穴：A组：关元、归来、子宫、中极、三阴交、足三里、血海、太冲、太溪。 B组:隔俞、肝俞、脾俞、肾俞、关元俞。两组穴位交替 使用。手法：关元、三阴交、太溪、肾俞、
47、关元俞用补法,其余平补平泻法,得气后留针30min,每隔10min行针1次,阳虚者加以温针灸,隔日1次。关元、太溪、肾俞、关元俞：补肾气、滋肾阴,足三里、脾俞、肝俞、太冲：健脾疏肝,三阴交：补肾健脾疏肝,归来、子宫、中极：养血活血,功效：补肾健脾、疏肝活血之功。main point：Acupoints A:Guanyuan，Guilai, uterus，Zhongji， Sanyinjiao, Zhusanli, Taichong, Taixi Acupoints B:Geshu， Ganshu(Liver Shu), Pishu, Shenshu, Guanyuanshu ，Above tw
48、o acupoints can be used alternately,针灸（2-2）,疗程：3个月为1疗程, 2个疗程为限,每疗程之间休息1周。结果：60例卵巢早衰者治愈13例（月经恢复正常,兼症消失,血清FSH、LH、E2正常）；好转14例（月经间断来潮,兼症改善,血清FSH、LH、E2接近正常）,未愈3例（月经始终未潮,兼症依然,血清FSH、LH、E2无较大改变）,总有效率为90%。（杨晓虹等，2008年）,针灸（3）,归肾丸合热敏灸治疗卵巢早衰32例，痊愈8例,显效9例,有效10例,无效5例,总有效率为86.50% 。归肾丸方剂组成:熟地、淮山各30g,枸杞子、菟丝子各20g,当归、川
49、芎、香附、杜仲、山萸肉、茯苓、巴戟天、制首乌、黑芝麻各12gMoxibustion points, which is temperature sensitive , combined with Guishen Pill treat 32 patients with POF, 8 patients were recovery after treatment,19 cases were improved and 5 useless. Its total effective rate is 86.5 %. （蒋贵林等，2007年） 归肾丸能使POF大鼠 LH 含量降低, 使 E2 含量升高。卵巢组织形态学观察可见归肾丸能明显改善病理状态下大鼠卵巢的形态结构和功能。（张军武,2008年),
