Treatment Of Perimenopausal Syndrome Research Articles

Non-targeted metabolomics strategy reveals the role of Geng-Nian-Shu in regulating ferroptosis in perimenopausal syndrome

Ovariectomy (OVX) is usually accompanied by the occurrence of metabolic syndrome. Previous studies have shown that Geng-Nian-Shu (GNS) plays an important regulatory role in perimenopausal syndrome (PMS) rats. GNS is a traditional Chinese medicine (TCM) prescription which composed of Suanzaoren Decoction and Ganmai Dazao Decoction in "Jingui Yaolue" and Siwu Decoction in "Heji Jufang". Recently, metabolomics analysis has been used to identify slight changes in the metabolic profile and to help understand disease progression and therapeutic interventions in PMS. However, the mechanism of GNS in the treatment of PMS is still unknown. We purposed to study the metabolic characteristics of PMS by serum and fecal metabolomics, and revealed the internal mechanism of GNS regulating ferroptosis against PMS. The PMS model was established by surgical removal of 4/5 ovaries of rats. HPLC-Q-TOF/MS was used to analyze the metabolomics of rat plasma and feces to explore the potential mechanism of GNS in PMS. The expression of ferroptosis-related proteins in rat ovaries was detected by tissue Prussian blue staining, Elisa kit and Western blotting. Cluster analysis of differential metabolites in plasma and feces between the control group and the model group showed that organic acids and their derivatives, lipids and lipid molecules were mainly disturbed during PMS in rats. After GNS administration, 17 differential metabolites were adjusted, involving several major pathways, such as the tricarboxylic acid (TCA) cycle, biosynthesis of amino acids and biosynthesis of unsaturated fatty acids. Further, we found that GNS affected ferroptosis in ovarian cells by regulating endogenous substances in OVX rats. Our study provides new insights into the mechanism of OVX-induced metabolic syndrome based on non-targeted metabolomics. It provides new ideas for the development and application of GNS and the diagnosis and treatment of PMS.

Advances in diagnosis and treatment of perimenopausal syndrome.

With the development and progress of society, people's average life expectancy has increased, and relevant literature reports that the number of postmenopausal women in China continues to increase. With lifespans extended, the transition period and post-menopause period have become the longest essential period in every woman's life. The life quality of women troubled by perimenopausal syndrome has been significantly reduced, which also places a burden on families and society. It is well known that hormone replacement therapy plays a vital role in improving women's menopause-related symptoms and is the most effective medical measure. With research ongoing into the treatment of menopausal symptoms in different patients, dose size, treatment duration, and medication regimens for hormones are still hot topics of discussion. This article reviews the definition, clinical diagnosis, staging, clinical manifestations, and treatment of menopause and explores the current diagnosis and treatment scenarios of perimenopausal syndrome.

Biomarkers based on multiplatform comprehensive analysis: A systematic analysis of Geng-Nian-Shu in perimenopausal syndrome.

Although Geng-Nian-Shu has been shown to be clinically effective in perimenopausal syndrome, its active components and mechanism have not yet been elucidated. To demonstrate the mechanism-based biomarkers of Geng-Nian-Shu in treating perimenopausal syndrome, a total of 135 chemical constituents including 52 prototype blood constituents were identified via high-performance liquid chromatography-quadrupole-time of flight/mass spectrometry. Then, network pharmacology showed significant enrichment for the PhosphoInositide-3 Kinase/Akt pathway, suggesting that it may be the main regulatory pathway for the Geng-Nian-Shu treatment of the perimenopausal syndrome. Subsequently, multivariate analysis was performed between the Geng-Nian-Shu sham-treated and Geng-Nian-Shu ovariectomy-treated groups and further screened out 18 prototype blood constituents by correlation analysis with plasma estrogen levels to identify potential biomarkers associated with Geng-Nian-Shu treat the ovariectomy-induced perimenopausal syndrome. Finally, the results of pharmacological experimental verification and Pearson correlation analysis indicated that catalpol, ligustilide, paeoniflorin, and gallic acid were selected as biomarkers of Geng-Nian-Shu which were strongly and positively correlated with PhosphoInositide-3 Kinase/Akt signaling pathway. In this study, based on high-performance liquid chromatography-quadrupole-time of flight/mass spectrometry combined with pharmacodynamics, network pharmacology, pharmacology, and other disciplines, we explored the effects and mechanisms of Geng-Nian-Shu in the treatment of perimenopausal syndrome at multiple levels. Using multiplatform technology to investigate the role of Geng-Nian-Shu represents a new strategy for the selection and verification of biomarkers of Geng-Nian-Shu and provides a basis for further development and utilization of Geng-Nian-Shu.

Effects of acupoint application therapy combined with chinese herbal medicine on perimenopausal syndrome: A systematic review and meta-analysis of randomized controlled trails

BackgroundAn increasing number of women suffer from perimenopausal syndrome (PMS) and the global burden of this disease has been steadily rising. Acupoint application therapy and Chinese herbal medicine (CHM) are widely used as effective methods for treating PMS, but the efficacy was inconsistent and the evidence should be summarized by quantitively analysis. ObjectiveThe purpose of this systematic review and meta-analysis was to evaluate the clinical efficacy and safety of the acupoint application combined with the CHM for the treatment of PMS. MethodsWe searched eight databases from their inception to August 2022 to identify relevant studies. Only randomized controlled trials (RCTs) focusing on acupoint application combined with CHM for the treatment of PMS were included in this study. To assess the clinical efficacy and safety, meta-analysis was used to quantitively synthesize the effect estimates. Subgroup analysis, publication bias assessment and sensitivity analysis were also performed. We further assessed whether the included studies had reported on the purity and potency of the CHM used in their trials. ResultsA total of 8 RCTs with 560 participants were included in the systematic review and meta-analysis, of which none of them included a description of an independent testing of purity or potency of the CHM product used. There were significant differences between the acupoint application combined with CHM and CHM alone in terms of Kupperman Menopausal Index (KMI) score (MD = –2.91, 95%CI: –3.91 to –1.91), total effective rate (RR = 1.22, 95% CI: 1.11–1.34), Pittsburgh Sleep Quality Interview (PSQI) score (MD = –2.86, 95% CI: –3.61 to –2.10) and reduction in the serum level of luteinizing hormone (LH) (MD = –2.52, 95% CI: –4.70 to –0.34), whereas there were no differences between the two groups regarding lowering serum level of follicle-stimulating hormone (FSH) (MD = –1.66, 95% CI: –3.98–0.67) and elevating serum level of oestradiol (E2) (MD = 2.41, 95% CI: –0.70–5.52). For the comparation between the acupoint application combined with CHM and western medicine (WM), the KMI score (MD = –6.80, 95%CI: –7.95 to –5.65) was substantially different, while the PSQI score (MD = –0.60, 95% CI: –1.88–0.68) was not substantially different. The total effective rate in the combined group (91.7%) was higher than the western medicine group (83.49%). ConclusionAcupoint application combined with CHM may enhance the efficacy and safety of patients with PMS. However, due to the lack of description of an independent testing of purity or potency of the CHM product used in the trials, as well as blinding of participants and investigators, these results should be interpreted with caution.

Efficacy, safety and mechanism of Honghua Xiaoyao Pill in the treatment of peri-menopausal syndrome: A study protocol for a randomized controlled trial.

Background: Peri-menopausal syndrome (PMPS) has a high incidence rate and seriously affects the physical and mental health of women. Honghua Xiaoyao Pill (HHXYP) is a Chinese patent medicine, which has been reported to be used to treat PMPS. However, there is still a lack of randomized clinical trial to evaluate the efficacy and safety of HHXYP on life quality, mood and vasomotor symptoms for PMPS women. This study aims to investigate whether HHXYP is effective and safe in treating PMPS and the possible mechanism. Methods: A multicenter, randomized, controlled clinical trial will be conducted in China to evaluate the efficacy and safety of HHXYP. Sixty women with peri-menopausal syndrome will be recruited at three centers and randomly in a 1:1 ratio to a treatment group using HHXYP (HHXYP group) and a control group using oryzanol (OC group). Participants will be treated with HHXYP or oryzanol for 12 weeks and followed up for 4 weeks. The primary outcome is the modified Kupperman Index (KI), which will be measured at baseline and 4, 8, 12, 16 weeks after randomization. The secondary outcomes include Hot flash scale (HFs), Menopause-Specific Quality of Life Scale (MENQOL) and Hamilton Depression/Anxiety Scale (HAMD/HAMA). The HFs are measured at the same point as the KI, other secondary outcomes are measured at baseline and 12, 16 weeks after randomization. The other outcomes are the levels of serum sex hormone, monoamine neurotransmitter, vascular vasomotor factor and the expression of phosphatidylinositol 3-active enzyme (PI3K)/protein activator enzyme B (Akt), which will be measured at baseline and 12 weeks after randomization. Adverse events will also be reported. Discussion: HHXYP is a potential alternative Chinese patent medicine for PMPS. This trial will provide evidence for HHXYP on improving the quality of life, mood and vasomotor symptoms, and sex hormone levels of PMPS patients.

The Efficacy of Warm Bile Soup in the Treatment of Perimenopausal Syndrome and Its Impact on Quality of Life

The Efficacy of Warm Bile Soup in the Treatment of Perimenopausal Syndrome and Its Impact on Quality of Life

Electroacupuncture for the treatment of perimenopausal syndrome: a systematic review and meta-analysis of randomized controlled trials.

To assess the efficacy, comparative effectiveness and safety of electroacupuncture (EA) in the treatment of perimenopausal syndrome (PMS). Nine databases were searched until June 2019. Only relevant randomized controlled trials (RCTs) of EA for PMS were included. Twelve trials involving 746 women were included. EA and hormone therapy (HT) did not significantly differ in terms of effective rate (risk ratio (RR) = 0.98, 95% confidence interval (CI) = 0.93 to 1.04), Kupperman index (KI) (mean difference (MD) = -0.25, 95% CI = -0.76 to 0.26) and serum levels of follicle-stimulating hormone (FSH) (MD = -3.80, 95% CI = -11.59 to 3.98) or luteinizing hormone (LH) (MD = -2.51, 95% CI = -10.72 to 5.70). Serum estradiol (E2) levels were significantly lower in EA versus HT groups (MD = -60.58, 95% CI = -71.93 to -49.23). Compared with sham EA, EA had a significantly greater effect on reductions in KI (MD = -4.71, 95% CI = -6.57 to -2.86) and hot flushes score/24 h (MD = -2.43, 95% CI = -2.93 to -1.93). There were no significant differences between EA and manual acupuncture (MA) in terms of effective rate (RR = 1.14, 95% CI = 0.98 to 1.33) or serum FSH (MD = -2.87, 95% CI = -29.65 to 23.91), LH (MD = 2.73, 95% CI = -9.65 to 15.11) or E2 (MD = 26.80, 95% CI = -12.06 to 65.65). However, it seemed that EA had a better effect than MA on KI (MD = -2.44, 95% CI = -4.80 to -0.08). Subgroup analyses indicated that EA may have more of a benefit in the pre-menopausal state (hot flushes score/24 h: MD = -1.66, 95% CI = -3.49 to 0.17) compared to post-menopause (p > 0.05). The effect of EA appeared broadly similar to HT and MA in the treatment of PMS, although EA-associated reductions in KI were superior to MA and sham EA, suggesting effects beyond placebo. The evidence base is limited by a small number of eligible studies, risk of bias and clinical/statistical heterogeneity, limiting our ability to draw firm conclusions. As such, additional larger scale, high-quality RCTs are needed.

An Effective Treatment of Perimenopausal Syndrome by Combining Two Traditional Prescriptions of Chinese Botanical Drugs.

Ethnopharmacological relevance: Two types of traditional Chinese formulas of botanical drugs are prescribed for treating perimenopausal syndrome (PMS), a disorder in middle-aged women during their transition to menopause. One is for treating PMS as kidney deficiency (KD) due to senescence and declining reproductive functions, and the other is for treating it as liver qi stagnation (LQS) in association with stress and anxiety. Despite the time-tested prescriptions, an objective attestation to the effectiveness of the traditional Chinese treatment of PMS is still to be established and the associated molecular mechanism is still to be investigated. Materials and methods: A model for PMS was generated from perimenopausal rats with chronic restraint stress (CRS). The effectiveness of traditional Chinese formulas of botanical drugs and a combination of two of the formulas was evaluated based on 1H NMR plasma metabolomic, as well as behavioral and physiological, indicators. To investigate whether the formulas contained ligands that could compensate for the declining level of estrogen, the primary cause of PMS, the ligand-based NMR technique of saturation transfer difference (STD) was employed to detect possible interacting molecules to estrogen receptors in the decoction. Results: Each prescription of the classical Chinese formula moderately attenuated the metabolomic state of the disease model. The best treatment strategy however was to combine two traditional Chinese formulas, each for a different etiology, to adjust the metabolomic state of the disease model to that of rats at a much younger age. In addition, this attenuation of the metabolomics of the disease model was by neither upregulating the estrogen level nor supplementing an estrogenic compound. Conclusion: Treatment of PMS with a traditional Chinese formula of botanical drugs targeting one of the two causes separately could ameliorate the disorder moderately. However, the best outcome was to treat the two causes simultaneously with a decoction that combined ingredients from two traditional prescriptions. The data also implicated a new paradigm for phytotherapy of PMS as the prescribed decoctions contained no interacting compound to modulate the activity of estrogen receptors, in contrast to the treatment strategy of hormone replacement therapy.

[Overview of systematic reviews on Kuntai Capsules in treatment of perimenopausal syndrome].

To evaluate the efficacy and safety of Kuntai Capsules in the treatment of perimenopausal syndrome. Systematic reviews on Kuntai Capsules in the treatment of perimenopausal syndrome were retrieved from Chinese and English databases from database establishment to August 31, 2020. AMSTER-2 scale, GRADE scale and ROBIS tools were used respectively to evaluate the methodological quality, evidence quality level and bias risk of the finally included systematic reviews. A total of 6 systematic reviews with 28 outcome indicators were included. The results of AMSTER-2 methodological quality assessment showed that one of the six systematic reviews was of low quality, and the other five were of extremely low quality. GRADE scale showed that 28 clinical outcome indicators were evaluated, three of which were intermediate-level ones, and the rest were low-level or very low-level ones. Two evidences of the three intermediate evidences were total efficiency, and the other intermediate evidence was Kupperman score. ROBIS bias risk assessment showed all the included studies were of high risk. The results showed that, Kuntai Capsules were effective in the treatment of perimenopausal symptoms, such as hot flashes and sweating. The improvement of E_2 level was not as good as that in the menopause hormone therapy group, but the incidence of adverse reactions was lower than that in the menopause hormone therapy group. However, the quality of evidence needs to be improved due to the low quality of methodology and high risk of bias. It is suggested that systematic review and reasonable design should be carried out in the future, and attention should be paid to the registration of research schemes. In addition, the research reports shall be prepared according to PRISMA statement.

Application of multivariate statistical analysis and network pharmacology to explore the mechanism of Danggui Liuhuang Tang in treating perimenopausal syndrome

Ethnopharmacological relevanceDanggui Liuhuang Tang (DGLHT), first recorded in “Lan-Shi-Mi-Cang” (written in 1276 AD), is a famous classical formula. In 2018, it was listed in the Catalogue of Ancient Classic and Famous Prescriptions (First Batch) formulated by the National Administration of Traditional Chinese Medicine and the National Medical Products Administration. Perimenopausal syndrome (PMS) refers to a series of syndromes with autonomic nervous system dysfunction and neuropsychological symptoms. The treatment of PMS demands non-hormonal drugs. Natural products are considered to be effective substitutes for the treatment of PMS. It is reported that DGLHT has not only good therapeutic effects but also higher safety and fewer side effects in the treatment of PMS. However, the mechanism of DGLHT in treating PMS is not clear. Aim of the studyTo explore the chemical basis and the mechanism of DGLHT in treating PMS. Materials and methodsMultivariate statistical analysis was used to analyze the difference of components in supernatant before and after compatibility of DGLHT based on LC-MS data. The qualitative analysis was performed on the precipitate formed in the decocting process using LC-MS while the quantitative analysis on the potential markers using LC-UV. Then, the potential markers were analyzed by network pharmacology. The regulatory effect of DGLHT on FSH, P and E2 were carried out in PMS rats. ResultsFive potential markers, epiberberine, coptisine, palmatine, berberine and baicalin, were screened from the analysis of compounds in the supernatant. Four complexes, composed of potential marker monomers, were identified in the sediment, including two that have not been reported. The key targets of potential markers include TNF, NOS3, EGFR, ESR1, PTGS2, AR, CDC42 and RPS6KB1. The top signaling pathways include the cGMP-PKG signaling pathway, PI3K-Akt signaling pathway and estrogen signaling pathway. DGLHT could call back the hormone levels of P and E2 in PMS rats. ConclusionDGLHT active ingredients, epiberberine, coptisine, palmatine, berberine and baicalin contribute a lot to the therapeutic effect. And DGLHT takes effect by regulating hormones secreted by the ovary.

[Research progress and thinking on the mechanism of acupuncture in treatment of perimenopausal syndrome].

The potential effect mechanism of acupuncture for perimenopausal syndrome is analyzed and summarized from five aspects, i.e. the influence on reproductive endocrine system, the regulation on nervous system, the improvement of immune function, the intervention on free radical metabolism and the regulation of adverse emotions. It is believed the mechanism research of acupuncture in the treatment of perimenopausal syndrome should be deepened in terms of acupoint specificity and the influence of acupoint compatibility based on the characteristics of acupuncture therapy itself. In clinic, the research on therapeuticmethods and treatment frequency should be enhanced.

Scraping therapy for treating the perimenopausal syndrome: 刮痧治疗围绝经期综合征

To evaluate the clinical effect of scraping therapy in the treatment of perimenopausal syndrome (PMS). Thirty recruited PMS subjects were treated with scraping therapy in the Outpatient Department, Acupuncture-Moxibustion Hospital, China Academy of Chinese Medical Sciences, at the areas including Shéntíng (神庭GV24)—Bǎihuì (百会GV20), Qìhǎi (气海CV6)—Guānyuán (关元CV4), Zǐgōng (子宫EX-CA1), Zúsānlǐ (足三里ST36)—Xiàjùxū (下巨虚ST39), Dìjī (地机SP8)—Sányīnjiāo (三阴交SP6), Tàichōng (太冲LR3)—Xíngjiān (行间LR2), Gānshū (肝俞BL18)—Dǎnshū (胆俞BL19), Píshū (脾俞BL20)—Wèishū (胃俞BL 21), and Sānjiāoshū (三焦俞BL 22)—Shènshū (肾俞BL 23), with an even reinforcing-reducing method. Before and after treatment, the serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were tested. And before treatment and at the 4th week, 8th week, and 12th week of treatment, the Kupperman index (KI) and menopause-specific quality of life questionnaire (MENQOL) symptom scores were recorded for evaluating the clinical efficacy. Comparing with before treatment, the modified Kupperman symptom scores were all decreased after treatment, the difference was statistically significant (P<0.05); all symptoms were relieved significantly after treatment, the difference was statistically significant (all P< 0.05). There was no significant difference in serum E2, FSH, and LH levels after treatment (all P>0.05); the total effective rate was 86% after the 4 weeks’ treatment, 97% after the 8 weeks’ treatment, and 96% after the 12 weeks’ treatment. scraping therapy can relieve the PMS symptoms to some extent. It can improve the life quality of PMS subjects. Its influence on the estrogen levels of PMS subjects was not obvious.

Effect of Kuntai Capsule Combined with Nilestriol Tablets in the Treatment of Perimenopausal Syndrome and on Reproductive Hormones

To investigate the efficacy of the Kuntai capsules combined with nilestriol tablets in the treatment of perimenopausal syndromes and on reproductive hormones, a total of 108 patients with perimenopausal syndromes detected by clinical diagnosis in the department of gynecology and obstetrics in Beijing Tongren Hospital were enrolled from January 2018 to June 2019. These clinical subjects were randomly divided into the observation group (n=54) and control group (n=54). The patients in the control group were treated with nilestriol 2 mg once every 2 w and the dosage was changed to 1 mg, twice a month after symptom improvement. The patients in the observation group were treated with oral Kuntai capsules in addition to nilesteriol, 4 each time, twice a day. Both groups were treated continuously for 3 mouths. The curative effect, clinical symptom score and reproductive hormone level before and after treatment were compared between the two groups. The results showed that the Kupperman menopause index and hot flush scores of both groups were significantly decreased from baseline levels. In the 3 mouths after treatment, the Kupperman menopause index in the observation group was lower than that in the control group (p=0.031), but there was no significant difference after 6 mouths (p=0.178). In the observation group, the hot flush score was significantly lower than that of the control group (p=0.05). The results showed that after treatment, the levels of reproductive hormones, follicle stimulating hormone, luteinizing hormone and testosterone and blood lipids, Triglyceride, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the two groups changed significantly compared to those before treatment. The levels of follicle stimulating hormone, luteinizing hormone, total cholesterol and lowdensity lipoprotein cholesterol in the observation group were lower than those in the control group, while the levels of serum estradiol and high-density lipoprotein cholesterol in the observation group were higher than those in the control group. Kuntai capsule may be a good alternative therapy for patients who have contraindication or concerns of hormone therapy.

The Efficacy and Safety of Modified Xiaoyao San for Perimenopausal Syndrome (PMS): A Systematic Review and Meta-Analysis

Objectives: To assess the efficacy and safety of modified Xiaoyao San (XYS) for treating Perimenopausal syndrome (PMS). Methods: Literature searches were carried out on PubMed, Cochrane Library, CNKI Database, Chinese Biomedical Literature Database, Wan Fang Database, and VIP Database up to December 2018. Hand search for further references was conducted. Study selection, data extraction, quality assessment, and data analyses were performed as request of the Cochrane standards. Results: Nine publications in total were suitable for inclusion. There was evidence that modified XYS was tested to be more effective in improving overall symptoms compared with HRT (odds ratio 3.50, 95% CI 2.56 to 4.78). Whereas HRT was more sensitive and direct in decreasing FSH (WMD 6.69, 95% CI 5.60 to 9.52) and LH (WMD 7.00, 95% CI, 5.75 to 8.25) in comparison with XYS group. It was also strongly supported that XYS had less adverse effect than HRT (odds ratio 0.07, 95% CI 0.05 to 0.10). Conclusion: Modified XYS might be more effective and safer in treatment of perimenopausal syndrome. However, due to poor methodological quality in the majority of included studies, the potential benefit and safety about XYS need to be confirmed in rigorously designed, multi-centre, and large-scale trials.

膏方治疗围绝经期综合征的优势及临床应用

膏方治疗围绝经期综合征的优势及临床应用

Acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome from 2007 to 2016

To discuss the acupoints selection pattern in acupuncture-moxibustion treatment of perimenopausal syndrome (PMS) from 2007 to 2016. Clinical literatures related to PMS treated with acupuncture-moxibustion published from 2007 to 2016 were collected from Chinese Biomedical Literature Database (CBM), Chongqing VIP Database (CQVIP), China National Knowledge Infrastructure (CNKI), and Wanfang Academic Journal Full-text Database (Wanfang). The retrieved data underwent descriptive analysis, cluster analysis and association pattern analysis to determine the acupoints selection principle in acupuncture-moxibustion treatment of PMS. The top five acupoints used in acupuncture-moxibustion treatment of PMS were Sanyinjiao (SP 6), Shenshu (BL 23), Guanyuan (CV 4), Baihui (GV 20), and Shenmen (HT 7). The leading 4 meridians were Bladder Meridian, Conception Vessel, Spleen Meridian, and Governor Vessel. The clustering analysis showed that the 5 core acupoint groups were: ① Sanyinjiao (SP 6); ② Shenshu (BL 23) and Guanyuan (CV 4); ③ Baihui (GV 20), Shenmen (HT 7), Zusanli (ST 36), Ganshu (BL 18) and Taichong (LR 3); ④ Taixi (KI 3), Pishu (BL 20), Xinshu (BL 15), Qihai (CV 6) and Neiguan (PC 6); ⑤ Sishencong (EX-HN 1), Zhongwan (CV 12), Hegu (LI 4), Yintang (GV 29), Fengchi (GB 20), Zhongji (CV 3) and Feishu (BL 13). The three most significant acupoints were Sanyinjiao (SP 6), Shenshu (BL 23) and Guanyuan (CV 4). Acupoint groups based on syndrome differentiation included: ① Hegu (LI 4), Zhongwan (CV 12) and Sishencong (EX-HN 1); ② Feishu (BL 13), Zhongji (CV 3), Fengchi (GB 20) and Yintang (GV 29); ③ Xinshu (BL 15), Pishu (BL 20), Qihai (CV 6), Neiguan (PC 6) and Taixi (KI 3); ④ Ganshu (BL 18), Zusanli (ST 36), Shenmen (HT 7), Taichong (LR 3) and Baihui (GV 20). The analysis of association pattern elaborated that Shenshu (BL 23) and Sanyinjiao (SP 6) won the highest support rate in the paired groups; Ganshu (BL 18), Shenshu (BL 23) and Sanyinjiao (SP 6) had the highest support rate among the acupoint groups. The data mining results of acupuncture-moxibustion treatment of PMS substantially conform to the general principle in traditional acupuncture-moxibustion theories, able to reflect the acupoints selection and grouping pattern and provide references for acupuncture-moxibustion treatment of PMS.

[Research progress in phytoestrogens of traditional Chinese medicine].

Phytoestrogens are plant-derived compounds, which have a similarity in structure with human endogenous estrogen 17-β-estradiol. Structural likeness enables phytoestrogens to interact with estrogen receptors, not simply mimicking the effects of human steroidal estrogen but also exhibiting similar and divergent actions. The global literature relating to phytoestrogen in recent years was systematically summarized in this paper. Chemical compositions of phytoestrogens were mainly flavonoids, coumarins, lignans, terpenoids, steroids, etc., with a character of prevention and treatment of perimenopausal syndrome, osteoporosis, cardiovascular disease, metabolic diseases, cancer, regulation of brain function and other pharmacological effects. The mechanisms of action mainly included classical estrogen receptor pathway, epigenetic effect, activation of 5'-adenosyl-phospho-activated protein kinase, inhibition of kinase, activation of peroxisome proliferator-activated receptor, regulation of apoptosis-related proteins, inhibition of nuclear factor κB signaling pathway and so on. According to their efficacy classification, phytoestrogens were mainly distributed in the tonifying medicines, blood-activating and stasis-resolving medicines and heat-clearing medicines. The classical prescriptions with estrogen activity included tonifying formula, Qi-regulating formula and harmonizing formula, etc. This review was aimed at providing a certain reference for the further study of phytoestrogens by researchers and clinicians.

Discussion on strategy of treatment of perimenopausal syndrome with Chinese and Western Medicine

Perimenopausal syndrome refers to a series of physical and mental symptoms ,caused by the fluctuation of the sex hormones in the menopause, which is one of the common diseases in gynecology. With the acceleration of the aging population ir the world, it has caused the world's attention. Modern medicine has developed rapidly in the field of basic theory and clinical research, but there are still some problems in the treatment. Clinical treatment is mainly in hormone replacement therapy, but there are some potential risks, adverse reactions and many contraindications, thereby reducing patients' compliance and tolerance. Traditional Chinese medicine under the guidance of the concept of wholism cure perimenopausal syndrome based on syndrome differentiation, which has unique advantages, such as a variety of ways, less side effect, curative effect, which was patients more and more welcome. It is very important for the study to explore the perimenopausal syndrome.

Diagnosis and treatment of perimenopausal syndrome

绝经是每个妇女生命进程中必然发生的生理过程.绝经表示卵巢功能衰退,生殖功能终止.卵巢功能衰退是一个渐进的过程,长期以来人们习惯用更年期(climacteric period)一词来描述这一渐进的变更期,但其确切的定义始终比较含糊。

Clinical efficacy analysis on treatment of peri-menopausal syndrome with electroacpuncture

Objective and Methods: Thirty-three patients with peri-menopausal syndrome were treated by electroacupuncture of points Guanyuan (CV 4) and Sanyinjiao (SP 6) according to the principle of regulating and tonifying the Thoroughfare and Conception vessels, and the curative effects were analyzed.Results and Conclusion: The results showed that there was a significant difference in the clinical symptoms of the patients with peri-menopausal syndrome between pre- and post-electroacupuncture of points Guanyuan (CV 4) and Sanyinjiao (CV 6) and the clinical effective rate reached 93.9%. The measurement of sexual hormones showed E2, FSH and LH levels were better after treatment than before treatment in the patients with peri-menopausal syndrome. The analyses indicated that electroacupuncture of points Guanyuan (CV 4) and Sanyinjiao (CV 6) could relieve the clinical symptoms in the patients with peri-menopausal syndrome and improve the patient's life quality.