RESUMEN
The objective of this study was to investigate the effects of switching therapy to wen-jing-tang (unkei-to) from previous selected herbal preparations on endocrine levels and induction of ovulation in women with polycystic ovary syndrome (PCOS). Sixty-four anovulatory women diagnosed with PCOS were enrolled in the study. After Kampo diagnosis, subjects received matched Kampo preparations (43 cases: dang-gui-shao-yao-san, 21 cases: gui-zhi-fu-ling-wan) selected by the matching theory of eight-principle pattern identification and Kampo diagnosis based on concepts of the qi, blood, and fluids as the physiologic activity. Fifty-four women who failed to ovulate after an 8-week treatment were randomly allocated to continuation of treatment with the preceding Kampo prescription (continuation group, n = 27) or treatment with wen-jing-tang (switching group, n = 27). Plasma FSH, LH and estradiol levels were measured and ovulation rates were determined at the beginning and after an 8-week treatment with the preceding Kampo prescription, as well as after the subsequent 8-week treatment with the same preparation or wen-jing-tang. No decrease in mean plasma LH level was observed in the 54 women who failed to ovulate among the 64 treated with a Kampo preparation. After the 8-week treatment with wen-jing-tang, plasma LH levels were decreased by 58.2% (p < 0.0001) and 49.4% (p = 0.0005) in the groups switched from dang-gui-shao-yao-san and gui-zhi-fu-ling-wan, respectively. In the group switched from dang-gui-shao-yao-san, a tendency towards increase in plasma estradiol level was observed (1.51-fold, p = 0.055), which was significant compared with that in the group switched from gui-zhi-fu-ling-wan (p = 0.032). The ovulation rate with switching of treatment to wen-jing-tang was significantly higher (59.3%) than that with continued use of the same preparation (7.4%, p = 0.0036). This study confirmed that wen-jing-tang was effective in improving endocrine condition in the treatment of disturbances of ovulation in patients with PCOS without taking eight-principle pattern identification into consideration. This finding indicates that wen-jing-tang is appropriate for use in treating PCOS in women with various constitutions (as determined by the matching theory of eight-principle pattern identification) in clinical practice and may prove to be a potent therapeutic agent with a wide therapeutic spectrum.
Asunto(s)
Medicamentos Herbarios Chinos/farmacología , Inducción de la Ovulación , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Adolescente , Adulto , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Síndrome del Ovario Poliquístico/fisiopatologíaRESUMEN
Eight weeks treatment with Unkei-to induced a significant increase in plasma follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels in hyper- (robust) and hypo- (asthenia) functioning patients with first- and second-grade amenorrhea. We observed no significant differences in the rate of change of these hormones between hyper- and hypo-functioning patients. Ovulation occurred in 61.3% and 66.7% of patients with first-grade amenorrhea, and in 27.3% and 22.4% of patients with second-grade amenorrhea, respectively. No significant difference was observed in the ovulation rate after an 8-week treatment with Unkei-to between hyper- and hypo-functioning patients. These results indicate that Unkei-to is effective in improving gonadotropin and estradiol secretion in the treatment of either hyper- or hypo-functioning anovulatory women.
Asunto(s)
Amenorrea/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Hormona Folículo Estimulante/metabolismo , Ovulación/efectos de los fármacos , Hipófisis/efectos de los fármacos , Adolescente , Adulto , Femenino , Gonadotropinas/metabolismo , Humanos , Hormona Luteinizante/efectos de los fármacos , Hormona Luteinizante/metabolismo , Masculino , Hipófisis/metabolismo , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: To assess the clinical efficacy of Unkei-to in women with luteal phase defects. STUDY DESIGN: A study of 103 consecutive subjects with luteal phase defects treated with unkei-to (7.5 g/d) and 94 control subjects was conducted. A venous blood sample was taken, and plasma gonadotropins, 17 beta-estradiol and progesterone levels were measured. Dominant follicle size and endometrial thickness were assessed in the late follicular phase. RESULTS: Unkei-to significantly decreased plasma luteinizing hormone and significantly increased 17 beta-estradiol concentration in the follicular phase and significantly increased progesterone (66.7%) in the midluteal phase (P < .05). Significant development of the dominant follicle (P < .01) and endometrium (P < .001) was also observed in patients treated with unkei-to. We observed significant prolongation of the luteal phase (43%, P < .001) as measured by basal body temperature. There was a 79.6% rate of correction of luteal phase defects in patients treated with unkei-to. Furthermore, the pregnancy rate in patients desiring pregnancy was 49.5% (41/83). CONCLUSION: Administration of unkei-to may normalize the gonadotropin-ovarian endocrine system and/or their interaction in the follicular phase and may improve the endocrine environment in the luteal phase in patients with luteal phase defects.