| Objective:1. Clinical research:To compare the endocrinic and metabolic index of phlegm-dampness group with non phlegm-dampness group of PCOS patients, and summarize the characteristics of phlegm-dampness group to give further objective basis on standardized diagnosis and treatment of PCOS.2. Animal experiment:To compare the endocrinic and metabolic index between the groups,and observe the effect of Invigorating Spleen and Removing Phlegm decoction on PCOS treatment.Methods:1. Clinical research:100PCOS patients were selected and divided into two groups: phlegm-dampness group and non phlegm-dampness group. Basal conditions were recorded. Sex hormone (LH,FSH,T,DHEAS,SHBG), blood fat (TG,TC,LDL,HDL,Apo-Al,Apo-B),FBG, OGTT-2hBG, Fins, OGTT-2hIns as well as adipokines (TNF-a, visfatin, PEDF) levels were measured.2. Animal experiment:50female rats were chosen in the experiment,which were randomly divided into two groups,control group and experimental group. Rats in the experimental group were injected daily with6mg/100g weight of DHEA+0.2ml oil for up to20days while rats in the control group were injected with the same volume of oil at the same time. Then the rats in experimental group were randomly divided into four groups, model group,TCM group, Metformin group and TCM+Metformin group. After treated for28days,we had an IVGTT experiment to measure the level of FBG, IVGTT-2hBG, Fins, IVGTT-2hIns.Sex hormone (LH,FSH,T,SHBG), blood fat (TG,TC,LDL,HDL,Lp-a), as well as adipokines (TNF-a,IL-6, visfatin, PEDF) levels were detected. Ovaries were stained with hematoxylin and eosin, and their histological changes were observed with light microscope.Results:1.Clinical research:The levels of SBP,DBP,BMI,WHR, TC,TG,LDL,Apo-B, FBG,FINS,PBG,PINS,HOMA-IR,HbA1c,DHEA-S as well as TNF-a,PEDF,visfatin are significantly higher in phlegm-dampness group than those in non phlegm-dampness group (P<0.05).The levels of HDL,Apo-Al,SHBG and LH/FSH are significantly lower in phlegm-dampness group than those in non phlegm-dampness group (P<0.05). Type of phlegm-dampness has positive correlation with IR (P<0.05)2. Animal experiment:In IPGTT experiment,we find that the levels of both blood glucose and insulin are fallen in all therapeutic groups compared to model group.And there is no statistically significant between TCM group and Metformin group.The levels of TG,TC,LDL and Lp-a are decreased in all therapeutic groups. The levels of HDL is increased in all therapeutic groups. And the levels of LDL is significantly decreased in TCM group. The levels of LH,LH/FSH and T are fallen significantly in therapeutic groups (P<0.05) too. The levels of FSH and SHBG are increased significantly in therapeutic groups (P<0.05). The levels of TNF-a,IL-6,visfatin and PEDF are lower in all therapeutic groups than in model group,and IL-6,visfatin,PEDF levels have statistically significance (P<0.05).Ovarian hematoxylin and eosin stain shows that there are multiple follicular cysts on the ovaries of model group, and the numbers of theca cells and interstitial cells are increased while the number of granulose cells is decreased compared with control group. Kinds of developing follicles and corpus lutea are almost absent. And in therapeutic groups,there are kinds of developing follicles and corpus lutea. And the numbers of theca cells and interstitial cells are decreased while the number of granulose cells is increased contrast with model group.Conclusion:1. Clinical research:There are characteristic expression on Sex hormone (LH/FSH, DHEA-S, SHBG), blood fat (TC, TG, LDL, HDL, Apo-B),blood glucose (FBG, PBG), insulin (FINS,PINS),HOMA-IR,HbA1c adipokines (TNF-a,PEDF,visfatin) levels in phlegm-dampness PCOS patients, they might be objective diagnosis basis of phlegm-dampness PCOS patients.2. Animal experiment proves that Invigorating Spleen and Removing Phlem decoction can improve the endocrinic and metabolic circumtance of PCOS rats.It can also improve their ovulation. Invigorating Spleen and Removing Phlem decoction is an effective treatment for PCOS. |
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