Study On The Distribution Of TCM Syndromes And Related Factors In Patients With Polycystic Ovary Syndrome With Insulin Resistance

Objective:To collect the clinical data of patients with Polycystic ovary syndrome Insulin Resistance(PCOS-IR)to study the distribution rule of PCOS-IR TCM syndromes,and analyze the TCM syndrome types and body mass index(Body Mass Index,BMI),Waist-Hip Ratio(WHR),fasting insulin(FINS),fasting plasma glucose(FPG),homeostatic model assessment of insulin resistance(HOMA-IR),sex hormones,and C-reactive protein(C-reactive protein,CRP)relationship provides a new theoretical basis for improving the syndrome differentiation and syndrome differentiation treatment of this diseaseMethods:From February 2019 to December 2019,PCOS-IR patients were collected from the infertility clinic of Department of gynecology and traditional Chinese medicine of Shandong provincial hospital.To establish the clinical observation table of PCOS-IR patients,to collect and sort out the hormone level,syndrome performance and other information of the patients,to establish TCM syndrome according to the clinical performance,tongue coating,pulse and so on of the patients,and finally to use statistical methods to analyze the relationship between syndrome and related factors,to draw the corresponding conclusions.result:1.The basic situation of PCOS-IR patients included in the study:92 patients with PCOS-IR were included in this study,including 23 patients with phlegm and blood stasis syndrome(25%),19 patients with spleen deficiency phlegm and dampness syndrome(20.65%),liver 19 patients(20.65%)with stagnation of blood and blood stasis syndrome,21 patients(22.83%)with deficiency of phlegm and coagulation syndrome of kidney,4 patients with deficiency of spleen and kidney yang syndrome(4.35%),2 patients with syndrome of dampness-heat syndrome of liver Two patients with depression of fire syndrome(2.17%)and two patients with phlegm and dampness syndrome(2.17%)were more common with phlegm and blood stasis syndrome;2.Comparison of BMI,WHR,FINS,FPG,HOMA-IR of different TCM syndromes:The mean BMI of 92 PCOS-IR patients is 26.86 ± 3.51kg/m2,which is more concentrated in 25.0～30.0kg/m2,of which abdominal type 51 obese patients(55.4%).The levels of BMI,WHR,FINS,FPG,and HOMA-IR of PCOS-IR patients in the phlegm and blood stasis group,spleen deficiency phlegm dampness group,and kidney deficiency phlegm coagulation group were significantly higher than those in liver stagnation and blood stasis group(P<0.05);BMI,WHR,HOMA-IR values are higher in the spleen-deficiency phlegm-dampness group,but there is no statistically significant difference between the groups(P>0.05)3.Comparison of sex hormone levels:The E2 level of PCOS-IR patients in kidney deficiency phlegm coagulation group was significantly lower than the other three groups,the difference was statistically significant(P<0.05),the E2 level in spleen deficiency phlegm and dampness group had an upward trend,but there was no difference between the groups Statistical significance(P>0.05);the levels of T,PRL and LH in patients with liver stagnation and blood stasis were significantly higher than the other three groups,the difference was statistically significant(P<0.05);FSH was compared between the four groups,and the difference was not statistically significant Significance(P>0.05);4.CRP level:The CRP level of patients with spleen deficiency and phlegm-dampness group was significantly higher than that of the other three groups,the difference was statistically significant(P<0.05).Conclusion: The main clinical syndromes of PCOS-IR are phlegm and blood stasis syndrome,spleen deficiency and phlegm dampness syndrome,kidney deficiency and phlegm coagulation syndrome,liver stagnation and blood stasis syndrome.Different syndromes of PCOS-IR have certain correlation with glucose metabolism,sex hormone level,CRP,which can be used as reference standards for clinical syndrome differentiation and individualized treatment of PCOS-IR patients.Among them,the incidence of obesity and central obesity in the patients with spleen deficiency and phlegm dampness syndrome is relatively higher,the degree of insulin resistance is more serious,and chronic inflammatory state is more likely to occur;the patients with liver stagnation and blood stasis syndrome are closely related to the occurrence of hyperandrogenemia and hyperprolactinemia.