| Objective:To observe the efficacy of replenishing kidney-essence and removing phlegm therapy combined with western medicine on patients with polycystic ovarian syndrome and insulin resistance,analyze and observe the changes in related clinical symptoms and clinical indicators before and after treatment,and preliminarily explore the action mechanism of traditional Chinese medicine,so as to give full play to the characteristics of syndrome differentiation and treatment of traditional Chinese medicine on the basis of symptomatic treatment of western medicine,and provide theoretical basis for guiding clinical practice.Methods:In this study,138 patients who were admitted into Department of Gynecology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from October1,2018 to August 31,2020 and diagnosed as polycystic ovarian syndrome and met the inclusion criteria were selected and randomly divided into the observation group and the control group,with 69 patients in both groups.The control group was treated with drospirenone and ethinylestradiol tablets and diformin tablets,while the observation group was treated with a combination of traditional Chinese medicine prescriptions related to replenishing kidney-essence and removing phlegm therapy prepared by supervisor on the basis of the control group.During the treatment period,the patients in the two groups were given health education and exercise supervision,with continuous treatment for 3 menstrual cycles as a course of treatment.After treatment,the changes in clinical signs,body mass index(BMI),waist-hip ratio(WHR),acne,basic sex hormone level,related glucose and lipid metabolism indexes,ovarian antrum follicle number and ovarian volume,as well as TCM clinical syndrome scores and comprehensive curative effect were observed before and after treatment 2 consecutive menstrual cycles were recorded after treatment,and the average menstrual cycles were compared,and the data collected in this experiment were statistically analyzed.Results:1.The analysis of curative effect results showed that the cure rate,marked improvement rate and effective rate in the observation group(1.5%,42.7%,100%,respectively)were higher than those in the control group(0%,4.4%,97%,respectively),and the results had significant statistical differences(χ~2=28.808,P<0.01).2.The analysis of body mass index and waist-hip ratio showed that the body mass index and waist-hip ratio of patients in the two groups were improved after treatment(P<0.01),with significant statistical difference;after treatment,there was no significant difference in waist-hip ratio and body mass index between the two groups(P>0.05).3.The analysis on acne symptoms showed that there was no significant difference in acne scores between the two groups before treatment(P>0.05).After treatment,the acne score in the observation group was significantly different from that in the control group(P<0.01).4.The comparison of TCM syndrome total scores showed that after treatment,the TCM syndrome scores in the two groups were lower than those in the corresponding groups before treatment(P<0.05),and there was a statistical difference;In the observation group,the improvement of TCM syndromes was better than that in the control group,with significant statistical difference(P<0.01).5.Single TCM syndrome score:Compared with the control group,the observation group has significant curative effects on menstrual cycle,menstrual color,dizziness,tinnitus and deafness,and limb drowsiness after treatment.There was a significant statistical difference between the two groups(P<0.01).6.The analysis on female sex hormone levels showed that after treatment,the levels of LH,LH/FSH,FSH,and T in the two groups were lower than those before treatment(P<0.05),which was statistically significant;after treatment,the levels of LH,T,LH/FSH and FSH in the observation group were lower than those in the control group,and there were significant statistical significances(P<0.01).7.Glucose metabolism index analysis showed that there was no significant difference in the intra-group comparison between the two groups after treatment and before treatment(P<0.05).After treatment,the observation group was better than the control group in reducing INS and IR levels(P<0.01),with significant statistical differences;there was no significant difference in reducing GLU level(P>0.05).8.The analysis of lipid metabolism index showed that after treatment,the two groups were compared within the group(P<0.05),which was statistically significant;In improving TG,TC,HDL-C,Apo A1,Lp A,the efficacy in the observation group was significantly better than that in the control group(P<0.05),with statistical significance;The improvement of LDL-C,Apo B index in the two groups had the same efficacy,and there was no statistical difference(P>0.05).9.Homocysteine analysis showed that there was no statistical difference in HCY level between the two groups before treatment(P>0.05).After treatment,the HCY levels in the two groups were lower than before treatment,and there was a statistical difference(P<0.05).Among them,the reduction degree of HCY level in the observation group was significantly better than that in the control group(P<0.01),with significant statistical difference.10.Analysis on bilateral ovarian volume and number of antral follicles showed that after treatment,the ovarian volume and number of antral follicles in the two groups were improved compared with those before treatment(P<0.05),with statistical difference;after treatment,the degree of reducing bilateral ovarian volume and antral follicle number in the observation group was significantly different from that in the control group(P<0.01).11.Follow-up comparison:During the follow-up,the number of normal menstrual cycles in the observation group(42 people)was more than that in the control group(6 people)(P<0.01),with significant statistical difference.Conclusion:Compared with western medicine alone,the replenishing kidney-essence and removing phlegm therapy combined with diformin tablets and Yasmin is more effective in treating PCOS with IR,the clinical symptoms are obviously improved,and the hormone and glucose and lipid metabolism of patients are more effectively regulated,with fewer adverse reactions,more secure safety and broader clinical application prospect. |
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