| Objective The aim of this study is to observe the efficacy of Cangjian Guifu Tang in treating depression and anxiety in patients with insulin-resistant polycystic ovary syndrome(PCOS),analyze the improvement of selected indexes before and after treatment,and compare with the control group using metformin alone to explore the differences in the efficacy of the two in improving depression and anxiety,alleviating insulin resistance(IR)and adjusting sex hormone levels and reducing body mass index(BMI).The differences in the efficacy of metformin in improving depression and anxiety,relieving insulin resistance(IR),adjusting sex hormone levels and reducing body mass index(BMI)were investigated to provide clinical reference for alleviating depression and anxiety in PCOS-IR patients.Methods60 patients with insulin resistance PCOS and phlegm dampness syndrome diagnosed in the gynecological clinic of XX Hospital of XX city from January 2021 to January 2022 were screened.The patients were randomly divided into 30 patients in the treatment group and 30 patients in the control group,and the treatment group was treated with Cangfu Daotan Decoction for 3 months and the control group was treated with metformin for 3 months.(SDS),Self-Assessment Scale(SAS),luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T),insulin resistance index(HOMA-IR),oral glucose tolerance test(OGTT),insulin release test(IRT),body mass index(BMI),etc.in the two groups.The data of this study were statistically processed using SPSS 20.0 statistical software to compare the differences in the efficacy of the two methods in patients with phlegm-hygroscopic PCOS-IR.Resulsts1.Comparison of comprehensive efficacy: The total effective rate of the treated group was89.66%,and the total effective rate of the control group was 74.07%.There was a significant difference between the comprehensive efficacy of the two groups(P < 0.05),and the comprehensive efficacy of the treated group was significantly better than that of the control group.2.Comparison of the efficacy of TCM symptoms: the total effective rate of TCM symptoms in the treatment group was 86.21%,compared with 62.96% in the control group after treatment.By the rank sum test of two samples,P < 0.05,the difference was statistically significant,indicating that the efficacy of the treatment group was significantly better than that of the control group in terms of the efficacy of TCM symptoms.3.Comparison of TCM evidence points: The TCM evidence points of both groups were significantly lower after treatment than before treatment,P < 0.05,indicating that the TCM clinical symptoms of patients in both groups improved significantly after treatment.The TCM evidence points in the treatment group were significantly lower than those in the control group after treatment in both groups,P < 0.05,suggesting that the improvement of clinical symptoms in the treatment group was more significant than that in the control group.4.Comparison of related sex hormone indexes:(1)LH was significantly lower in both groups after treatment than before treatment(P < 0.05).There was no significant difference in LH between the two groups after treatment(P>0.05),and the LH levels were comparable between the two groups after treatment.(2)After treatment,FSH was significantly lower in the treatment group compared with that before treatment(P < 0.05),and there was no significant difference between FSH before and after treatment in the control group(P > 0.05),and there was a significant difference between FSH levels in the two groups after treatment(P < 0.05),and the decrease in FSH levels in the treatment group was significantly better than that in the control group.(3)After treatment in both groups,LH/FSH was significantly lower in the treatment group compared with that before treatment(P < 0.05).There was no significant difference in LH/FSH before and after treatment in the control group,and there was a significant difference in LH/FSH after treatment in the two groups(P < 0.05),and the decrease in LH/FSH ratio in the treatment group was significantly better than that in the control group.(4)Serum T was significantly lower in both groups after treatment than before treatment(P <0.05).There was a significant difference in serum T levels between the two groups after treatment(P < 0.05),and the decrease in serum T levels in the treatment group was significantly better than that in the control group.5.Comparison of OGTT,IRT and HOMA-IR: OGTT: fasting blood glucose,1h blood glucose and 2h blood glucose were significantly lower in both groups after treatment than before treatment(P<0.05).There was no significant difference in fasting blood glucose,1h blood glucose and 2h blood glucose after treatment between the two groups(P>0.05),and the levels of fasting blood glucose,1h blood glucose and 2h blood glucose were comparable between the two groups after treatment.IRT: Fasting insulin,1h insulin and 2h insulin were significantly lower in the two groups after treatment compared with those before treatment(P<0.05),and the levels of fasting insulin,1h insulin and 2h insulin in the two groups after treatment were HOMA-IR: The HOMA-IR was significantly lower in both groups after treatment compared with that before treatment(P < 0.05),and there was a significant difference between the two groups after treatment(P < 0.05),and the HOMA-IR level decreased significantly better in the treatment group than in the control group.The decrease in HOMA-IR level in the treatment group was significantly better than that in the control group.6.BMI comparison: BMI was significantly lower in both groups after treatment than before treatment(P < 0.05).There was a significant difference between the BMI of the treated group and the control group after treatment(P > 0.05),and the level of decrease in the BMI level of the treated group was significantly better than that of the control group.7.Comparison of SAS and SDS scores: The SAS scores and SDS scores of patients in both groups were significantly lower after treatment than before treatment(P < 0.05).There were significant differences in SAS scores and SDS scores between the two groups after treatment(P < 0.05),and the degree of decrease in SAS scores and SDS scores in the treatment group was significantly better than that in the control group.8.Correlation between SAS and SDS scores and insulin resistance and sex hormones:According to the results of dichotomous logistic regression analysis,there was a positive correlation between SAS scores and SDS scores and HOMA-IR,which is a risk factor for the development of depressive and anxiety states.9.Correlation between changes in SAS and SDS scores and changes in insulin resistance and sex hormones: the difference between pre and post SAS scores,pre and post SDS scores and pre and post HOMA-IR,pre and post LH,LH/FSH,and T were positively correlated,i.e.,the greater the difference between pre-treatment SAS scores and SDS scores and post-treatment SAS scores and SDS scores,the greater the difference between HOMA-IR,LH,FSH,and T before and after treatment.IR,LH,FSH,T and other indexes before and after treatment were also greater,P < 0.05.There was no correlation between the difference before and after SAS treatment and the difference before and after FSH treatment,P > 0.05.Conclusion1.The results of this study showed that there is a positive correlation between depression and anxiety state and the degree of insulin resistance(IR)in PCOS patients,and IR is a risk factor for the development of depression and anxiety state,as well as an important cause of disordered sex hormone levels,and the better the improvement of IR and disordered sex hormone levels,the more the depression and anxiety state is relieved.2.Cangfu Daotan Decoction can improve the degree of insulin resistance in patients with phlegm-damp PCOS,which in turn can effectively reduce SAS and SDS scores,and reduce depression and anxiety.Meanwhile,it also has good modulating effects on LH,FSH,LH/FSH,T and other related sex hormone levels and BMI,and no adverse effects were observed,which is safe and effective.3.The efficacy of Cangfu Daotan Decoction was better than that of the control group in terms of overall efficacy,efficacy of TCM symptoms,and reduction of hyperinsulinemia,reduction of depression and anxiety score,TCM symptoms score,HOMA-IR index,improvement of BMI and abnormal sex hormone index levels such as LH,FSH,LH/FSH and T.The efficacy was comparable to that of the control group in reducing LH levels and blood glucose levels. |
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