Clinical Observation On Treatment Of Abnormal Uterine Bleeding With Polycystic Ovary Syndrome By

Background:Due to the existing of ovarian dysfunction and endocrine abnormality in Polycystic Ovary Syndrome (PCOS), follicular development was delayed, mainly showed as anovulation and hyperandrogenism, influencing the endometrium through continued estrogen secretion in the absence of progesterone which could lead to endometrial hyperplasia and endometrial repairment delayed, while hyperandrogenism impared the growth of endometrium, therefore causing abnormal uterine bleeding (AUB). Nowadays, PCOS has been a focus research and scientific challenge in the gynecology field.From the view of western medicine, the etiology of PCOS is complicated, the clinical manifestations and laboratory tests are diverse and there are limitations in the treatments of the disease.On the other hand, the traditional Chinese medicine (TCM) has its own characteristics and advantages in treating PCOS, along with the markedly curative effect on hemostasis and menstrual regulation. However, the present TCM studies about PCOS were more focus in regulating menstruation based on amenorrhea and oligomenorrhea, while the TCM hemostasis therapy research about AUB as the major clinical manifestation of PCOS is very few and lack of standardized and systemized. Therefore, regarding to the inadequacies of the TCM research field, this study is conducted in order to emphasize its significant practical applications.Research:Part Ⅰ:Literature study. This study reviews the view of TCM about AUB associated with PCOS and current research of TCM, along with the present researches of AUB associated with PCOS in the western medicine field.Part Ⅱ:Clinical observation.Objectives:The patients of AUB associated with PCOS in this study is treated by using the method of reinforcing Qi and replenishing Yin during the spotting phase, focusing on the TCM hemostatic therapy in this disease whilst observing the improvements of menstrual cycle in the case group patients which continue using the same method to regulate the menstruation during the non-bleeding phase. This study is conducted in order to objectively evaluate the clinical efficacy of the method of reinforcing Qi and replenishing Yin.Methods:45 AUB associated with PCOS patients with Deficiency of Qi and Yin were selected and randomized in a distribution of 2:1, treating them by using YiQiYangYin Decoction (case group) or Progesterone (control group), to observe the efficacy of hemostatic therapy in both groups. During the non-bleeding phase, only the case group patients were continuously using the YiQiYangYin Decoction to regulate menstruation for three menstrual cycles and observe its improvements.Results:(1) The effective rate of hemostatic therapy is 96.70% in case group and 93.30% in control group (P>0.05).(2) The differences in the improvement of clinical symptoms and signs between both groups were statistically significant (P<0.05).(3) The age, course of disease, endometrial thickness and days of AUB were irrelevant with the hemostatic time (P>0.05).(4) The rate showed in the improvement of menstruation in case group after regulating menstruation is 93.40%, while the control group which didn’t regulate the menstruation is 66.70%(P<0.05).(5) The difference in the improvement of BBT between both groups was statistically significant (P<0.05).(6) The difference of the ratio of LH/FSH between both groups was statistically significant (P<0.05).(7) The difference in the changes of polycystic ovaries between both groups was not statistically significant (P>0.05), indicating the efficacy of Chinese medicine on morphological changes of polycystic ovaries was unapparent in the short term.(8) There were 9 patients in the case group occurred recurrent bleeding during the menstrual regulation therapy while 11 patients in the control group was noted as the same occurrence. During the follow up of both groups,2 patients in the case group achieved pregnancy, one of them has given birth and the newborn baby is healthy, while the other patient’s pregnancy condition is well.Conclusion:1. The hemostatic therapy through the method of reinforcing Qi and replenishing Yin in treating AUB associated with PCOS is effective.2. The clinical symptoms were improved obviously through the method of reinforcing Qi and replenishing Yin in treating AUB associated with PCOS.3. The gynecology endocrine disorder can be corrected through the method of reinforcing Qi and replenishing Yin in treating AUB associated with PCOS.4. The menstrual cycle can be improved by continuously using the method of reinforcing Qi and replenishing Yin to regulate the menstruation after the hemostatic therapy.