| ObjectiveIn recent years the Polycystic ovary syndrome (PCOS) has become a common gynecological diseases and it is also one of the principle causes of anovulatory infertility and endocrine dyscrasia of women in reproduce tive age. Its’characteristics of endocrinology are hyperinsulinemia (H1), insulin resistance (IR),and hyperandrogenism (HA). The clinical symptoms are various and heterogeneous.Its’typical performances are occasional or none ovulation, irregular menstrual periods, infertility, polytrichia, obesity and the change if ovary polycystic. As the incidence of women with polycystic ovary syndrome increases year by year, the PCOS has become the common and difficult disease which has troubled both doctors and patients. During these years, my advisor achieved a good effete on the treatment of Obese PCOS by using Chinese medieine" Jia jian chang fu dao tan decoction" to invigorate spleen and remove phlem. But it is dissatisfied fo Patlents to lose weight or to improve insulin resistance through this method. Clinical pharmacology study demonstrates berberine in improving the insulin resistance, improve ovulation disorders have obvious curative effect. the combination of Berberineand traditional Chinese medicine may be able to improve the effect of treatment of fueling PCOS patients. The research aims to evaluate the therapeutic effects and explore the therapeutiu mechanism. These studies were performed under the direction of Professor LiliYaoMethodsIn this paper,46 Patients with PCOS were randomly divided into control group (n=23)and treatment group(n=23), The patients in treatment group will be treated by adding or subtracting the combination of Berberine and Jia jian chang fu dao tan decoction, and the others in another group will be treated only by adding and subtracting the Jia jian chang fu dao tan decoction. The treatment lasted for 3 months, and our task was to observe the differences in the pretherapy and post-treatment of the two groups, and recorded the changes of BMI、FSH、Lh、T、LH/FSH、 FINS、FPG、HOMA-IR、and MCP-1.Results1. Irregular menstrual periods problems has significant improved in two groups and the difference is significant (P＜0.05). After the treatment, the treatment group, which has 12 patients of infertility,2 patients of acne,2 patients of hirsutism, just has 3 patients of pregnancy,1 patient of acne and 1 patient of hirsuitism. And the control group,which has 10 patients of infertility,3 patients of acne,2 patients of hirsutism, just has 1 patient of pregnancy,1 patient of acne, and 1 patient of hirsuitism.2. BMI、Chinese medicine symptom integral:After the treatment, two groups of the BMI has reduced. the difference has statistical significance (P<0.05). It means both two treatments can reduce BMI, and the effect of treatment group is better than the treatment of control group.two groups of the Chinese medicine symptom integral has obviously reduced (P<0.05) after the treatment. But the difference of Chinese medicine symptom integral in two groups is not very clear, and it has no statistical significance.3. Chinese medicine symptom integral:After the treatment, the treatment group has no case of recovery but 2 with obviously curative effect,14 with effect, and 4 with no effect. In general, there are 16 cases which has effect, and the total rate is 80.00%. The control group has no case of recovery but lwith obviously curative effect,9 with effect, and 9 with no effect. In general, there are 10 cases which has effect, and the total rate is 52.63%. The effect of treatment group is much better than the treatment of control group.4. After treatment, the levels of serum LH, LH/FSH in Berberine combined with Chinese medieine group and simple Chinese medieine group were all obviously lower than those of pretherapy(P<0.05), but there was no significant difference between the two groups (P>0.05). The levels of serumFSH were not obviously lower than those of pretherapy(P>0.05)while there was significant difference between the two groups after treatment(P>0.05); The levels of serum T in Berberine combined with Chinese medieine group was obviously lower than pretherapy (P<0.05):while it was not obviously lowerthan pretherapy(P>0.05);There was significant difference between the two groups (P<0.05).5. Insulin resistance:the serum FINS has obviously reduced after those two treatment and the difference is significant(P＜0.05). serum FPG has no obvious difference after the two treatments. HOME-IR has obvious reduced after the two treatments, and the difference is significant (P＜0.05). And comparing with the control group, the level has obviously reduced after the treatment of treatment group (P<0.05).6. Monocyte chemoattractant protein-1(MCP-1):according to statistic analysis, comparing with the patients himself, the difference of pretherpy, P<0.05. and the difference has statistical significance. Comparing the patients of treatment group to control group, the difference of post-treatment, P<0.05, the difference has statistical significance. It shows that both two treatments can obviously reduce the serum MCP-1 level, and the treatment effect of treatment group is much better than the treatment of control group.Conclusion1 Phlegm and damp is the main Pathogenesis of Obese PCOS.2 The important clinieal and bioehemieal indieator features of Phlegm and damp in Obese PCOS were hyperandrogenism, HyPerinsulinism, insulin resistanee. And among these, Hyperinsulinism and insulinresistane were the mainfeatures. At the same time, the serum MCP-1 levels of most paitients increased.3 Berberine combined with invigorating spleen to remove phlem was a signifieant therapeutic principle for weak spleen with phlegm and damp in Obese PCOS patients. Berberine combined with the herb(jia jian CFDT decoction)of invigorating spleen to remove phleme could obviously inerease the serum adiponectin level while decrease BMI;snd it coula decrese the level of T to improve hyperadrogrnism;and it also could deerease the level of FINS while decrease the level of HOMA-IR to reduce insulin resistanee;besides, it could deerease the levels of LH T and LH/FSH to regulate menstruation, recover OV, and impregnate a few infertility patients. The therapeutic effect was better than the effect of using simple jia jian CFDT decoction. |
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