| Objective:1.Experimental part:Based on the PCOS rat model,the mechanism of the expression of IRS-1-PI3K/AKT pathway was studied by immunohistochemistry and histopathological analysis.The mechanism of Zishen Huatan Zhuyun Decoction in the treatment of PCOS was studied.2.Clinical part:The clinical part of the study through the use of literature analysis and epidemiological investigation and research methods to Pearson correlation analysis as a means to explore the lifestyle(diet,exercise and psychosocial factors)related factors and the formation of different TCM syndromes,From the perspective of the Chinese medicine to understand the overall disease,and to guide the intervention of the patient's lifestyle as a means of the syndrome of polycystic ovary syndrome patients with treatment recommendations.Method:The research in this paper is divided into three parts,namely:The first part:the literature research,including modern medicine and traditional medicine prevention and treatment of polycystic ovary syndrome research progress;The second part:experimental part:Bushen Huatan treatment of PCOS Mechanism research;The third part:clinical part:polycystic ovary syndrome patients with TCM syndrome and lifestyle related research.In the experimental group,40 female rats aged 24,weighted 180-190 g were randomly divided into model group(n = 30)and normal control group(n = 10).The rats were treated with dehydroepiandrosterone as model drug.Rat model.After the model was successfully established,the rats in the model group were randomly divided into model control group,western medicine positive group,traditional Chinese medicine group and 10 rats in each group.Normal group of normal saline,conventional feeding;Chinese medicine group fed granule decoction 2ml/only,the crude drug content of 1.41 g/ml,once a day for 21 days;model control group,fed daily drinking water 2ml/Once a day for 21 days;Western medicine positive group,fed metformin hydrochloride 200mg/kg gavage(concentration:0.02g/ml)10,once a day for 21 days.After 21 days of administration,the ovaries of all rats were measured with transverse diameter,and the ovarian pathology was examined.The levels of serum sex hormones and chronic inflammatory factors were measured.Clinical part:included in the standard of 220 cases of patients with polycystic ovary syndrome to register the relevant personal information,sum up fill in "the polycystic ovary syndrome of TCM syndrome and lifestyle correlation analysis" clinical questionnaire,including menstrual history,physical examination,way of life,past medical history,family history,etc.Reference to national Chinese medicine clinical research base type single diseases diagnosis standard score,and connecting with the table of syndromes,with reference to the gynecology of TCM diagnostics of TCM,in combination with related literature,dialectical classification,statistics,the incidence of various TCM syndrome type PCOS,summing up the TCM syndrome type of each patient.Respectively under the analysis of each card type,the influence of the different ways of life in patients with lifestyle including diet,work pressure and movement,the epidemiological investigation method,analyzing recycling questionnaire,weed out unqualified incomplete questionnaire,statistical analysis of qualified questionnaires.Further lifestyle associated with TCM syndrome types in patients with PCOS were analyzed,and the application of Microsoft Excel2007 database established,using frequency analysis of the IBM SPSS Statistics software 21.0(descriptive analysis method),Pearson chi-square(comparison between count data set),statistical methods,explore the clinic in Beijing university of Chinese medicine in the third affiliated hospital of gynecology outpatient and ward patients' TCM syndrome type distribution of the syndrome type of traditional Chinese medicine(TCM)and its possible influence its way of life and related factors,by inspection of the discriminant,when P<0.05 believes it has statistical significance.Discussed in the third affiliated hospital of Beijing university of TCM gynecology clinic patients of TCM syndrome type distribution and their way of life for each card type.Result:1.The experimental part:Compared with the normal group,the serum LH and FSH of the rats in the model group were significantly higher than those in the normal group(P<0.05).The body weight of the rats in the model group was significantly lower than that in the control group(P<0.01).Serum levels of E2 and P were decreased(P<0.01).Compared with the model group,the levels of serum LH,T and FSH were significantly decreased(P<0.01)(P<0.05).Compared with the traditional Chinese medicine group,the levels of serum LH,FSH and T were higher than those of the traditional Chinese medicine group,and the serum E2 and P levels were slightly lower in the traditional Chinese medicine group than that in the western medicine group and the model group(P>0.05).Compared with the model group,the follicles were found in the ovary of the traditional Chinese medicine group,and the follicular follicles were obvious,the granule cell layer was thickened,the number of corpus luteum increased,and the cystic dilatation Follicles less or none.Chronic inflammatory factors IL-6,VISFATIN in the model group and the traditional Chinese medicine group,western medicine group and normal group,the model group compared with the other three groups were statistically significant(P<0.05),traditional Chinese medicine group,There was no significant difference between the two groups(P>0.05),indicating that Zishen Huatan Zhuyun Decoction could improve the chronic inflammatory factors of rats,but there was no significant difference compared with the western medicine(P>0.05).2.The clinical part:In this study,220 cases of polycystic ovary syndrome collected in the case survey,women of childbearing age more common.Kidney deficiency syndrome accounted for the majority,45.5%,followed by kidney deficiency phlegm syndrome patients,accounting for 36.4%.There were significant differences in the formation of family history,body mass index,waist-to-hip ratio in the syndrome type,lifestyle(diet,exercise,mental and psychological factors)on the formation of TCM syndromes of PCOS patients Have an impact,indicating that there is a correlation between the two.Conclusion:1.Experimental part:Application of dehydroepiandrosterone can successfully model the rat PCOS,from the serum hormone levels and ovarian morphology similar to human PCOS,modeling method feasible.Chinese medicine Zishen Huatan Zhuzhe Decoction can improve the performance of Kaohsiung in rats,reduce LH,FSH,T levels,so that E2,P levels increased.Improve the ovarian morphology of polycystic ovary syndrome rats,and promote the formation of dominant follicles.At the same time Zishen Huatan Zhuyun by improving,the role of serum chronic inflammatory factors.The results showed that the expression of IRS-1-PI3K/AKT pathway was up-regulated by chronic inflammatory cytokine as the bridge.2.Clinical parts:different living habits,changes in lifestyle and PCOS patients with the formation of TCM syndrome type are related.The formation of different syndromes is related to different lifestyles. |
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