Professor Liu Ximing's Theory And Application Research On Treatment Of Polycystic Ovary Syndrome (dampness Block Syndrome)

Objective:To summarize the causes,mechanism and treatment ideas of polycystic ovary syndrome(the retention of dampness and phlegm syndrome)according to Professor Liu Ximing's theory.Through clinical observation,investigate the clinical manifestation,subordinate syndrome and the principle of herbs used by TCM treatment of PCOS(the retention of dampness and phlegm syndrome).Method:32 cases of polycystic ovary syndrome(the retention of dampness and phlegm syndrome)were collected for clinical observation.All these 32 patients received treatment in Guang'anmen Hospital by Professor Liu between January 2014 and January 2018.Self-control method was used.The menstruation conditions(menstrual cycle,volume,color and property),BMI,concomitant symptoms were observed before and after treatment.The syndrome differentiation and the herbal medicine used in 202 prescriptions were recorded.Excel 2010 and SPSS22.0 were used for statistical analysis.Results:1.General Information:Among the 32 cases,the youngest and the oldest were respectively 16 years old and 35 years old.The majority of the patients(62.50%)were between 21 and 30 years old,with a mean age of 25.88±5.13.2.Menstruation Condition:The cases belonged to three kinds of menstrual disorders:oligomenorrhea in 25 cases(78.13%),amenorrhoea in 4 cases(12.50%)and irregular uterine bleeding in 3 cases(9.38%).All the 32 patients had abnormal menstrual cycle.Most of them menstruated more than 20 days late.The abnormal menstrual volume,color and property:hypomenorrhea in 22cases,blood clots in 21 cases and dysmenorrhea in 8 cases.3.Body Mass Index:The average BMI was 29.84± 5.87.Among the 32 cases,4 cases(12.50%)had normal weight,with BMI lower than 23.The other 28 cases(87.50%)were overweight(including pre-obesity,class-1 obesity,class-2 obesity).The ratio of normal weight to the overweight was 1:7.There were 15 patients belonging to class-2 obesity,with the largest proportion of 46.88%.4.Symptoms:The most frequent 10 symptoms in 32 cases were fatigue and somnolence(62.50%),acne(50.00%),abdominal and breast distension(37.50%),soreness of waist(37.50%),crinosity(34.38%),heavy body and limbs(34.38%),excessive sweating(31.25%),irritability(31.25%),chest distress and nausea(28.13%),loss of appetite(25.00%).5.Subordinate Syndrome:There were no subordinate syndrome in 11 cases,fire stagnation in 7 cases,qi stagnation in 4 cases,blood stasis in 4 cases,spleen deficiency in 3 cases,Tiangui water deficiency in 2 cases and liver blood deficiency in 1 case.6.Efficacy assessment:According to Efficacy assessment criteria,there were 7 cases markedly effective,24 cases effective and 1 case ineffective.The total effective rate was 96.88%.The TCM scores(8.41 ± 5.33)decreased with statistically significant differences(P=0.002<0.01)compared to the scores before the treatment(20.09± 6.28).The TCM scores decreased steadily,according to the scores collected respectively 1 month,3 months and 6 months after the first visit.The clinical symptom scores after the treatment of the four groups of different BMI degrees were significantly different(P=0.004<0.01).The pre-obesity group had the best efficacy,followed by the class-1 obesity,normal weight and class-2 obesity group.7.The Principle of herbs used:There were 202 prescriptions for 32 patients.Each prescription had 5-12 herbs,while the prescriptions with 6 herbs had the largest proportion.127 kinds of herbs were used,of which the 10 most frequently used herbs were Pinellia Tuber(Ban Xia),Angelica(Dang Gui),Golden Thread(Huang Lian),Poria Cocos(Fu Ling),Red Sange Root(Dan Shen),Dried Tangerine Peel(Chen Pi),Coix Seed(Y1 Yiren),Motherwort(Yi Mucao),Radix Scutellariae(Huang Qin),Fruit of Immature Citron(Zhi Shi).The herbs for patients without subordinate syndrome were mainly to eliminate dampness and phlegm.The 10 most frequently used herbs were Pinellia Tuber(Ban Xia),Poria Cocos(Fu Ling),Dried Tangerine Peel(Chen Pi),Golden Thread(Huang Lian),Angelica(Dang Gui),Motherwort(Yi Mucao),Coix Seed(Yi Yiren),Fruit of Immature Citron(Zhi Shi),Lycopus Herb(Ze Lan),Nutagrass Flatsedge Rhizome(Xiang Fu).The 10 most frequently used herbs for patients accompanied by fire stagnation syndrome were Golden Thread(Huang Lian),Pinellia Tuber(Ban Xia),Radix Scutellariae(Huang Qin),Angelica(Dang Gui),Coix Seed(Yi Yiren),Fruit of Immature Citron(Zhi Shi),Red Sange Root(Dan Shen),Poria Cocos(Fu Ling),Silkworm Excrement(Can Sha),Dried Tangerine Peel(Chen Pi).Erchen Decoction and Qinliansiwu Decoction were often used.The 10 most frequently used herbs for patients accompanied by blood stasis syndrome were Angelica(Dang Gui),Golden Thread(Huang Lian),Red Sange Root(Dan Shen),Pinellia Tuber(Ban Xia),Radix Scutellariae(Huang Qin),Cat-tail Pollen(Pu Huang),Rhizome of Sichuan Lovage(Chuan Xiong),Lycopus Herb(Ze Lan),Poria Cocos(Fu Ling),Peach Kernel(Tao Ren).The 10 most frequently used herbs for patients accompanied by spleen deficiency syndrome were Pinellia Tuber(Ban Xia),Coix Seed(Yi Yiren),Angelica(Dang Gui),Asiabell(Dang Shen),White Hyaciath Bean(Bai Biandou),Golden Thread(Huang Lian),Dried Tangerine Peel(Chen Pi),Poria Cocos(Fu Ling),Beach Silvertop Root(Bei Shashen),Nutagrass Flatsedge Rhizome(Xiang Fu).Liujunzi Decoction were often used.Among the 43 prescriptions used after the retention of dampness and phlegm were reduced,the 10 most frequently used herbs were Angelica(Dang Gui),White Peony Root(Bai Shao),Red Sange Root(Dan Shen),Red Peony Root(Chi Shao),Bupleurum(Chai Hu),Fruit of Barbary Wolf Berry(Gou Qi),Eucommia Bark(Du Zhong),Motherwort(Yi Mucao),Glossy Privet Fruit(Nv Zhenzi),Lycopus Herb(Ze Lan).Zuogui Decoction or Pill were often used for Tiangui water deficiency syndrome,while Sini Decoction for qi stagnation syndrome.Angelica(Dang Gui)and White Peony Root(Bai Shao)were often used for liver blood deficiency syndrome.Conclusion:1.Most patients of PCOS in this study were between 21 and 30 years old.Women in child-bearing period were the largest group.2.The main clinical manifestation of PCOS in this study were the disorder of menstrual cycle.Most patients had amenorrhoea or oligomenorrhea.Most patients were overweight.The efficacy correlated with the severity of obesity.The treatment was most effective in the mild and moderate obesity group.3.Professor Liu focused on eliminating dampness and phlegm in uterus in the treatment.The herbs,which can eliminate dampness and phlegm,were used most frequently.4.Patients of PCOS(the retention of dampness and phlegm syndrome)often had subordinate syndromes,including fire stagnation,qi stagnation,blood stasis,spleen deficiency,etc.Professor Liu also took the subordinate syndrome into account in the treatment.Professor Liu thought of PCOS(the retention of dampness and phlegm syndrome)as a dynamic process.After the retention of dampness and phlegm syndrome was relieved,the treatment should focus on reinforcing the tiangui water,improving liver blood and dredging the movement of qi.