Clinical Research And Empirical Study On Polycystic Ovarian Syndrome's Treatment With Cang Fu Dao Tan Tang

Objective:To explore the efficacy and mechanism of Cang Fu Dao Tan Tang(CFDTT)in treatment of polycystic ovary syndrome(PCOS)patients with the type of phlegm-damp,by changes of clinical symptoms and the main outcomes of serum reproductive hormone,combined the experimental study of CFDTT on phlegm-damp PCOS rat model.We hope to provide theoretical foundation for clinical application of CFDTT on phlegm-damp PCOS.Methods:1.Clinical observationThis subject adopts the method of self controlled trials before and after the treatment.(1)Observed object:During the period of January 2014 to August 2014 in the gynecology clinic of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,40 cases of patients met the inclusion criteria and exclusion criteria,during treatment for failing to adhere to the treatment of loss in 4 cases,collected 36 standard cases.2.Outcome measures:(1)Record the patient's situation of height,weight,waist,hip,hirsutism,acne.(2)Detection the level of sex hormones,fasting glucose,fasting insulin.(3)Record the patient's clinical symptoms of menstrual cycle,floating face swollen limbs,lassitude,dizziness,etc.Observed in patients with basal levels and treatment to improve the situation three months after the above symptoms,and observe the adverse events.3.Treatment method:Administering to the patient CFDTT oral(First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine offers).It consisting of fried herb 20g,Cyperus 20g,prepared gall Southern Star lOg,France Pinellia 20g,ginger 10g,tangerine peel 10g,Citrus aurantium 10g,Poria 15g,licorice lOg composed,by unified fried decoction chamber by the First Affiliated Hospital of Heilongjiang University of Chinese Medicine.A daily dose,decoct juice 200 ml water,morning and evening suit,menstruation stop medication,to continue medication after menstrual clean,treatment for 3 months.2.Experiment study(1)Building:the age of the rat 10 weeks,the law of estrus 50 SD rats after cervical subcutaneous insulin injections and HCG,were establishmented of PCOS rats.They were randomized rats with estrus cycle prolong or no estrus and blank group each 6.The rats were based in estrogen interphase.The selection of rats with estrus cycle prolong or no estrus were randomly divided into model group,the pale with phlegm decoction low-dose group,pale with phlegm decoction high dose group,each group 10 rats;(2)Chinese medicine intervention:To fill the stomach with CFDTT for the rats of CFDTT low-dose group and high dose group.There were twice in one day,lavage 30 days in a row.The rats in blank group and model group were given 5 ml/kg dose of 0.9%saline lavage;(3)Observation indexes:(1)To measurement once a week each rat body weigh in treatment;(2)To detect after treatment between groups of rats serum sex hormones and glucose tolerance test,blood lipid levels;(3)By real-time quantitative PCR detection the expression of CYP17,CYP19 gene in rats ovaries.Statistical methods:In this study,all data were calculated using SPSS21.0 statistical analysis system.Measurement data using t test,One-WayANOVA;count data using x2 test;grade data using non-parametric tests.With P<0.05 was considered statistically significant,P<0.01 was obviously statistically significant.Results:1.Clinical observations:(1)After CFDTT treatment,the patient's clinical total effective rate is86.11%.Comparing with before treatment,menstrual disorders,floating face swollen limbs,abdominal fullness,lassitude,dizziness,palpitations,shortness of breath,body fat aspect of patients with PCOS,were significantly improved.There are significant differences that CFDTT can significantly reduce the TCM syndrome integral and the weight(P<0.05).(2)CFDTT can reduce the level of LH,T,LH/FSH,FINS,FPG,HOMA-IR of PCOS patients(P<0.05).It also can improve the level of FSH,E2 of PCOS patients(P<0.05).It was the statistically significant difference.2.The experiment results:(1)After modeling,blank group and successful modeling rats comparative analysis:It was significantly higher that the body weight and the serum level of LH,LH/FSH,T of the successful model group rats,comparing with the rats of blank group.It was a significant difference(P<0.01).(2)After treatment,the indicators four of groups of rats compared:? Weight:Compared with the control group,the body weight of rats in the model group increased significantly(P<0.01);Compared with the model group,CFDTT high dose group and low dose group rats body weight was significantly reduced(P<0.01).The difference was statistically significance.? Serum indicators:Compared with the control group,the serum glucose levels of 0,30,60,90,120min of the model group rats were increased(P<0.05).The levels of TC,LDL also can be increased(P<0.05).Levels of LH,LH/FSH,FINS can be elevated(P<0.01);The serum level of E2,T,LH,LH/FSH,TC,LDL,FINS,HOMA-IR in rats of CFDTT high-dose group and low dose group could be reduced(P<0.05).Blood glucose levels of rats of CFDTT high-dose group and low dose group also can be reduced in 0,30,90,120min(P<0.05).The blood glucose level of CFDTT high dose group rats can be significantly reduced in 60min(P<0.01).(3)The content of ovary gene:Compared with the blank group,the expression quantity of CYP17a1 of ovaries in model group rats was increased.The expression quantity of CYP19al of model group rats ovaries was reduced(P<0.01);Compared with model group,the expression quantity of CYP17a1 of ovaries in CFDTT high dose group rats could be significantly reduced.the expression quantity of CYP17al of ovaries in CFDTT high dose group rats could be significantly increased(P<0.01).Conclusions:1.CFDTT can effectively treat phlegmy wet PCOS patients.CFDTT can significantly reduce androgen levels and improve the insulin resistance and glucolipid metabolic abnormalities and improve menstrual cycle,acne,obesity and other clinical symptoms.2.CFDTT could reduce levels of testosterone and promote estrogen secretion by raising expression of CYP19 genetic and cutting expression of CYP17 gene.CFDTT could regulate the sex hormone levels.3.In clinic,CFDTT is an effective prescription for treating phlegm wet PCOS,as to provide theoretical basis for the treatment of phlegm wet PCOS.