Clinical Observation On The Treatment Of Spleen Deficiency Phlegm Dampaness Type Polycystic Ovary Syndrome With Insulin Resistance By The Method Of Jianpi Huatan Decoction Combined With Metformin

Objective:To explore the clinical effect of Jianpi Huatan Decoction combined with metformin in the treatment of Spleen Deficiency Phlegm Dampness Type polycystic ovary syndrome with insulin resistance,and to analyze its mechanism of action to provide theoretical support and scientific basis for clinical application.Method:60 cases patients of Spleen Deficiency Phlegm Dampness Type PCOS with IR were selected from October 2017 to March 2019 in the Reproductive Department of Xuzhou city Hospital of TCM as the observation object.The control group oral metformin,the treatment group on the basis of the control group,oral self-prepared Jianpi Huatan Decoction(starting from the 5th day of menstruation or withdrawal hemorrhage),with 3 courses of treatment.To observe the changes of menstrual improvement,ovulation rate,pregnancy rate,and TCM symptoms in the two groups before and after treatment.Measure and compare two groups of patients’ luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),estradiol(E2),fasting plasma glucose(FPG),fasting insulin(FINS)levels,and steady-state model insulin resistance index(HOMA-IR),calculate body mass index(BMI)and waist-to-hip ratio(WHR)before and after treatment.Statistical analysis was carried out using SPSS20.0 statistics software.Results:1.The age,weight,height and waist-to-hip ratio of the two groups were analyzed by independent sample t test,the difference was not statistically significant(P>0.05),and it was comparable.2.After treatment,the total effective rate of the treatment groups was 93.33%,and the control group was 73.33%.The two groups compared with each other(P<0.05),indicating that the curative effect in the treatment group was better than that of the control group.3.After treatment,both groups of TCM syndromes decreased,and there was a statistical difference(P<0.01)compared with before treatment,suggesting that both groups could improve the clinical symptoms of PCOS-IR after treatment.And after treatment,there was a statistically significant comparison between the two groups(P<0.05).4.Compared with sex hormone level in the pre-treatment groups,the difference was not statistically significant(P>0.05).After treatment,the levels of LH,T and LH/FSH in the two groups are significantly lower(P<0.05),FSH,E2 levels there was no significant difference(P>0.05).After treatment LH and T levels in the treatment group were significantly lower than those in the control group(P<0.05).There was no significant difference in FSH、E2 and FSH/LH levels between the two groups(P<0.05).5.C.ompared with FINS,FPG and HOMA-IR in the pre-treatment groups,the difference was not statistically significant(P>0.05),there was comparability.After treatment,two groups of FINS,FPG and HOMA-IR levels were decreased(P<0.05),and the treatment group was superior to the control group(P<0.05)6.Before treatment,there was no statistically significant difference in BMI and WHR between the two groups(P>0.05)、which was comparable.After treatment,the BMI and WHR decreased in the two groups(P<0.05),and there were no significant differences between the two groups(P>0.05).7.During the observation period,the ovulation rate in the treatment group was 73.26%,in the control group was 46.43%,and there were significant differences between the two groups(P<0.01).After treatment,10 people were pregnant in the treatment group and 3 in the control group,the difference was statistically significant(P<0.05).Concisions:The main clinical manifestations of PCOS-IR patients are hyperinsulinemia(HI),lipid metabolism disorder,hyperandrogenism(HA),ovulation disorder,obesity and so on.Professor Xuxia based on years of experience in clinical diagnosis and treatment,considered that spleen deficiency and phlegm dampness block are the root causes of metabolic disorder caused by PCOS-IR.Therefore,in clinical treatment,self-made Jianpi Huatan Decoction is often used to improve insulin resistance and regulate metabolic disorders in PCOS-IR patients.This experimental study shows that compared with oral metformin alone,Jianpi Huatan Decoction combined with metformin can effectively reduce the body mass index,waist-to-hip ratio,regulate sex honnone levels and glucose metabolism disorders,improve patients clinical symptoms,and then increase ovulation rate and pregnancy rate,and no toxic side effects,has a wide range of clinical application prospects.