Clinical And Metabonomic Study Of Polycystic Ovary Syndrome With Phlegm And Blood Stasis

ObjectiveBy comparing the general data between phlegm and blood stasis type of polycystic ovary syndrome patients,kidney deficiency and liver depression type and healthy population,the relationship between phlegm and blood stasis in patients with PCOS was compared.The indexes and the changes of serum metabolic state were analyzed by LC-MS to find the difference between PCOS patients with different syndromes and to provide evidence for the objectification of syndromes and dialectical treatment of TCM.To find out the difference between polycystic ovary syndrome patients and healthy volunteers in order to provide guidance for the analysis of etiology and pathogenesis and accurate treatment.MethodsFrom October 1,2018 to January 31,2019,60 patients with PCOS who met the standard of the gynecological outpatient clinic of the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine,including 28 cases of phlegm and blood stasis type,32 cases of kidney deficiency and liver depression type,were included.In addition,30 healthy volunteers who met the standard of discharge were selected,and their general data were collected.Six items of sex hormones were detected on the 2-3 days of menstruation,and the fasting blood samples were collected by coagulation tube in the morning 4-5 ml.The changes of serum metabolic map were detected by using super-high efficiency liquid LC-MS technique,and the changes of serum metabolic patterns were analyzed between patients and healthy persons,and between patients with different syndromes and different types of syndromes.The indexes were compared.Results1.In this study,the weight and BMI of PCOS patients in the phlegm and blood stasis group were higher than those in the kidney deficiency and liver stagnation group;the incidence of acne in the PCOS patients in the kidney deficiency and liver stagnation group was higher than that in the phlegm and blood stasis group;There was no significant difference between the hairy condition and the sex hormone test;the LH,T,LH/FSH of PCOS patients were higher than those of the healthy group,and the LH/FSH ratio was more than 2 times;2.A total of 4371 serum markers were screened in this study.According to the VIP values(VIP>1)and t-test results in the PLS-DA model,the results of the mass spectrometry isotope matching and the search results and identification results of databases such as HMDB and KEGG.In this study,20 possible serum markers were included in the study.Among them,14 markers were statistically significant in patients with PCOS compared with those with kidney-deficiency and liver-stagnation-type PCOS.Eighteen people tested were statistically significant.conclusion:1.Through the comparison of clinical data,body weight,BMI,and hemorrhoids can be considered as syndrome differentiation points of phlegm and blood stasis type and PCOS of kidney deficiency and liver stagnation.The small samples selected in this study are basically consistent with the statistics of large samples.With a certain sample representative,it can be used as a further study of metabolomics data;2.The main metabolic pathways involved in the analysis of serum marker metabolic pathways are:amino acid metabolism(histidine,tyrosine,leucine,phenylalanine,cysteine,methionine,proline)Etc.),lipid metabolism(decomposition of fatty acids,lipid transport,decomposition of phospholipids),carbohydrate metabolism(decomposition of maltose,synthesis of glycosaminoglycans,synthesis of glycoproteins)and other pathways(biotransformation of liver,bile acid)Metabolism,etc.).1.3.Screening of markers by HPLC-MS technique revealed that the main serum markers of phlegm and blood stasis type PCOS patients compared with healthy people were histidine,a-tocopherol,1,4-?-D-glucan,Undecyl glycine,methyl selenate,3,4-Dihydroxybenzylamine,oleamide,N-Jasmonoylisoleucine,deoxycholic acid,keratin sulfate I,benzenediol,2-Oxo-4-methylthiobutan-oic acid,hydrazine Acid,L-fucose,fatty amine amide,LysoPC(22:1(13Z)),Glutaminylhydroxyproline,Methionyl-Glutamate;2.4.The serum markers of PCOS patients with phlegm and blood stasis type were histidine,a-tocopherol,Pentadecanoylcarnitine,undecyl glycine,methyl selenate,3,4-Dihydroxybenzylamine,2-amino-4-butanoic acid,deoxycholic acid,phenylene glycol,proline,L-fucose,LysoPC(22:1(13Z)),Glutaminylhydroxyproline,Methionyl-Glutamate.