Clinical Research Of Bushen Huatan Decoction Combined With Metformin For The Treatment Of The Patients With PCOS Of Type Of Kidney Deficiency And Phlegm Dampness Based On Metabonomic Technology

Objective:(1)By comparing healthy women with PCOS of kidney deficiency and phlegm dampness type,the main metabolic characteristics of PCOS of kidney deficiency and phlegm dampness type were summarized,and the pathogenesis of PCOS of kidney deficiency and phlegm dampness type was discussed from the metabonomics level.(2)The patients with PCOS of kidney deficiency and phlegm dampness type were divided into two groups.One group was treated with Bushen Huatan Decoction.By comparing the two groups before and after treatment,the clinical value of Bushen Huatan Decoction was affirmed,and the mechanism of the self-made Bushen Huatan Decoction was analyzed.Methods:40 healthy women were selected as control group A.60 patients with PCOS of kidney deficiency and phlegm dampness type diagnosed in the outpatient department of Reproductive Center of Jiangsu Provincial Hospital were randomly divided into test group B and test group C,30 cases each.Firstly,based on GC-MS and ELISA technology,the serum metabolites and PYY of all subjects were detected,and all kinds of indexes(BMI,sex hormone,glycolipid metabolism,PYY index and metabolites)were collected,and the comparison between normal group and PCOS group before treatment was carried out.Second,the experimental group was treated with metformin alone.Second,the experimental group B was treated with metformin alone.Second,the experimental group C was treated with self-made Bushen Huatan Decoction+metformin.The treatment period was 3 months.Then the BMI,TCM syndromes,sexual hormone levels(LH,FSH,LH/FSH,T,E2,DHEAS,SHBG,FAI),glucose and lipid metabolism levels(FBG,FIN,HOMA)of the experimental group B and C before and after treatment were compared-The differences of IR,TC,TG,HDL,LDL and PYY were used to judge the comprehensive effect.Results:(1)Compared with the healthy population,the BMI of PCOS patients with kidney deficiency and phlegm dampness type was significantly higher;the levels of LH,LH/FSH,T,E2,DHEAS,FAI,FIN,HOMA-IR,TC,SHBG and TG,LDL were significantly higher;the PYY levels of HDL and glucose tolerance test at each time node were significantly lower;and there were 18 significant differences in the metabolites,including phosphoric acid,butanol,3-hydroxybutyric acid,glycolic acid,hydroxyisovaleric acid and ketoglutaric acid Diacid,threonine,xylitol,D-Threonine,3-deoxyamyl alcohol,3-hydroxyphenylacetic acid,xylose,alloketose,d-alose,ribol,trans aconitic acid,isocitrate,methylmalonic acid,alanine,aspartic acid,glutamic acid metabolism,cysteine metabolism and other pathway changes,the above differences are statistically significant(P<0.05).(2)The effective rate of Bushen Huatan Decoction Combined with metformin in the treatment of PCOS of kidney deficiency and phlegm dampness type was 86.6%,higher than that of pure metformin(63.3%);metformin can effectively restore menstrual cycle and reduce BMI,TCM syndrome score,LH,T,DHEAS,AFI,FIN HOMA-IR,TC and LDL levels;it can effectively increase HDL and PYY levels,and the effect of Bushen Huatan Decoction Combined with it is better,in addition,Bushen Huatan Decoction can The results showed that E2 was increased slightly,and the significance of LH,LH/FSH,DHEAS and PYY was the greatest(P<0.01).Conclusion:(1)The main metabolic characteristics of PCOS patients with kidney deficiency and phlegm dampness were as follows:? BMI index increased,obesity was the majority;?sex hormone level was disordered,showing high LH and ha status;?glycolipid metabolism was seriously disordered,showing hyperinsulinemia and hyperlipidemia status;?gastrointestinal hormone PYY low level status;? alanine,aspartic acid,glutamic acid metabolism,cysteine and other metabolic pathways were significantly improved Change.Based on the analysis of metabonomics,the pathogenesis may be related to the imbalance of carbohydrate metabolism,lipid metabolism and amino acid metabolism pathway,such as tricarboxylic acid cycle and oxidative stress response.(2)Metformin can effectively improve the menstrual cycle,BMI,TCM syndrome score,sex hormone,glycolipid metabolism and PYY level of PCOS patients with kidney deficiency and phlegm dampness type,but the effect is better after combined with Bushen Huatan Decoction,which makes clear the significance of metformin in treating PCOS with kidney deficiency and phlegm dampness type,affirms the clinical value of self-made Bushen Huatan Decoction,and boldly speculates that Bushen Huatan Decoction may affect the gonadal axis Adrenal axis and gut brain axis play a role in improving metabolism.