Clinical Research Of Tonifying The Kidney And Adjusting The Menstrual Cycle Combined With Food-exchange In The Treatment Of Insulin-resistant Polycystic Ovary Syndrome Among "18 To 24" Age-bracket

Purpose:By observing the clinical efficacy of"Tonifying the kidney and adjusting the menstrual cycle" combined with"Food exchange,"in the treatment of insulin-resistant Polycystic Ovary Syndrome among "18 to 24" age-bracket,to explore its mechanisms,in order to form a specific traditional Chinese medicine-Food intervention for the treatment of IR-PCOS,to provide new ideas for clinical treatment of“18 to 24" age-bracket IR-PCOS.Methods:This study collected 60 patients with IR-PCOS who met the inclusion criteria in the outpatient clinic of department of gynecology in Jiangsu Province Hospital of TCM from march 2018 to march 2020.They were equally divided into joint intervention group(Tonifying the kidney and adjusting the menstrual cycle combined with Food exchange)?traditional Chinese medicine group(Tonifying the kidney and adjusting the menstrual cycle)and western medicine group(Metformin).The 1 course is 3 menstrual cycles,totally 2 courses in this treatment.To observe and compare the improvement of TCM syndrome?clinical efficacy?TCM symptom scores?menstrual cycle?PCOM scores?BMI?BBT?sugar metabolism?hyperandrogenemia and signs?sex hormone and inflammatory factors before and after treatment in 3 groups.To evaluate the clinical curative effect and advantages of "Tonifying the kidney and adjusting the menstrual cycle" combined with"Food exchange"in the treatment of“18 to 24" age-bracket IR-PCOS.Results:(1)TCM Syndrome:The total effective rate of the joint intervention group and the traditional Chinese medicine group was 95%,and the total effective rate of the western medicine group was 55%.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group.(2)Clinical efficacy:The total effective rate of the joint intervention group and the traditional Chinese medicine group was 95%,and the total effective rate of the western medicine group was 55%.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group.(3)TCM symptom scores:All 3 groups were effective in improving TCM symptom scores.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group.(4)Menstrual cycle:All 3 groups were effective in improving menstrual cycle.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group.(5)PCOM scores:All 3 groups were effective in improving PCOM scores.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group.(6)BMI:All 3 groups were effective in improving BMI.The curative effect of traditional Chinese medicine group and western medicine group was equal,but the joint intervention group was superior to these 2 groups.(7)BBT:The joint intervention group and traditional Chinese medicine group were uniformly effective in improving BBT,but the western medicine group was ineffective.(8)Sugar metabolism:All 3 groups were effective in improving FPG?FINS and HOMA-IR.The 3 groups had the same effect on FPG.The curative effect of traditional Chinese medicine group and western medicine group was equal on FINS and HOMA-IR,but the joint intervention group was superior to these 2 groups.(9)Signs of hyperandrogen:All 3 groups were effective in improving hairy and acne.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group.(10)Hyperandrogenemia:All 3 groups were effective in improving T?SHBG and FAI.The curative effect of traditional Chinese medicine group and western medicine group was equal on T,but the joint intervention group was superior to these 2 groups.The 3 groups had the same effect on SHBG.The joint intervention group was superior to the traditional Chinese medicine group,and the latter group was superior to the western medicine group on FAI.(11)Sex hormone:All 3 groups were effective in improving E2?AMH?LH and LH/FSH.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group on E2 and AMH.The joint intervention group was superior to the traditional Chinese medicine group,and the latter group was superior to the western medicine group on LH and LH/FSH.The joint intervention group and traditional Chinese medicine group were uniformly effective on FSH,but the western medicine group was ineffective.(12)CRP:All 3 groups were effective in improving CRP.The curative effect of joint intervention group and traditional Chinese medicine group was equal and better than that of western medicine group.Conclusion:(1)In the treatment of IR-PCOS among "18 to 24",age-bracket,"Tonifying the kidney and adjusting the menstrual cycle" was better than metformin in TCM syndrome and clinical efficacy;It is more effective than metformin in rebuilding menstrual cycle,improving hyperandrogenital signs,lowering TCM syndrome and ovarian PCOM scores,adjusting the level of sex hormone and reducing the level of inflammatory factors;The curative effect of these two treatments was equivalent in decreasing BMI and correcting the disorder of sugar metabolism.(2)In the treatment of IR-PCOS among“18 to 24" age-bracket,"Tonifying the kidney and adjusting the menstrual cycle" combined with "Food exchange" was equivalent with"Tonifying the kidney and adjusting the menstrual cycle" in TCM syndrome and clinical efficacy;It is more effective than "Tonifying the kidney and adjusting the menstrual cycle" in decreasing BMI,correcting the disorder of sugar metabolism and adjusting the level of sex hormone;The curative effect of these two treatments was equivalent in rebuilding menstrual cycle,improving hyperandrogenital signs,lowering TCM syndrome and ovarian PCOM scores and reducing the level of inflammatory factors.(3)In the treatment of IR-PCOS among“18 to 24" age-bracket,as a mean of lifestyle intervention,"Food exchange" has a synergistic effect on "Tonifying the kidney and adjusting the menstrual cycle" in reducing weight,correcting the disorder of sugar metabolism and adjusting the level of sex hormone.