| Objective:The clinical research is aimed to observe the changes of clinical symptoms and related indexes of patients with polycystic ovary syndrome(PCOS)with insulin resistance(IR)treated by tonifying kidney and clearing phlegm and removing blood stasis method combined with metformin,to evaluate the clinical efficacy and to explore mechanism of professor’s experience prescription in the treatment of PCOS and insulin resistance.The ultimate goal is to provide new ideas and methods for treating this disease.Methods : The research collected 64 patients with polycystic ovary syndrome with insulin resistance according to the inclusion criteria.The patients were divided into 32 cases in the treatment group and 32 cases in the control group according to the random number table method.After the treatment group was given the mentor experience prescription tonifying kidney and invigorating spleen and resolving phlegm,and the mentor experience prescription regulating qi and clearing phlegm and removing blood stasis prescription during the premenstrual period.Metformin hydrochloride tablets,once 0.5 g,three times a day,were taken continuously with traditional Chinese medicine for 3 months at the same time.The control group was given estradiol ciproprogesterone tablets on the 5th day of menstruation,one tablet per day for 21 days.Metformin hydrochloride tablets were taken in the same treatment group.The two groups of patients were given health education during taking medicine,told to control diet,pay attention to rest,strengthen exercise(at least 3 times a week physical exercise,each time not less than 30 minutes),family members actively support and encourage,if necessary psychological counseling.Both groups treated 3 menstrual cycles.Menstruation,hairiness,acne,waist-to-hip ratio(WHR),body mass index(BMI),fasting blood glucose(FPG),fasting insulin(FINS),basic hormone level,bilateral ovarian volume were observed and recorded in the two groups before and after treatment,and the number of small follicles in the ovary and the changes of TCM syndrome score.Results1.Comparison of the total effective rate: The total effective rate of the therapy group was93.33%,and the control group was 83.87%.In terms of efficiency,the therapy group is higher than the control group(P<0.01),and this gap is statistically significant.2.Total score of TCM syndromes: The total TCM symptom scores of the two groups of patients decreased compared with the same group before treatment(P<0.05),the difference was statistically significant.The total score of TCM symptoms after treatment in the therapy group was lower than that in the control group(P<0.05),and the difference was statistically significant.3.Comparison of individual TCM symptom scores: After treatment,the individual TCM symptom scores of the two groups of patients were lower than before treatment(P<0.05),the difference was statistically significant.After the treatment,the single TCM symptom scores of the therapy group were all lower than those of the control group(P<0.05)except for menstruation,the difference was statistically significant.4.Comparison of polychaemia and acne scores:After treatment,the hairiness and acne scores of the two groups were lower than before treatment(P<0.05),and the difference was statistically significant.The hairy and acne scores of the therapy group were lower than those of the control group(P<0.05),and the difference was statistically significant.5.Comparison of female sex hormone levels:Compared with before treatment,LH/FSH and T decreased after treatment in both groups(P<0.05),the difference was statistically significant.After treatment,LH/FSH and T in the therapy group decreased significantly compared with the control group(P<0.05),the difference was statistically significant.6.Comparison of Insulin resistance index: Insulin resistance index in both groups were lower than before treatment(P<0.05),the difference was statistically significant.Insulin resistance index in the therapy group were significantly lower than those in the control group(P<0.05),the difference was statistically significant.7.Comparison of ovarian volume and total number of follicles: The ovarian volume and total number of follicles of both groups of patients decreased,compared with before treatment(P<0.05),the difference was statistically significant.the ovarian volume and total number of follicles of the therapy group decreased significantly compared with the control(P<0.05),the difference was statistically significant.8.Body mass index,waist-to-hip ratio comparison: The body mass index and waist-to-hip ratio of both groups of patients decreased before treatment(P<0.05),the difference was statistically significant.Body mass index and waist-to-hip ratio of the therapygroup decreased significantly compared with the control(P<0.05),and the difference was statistically significant.Conclusion:Tonifying kidney and clearing phlegm and removing blood stasis method combined with metformin tablets obvious advantages in treating phlegm-heat stasis type polycystic ovary syndrome complicated with insulin resistance.It is better than western medicine in reducing Insulin resistance index,LH/FSH,testosterone(T)level,body mass index,reducing the number of follicles in ovary,reducing ovarian volume and improving the symptoms of polychaemia and acne. |
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