Clinical Observation On The Therapeutic Effect Of Nourishing Yin And Clearing Heat,Dissipating Phlegm And Eliminating Blood Stasis In The Treatment Of PCOS With IR

Objective:To observe the clinical efficacy of the method of nourishing yin and clearing heat,dissipating phlegm and eliminating blood stasis combined with metformin in the treatment of polycystic ovary syndrome(PCOS)with insulin resistance(IR),and to explore the mechanism,so as to provide new ideas and methods for the treatment of PCOS with IR.Methods:According to the principle of random control,66 patients who met the inclusion criteria were randomly divided into control group(33 cases,oral administration of metformin)and treatment group(33 cases,oral administration of metformin and modified Yiguan Decoction).During this period,2 cases lost follow-up and 1 case had poor compliance in the control group.3 cases in the treatment group had poor compliance.30 cases in the control group and 30 cases in the treatment group completed clinical observation for 3 months.Menstruation,body mass index(BMI),waist-to-hip ratio(WHR),basal body temperature(BBT),ovarian morphology under B-ultrasound,TCM syndrome score(TCM),fasting plasma glucose(FPG),fasting insulin(FINS),estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),prolactin(PRL)and C-reactive protein(CRP)levels were observed and recorded before and after treatment.Statistical methods were used to analyze the differences before and after treatment and the differences between the two groups after treatmentResults:In terms of comprehensive curative effect,the total effective rate was 73.33%in the control group and 96.67%in the treatment group,and there were significant statistical differences between the two groups(P<0.01).The total scores of TCM syndromes in the two groups were significantly lower than those before treatment(P<0.01),and the curative effect of the treatment group was better than that of the control group(P<0.01).In terms of single TCM symptoms,both groups could relieve the TCM symptoms of patients(P<0.05).The improvement of menstrual cycle,chest tightness,subzona,tongue and pulse in the treatment group was better than that in the control group(P<0.05).In terms of BMI and WHR,the levels of that in the treatment group were significantly lower than that in the control group(P<0.01),especially in the treatment group(P<0.01),and the decrease in the treatment group was more significant than that in the treatment group(P<0.01).In terms of sex hormone levels,the levels of PRL and FSH in two groups decreased slightly after treatment,but there were no significant differences between the two groups(P>0.05).After treatment,the levels of LH and LH/FSH in two groups were significantly lower than those before treatment(P<0.01),and the levels of LH and LH/FSH in the treatment group were significantly lower than that in the control group(P<0.05),while the level of E2 in the control group were only slightly higher than that before treatment(P>0.05),the level of E2 in the treatment group was significantly higher than that before treatment(P<0.01).After treatment,the level of E2 in the treatment group was significantly higher than that in the control group(P<0.01).After treatment,the levels of T in two groups were lower than that before treatment(P<0.01).The decrease of T level in the treatment group was more significant than that in the treatment group(P<0.05).In terms of inflammatory factors and glucose metabolism,after treatment,the levels of CRP,FINS,FPG and HOMA-IR in two groups were significantly lower than that before treatment(P<0.01),and the level of CRP in the treatment group was significantly lower than that in the control group(P<0.01).The levels of FINS,FPG and HOMA-IR in the treatment group were significantly lower than those in the control group(P<0.05).In terms of drug safety,there were no obvious adverse reactions such as abnormal liver and kidney function,skin pruritus,lactic acidosis,allergy,hypoglycemia and so on.Conclusion:The method of nourishing yin and clearing heat,dissipating phlegm and eliminating blood stasis combined with metformin tablets in the treatment of PCOS-IR can effectively treat the clinical symptoms of patients,reduce the chronic inflammatory state of patients,and reduce insulin resistance,the effect is better than the simple use of metformin tablets.