Clinical Study Of Xie He Decoction In Treatment Of PCOS With SCH

Objective:To observe the clinical efficacy of Xie He Decoction treating obese PCOS with SCH and its influence on thyroid function,coagulation and fibrinolysis indexes,and to evaluate the application value of Xie He Decoction in the treatment of hypothyroidism and hypercoagulability in obese PCOS with Sch,so as to provide experience and ideas for Chinese medicine to improve the clinical complications and future thrombosis tendency of PCOS patients.Method:The patients were selected from the gynecological clinic of Jiangsu Provincial Hospital of traditional Chinese medicine from December 2019 to December 2020.They were diagnosed as obese,PCOS and SCH respectively,and they were diagnosed as phlegm dampness syndrome.The 92 patients were divided into treatment group and control group,46 cases in treatment group and 46 cases in control group.The treatment group was given Xie He Decoction orally(stopped during menstruation)and the control group was given metformin orally.Both groups were treated with lifestyle intervention for 3 months.The relevant laboratory indexes and scores of TCM symptoms in the two groups after treatment were evaluated,and then the relevant indexes of the two groups were compared by stratified method with TSH=4mIU/L as the cut-off point.Results:1.Both groups can effectively reduce the scores of TCM symptoms(P<0.05),and the treatment group is better than the control group.2.Both groups can effectively improve LH,LH/FSH,T,SHBG,FAI,PRL(P<0.05),and the treatment group is better than the control group in improving LH,LH/FSH,SHBG and FAI(P<0.05).3.TSH was decreased in both groups(P<0.05),but there was no significant difference between the two groups(P>0.05).4.The two groups could effectively reduce FINS,HOMA-IR and BMI(P<0.05),but there was no significant difference between the two groups(P>0.05).5.There was no significant difference in APTT in the two groups before and after treatment(P>0.05),and D-D decreased slightly,but the difference was not statistically significant(P>0.05).6.The comprehensive effective rate was 73.90%in the treatment group and 75.70%in the control group,but there was no significant difference between the two groups(P>0.05).7.Comparison by taking TSH=4mIU/L as cut-off point:(1)Before treatment,the indexes of LH,LH/FSH,PRL,HOMA-IR,BMI and TCM symptoms scores in patients with 2.5mIU/L≤TSH<4mIU/L were lower than those of patients with 4mIU/L≤TSH<10mIU/L(P<0.05).(2)When 2.5mIU/L≤TSH<4mIU/L,the treatment group was better than the control group in improving TSH,FINS,HOMA-IR and BMI(P<0.05),but when 4mIU/L≤TSH<10mIU/L,there was no significant difference between the two groups(P>0.05).(3)The comprehensive effective rate of 2.5mIU/L≤TSH<4mIU/L was 80.00%,and that of 4mIU/L≤TSH<10mIU/L was 68.40%,but the difference was not statistically significant(P>0.05).Conclusion:1.Xie He Decoction can significantly improve the clinical syndromes and thyroid function of PCOS with SCH,regulate the reproductive endocrine and metabolic disorders.It is safe and effective,and can be further applied in clinical application.2.According to the hierarchical comparison,when TSH level is higher,the more obvious reproductive endocrine and metabolic disorders may exist in PCOS patients with SCH,which reduces the effective rate of traditional Chinese and Western medicine treatment,suggesting the importance of thyroid function screening in PCOS patients and the necessity of early diagnosis and treatment for PCOS patients with SCH.