| Objective:By collecting and sorting out the clinical data of non obese PCOS patients,the first step is to analyze and discuss the characteristics of TCM syndrome distribution of non obese PCOS patients;the second step is to compare the therapeutic effect of Da Ying and traditional Chinese medicine combined with Da Ying in the treatment of non obese PCOS patients with Qi stagnation,phlegm and blood stasis,and to explore the intervention effect of xiaobaotiaojing decoction,so as to provide theoretical basis for clinical application of Huatan Jiangqi method in the treatment of non obese PCOS.Methods:First of all,through the questionnaire survey of non obese PCOS patients,recording their clinical manifestations and tongue pulse,summed up the characteristics of TCM syndrome distribution of these patients.Secondly,the non obese PCOS patients with qi stagnation,phlegm and blood stasis type who meet the inclusion criteria were admitted into the group.They were divided into the treatment group and the control group with a random number table.The control group was treated with Diane-35,and the treatment group was treated with xiaobaotiaojing decoction,a self-made Chinese medicine,for three months.Before treatment,after treatment and 3 months after discontinuation of treatment,the levels of six endocrine items,AMH,inhb and IGF-1were measured and recorded,and the changes of the number of antral follicles,ovarian volume and the largest diameter of follicles were monitored by ultrasound.The changes of indexes before and after treatment were compared in the group,and the indexes and curative effects between the two groups were also compared.To explore the effectiveness of the treatment of qi stagnation and phlegm stasis PCOS.Result:Study 1:(1)The main TCM symptoms include: Post menstrual errors,chest and flank pain or percussion pain,less abdominal tenderness,less menstrual volume,dark menstrual color,blood clots,fatigue and fatigue,heavy limbs,irritability and irritability,low back and knees,acne,dim complexion,insomnia,dreaminess,constipation and lower abdominal pain and distension.Tongue vein mainly includes: dark red tongue,fat tongue,stringy vein,smooth vein,weak vein,tooth mark,etc.(2)The order of syndrome type distribution of non obese PCOS patients is Qi stagnation 81.6% > liver depression 70.8% > phlegm dampness 68.3% > blood stasis 63.3% > kidney deficiency56.6% > spleen deficiency 42.5% > blood heat 29.2% > Yin deficiency 18.3%.Study two:(1)Reproductive endocrine hormone: before and after treatment,the levels of LH,LH / FSH and T in the two groups were significantly decreased after treatment,and the difference was statistically significant(P The difference was not significant(P >0.05).In the inter group comparison,after 3 months of drug withdrawal,the levels of LH and LH / FSH in the treatment group were lower than those in the control group(P< 0.05);there was no significant difference in the levels of T and FSH(P > 0.05).There was no significant difference in PRL and P before and after treatment(P > 0.05).In the intra group comparison,the E2 level of the two groups increased after treatment,and the difference was statistically significant(P < 0.05)。After 3 months of discontinuation,the level of E2 in the control group was lower than that before treatment(P > 0.05),but there was no significant difference between the two groups(P > 0.05).(2)Ovarian reserve function: the levels of AMH,inhb and IGF-1 in the treatment group were significantly lower than those before treatment(P < 0.05);the levels of inhb in the control group were significantly lower than those before treatment(P < 0.01),while the levels of AMH and IGF-1 were not significantly different than those before treatment(P > 0.05).The levels of AMH,inhb and IGF-1 in the treatment group were lower than those in the control group after treatment and 3 months after drug withdrawal,and the difference was statistically significant(P < 0.05).(3)The number of antral follicles,the volume of ovaries and the largest diameter of follicles: in the comparison between the two groups,the number of antral follicles and the volume of ovaries in the two groups decreased after treatment(P < 0.01);the number of antral follicles and the volume of ovaries in the control group had no significant difference after 3 months of treatment(P > 0.05).In the inter group comparison,after 3 months of drug withdrawal,the number of antral follicles and ovarian volume in the treatment group were smaller than those in the control group,and the maximum diameter of follicles in the ovulation period was larger than that in the control group,the difference was statistically significant(P < 0.01).(4)Comparison of clinical efficacy judgment: according to the clinical efficacy judgment standard,after treatment,the total effective rate of the treatment group is 100%,the total effective rate of the control group is 100%.Three months after discontinuation,the total effective rate was 89% in the treatment group and 65% in the control group.Using the rank sum test,there was a significant difference between the treatment group and the control group(P < 0.01).Conclusion:1.The TCM syndrome elements of non obese PCOS patients mainly include: liver,spleen and kidney;the disease syndrome elements mainly include qi stagnation,phlegm dampness and blood stasis.2.The combination of Diane-35 and Diane-35 alone can improve the hormone level and menstrual disorder of the patients.There is no significant difference in the treatment between them.3.In the long term,the effect of Diane-35 combined with traditional Chinese medicine on improving ovarian reserve function and Promoting Follicular Development in PCOS patients is better than that of Diane-35 alone.4.Xiaonangtiaojing decoction,a self-made Chinese medicine,can effectively improve the clinical symptoms,improve the ovarian reserve function,promote the development of follicles and improve the clinical efficacy in the treatment of non obese PCOS patients with qi stagnation and phlegm stasis. |
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