| [Objective] In order to explore the clinical efficacy and mechanism of strengthening the spleen and kidney or resolving phlegm ,as well as acupuncture treatment to obesity patients with PCOS ,and to investigate the important role of hyperandrogenism in the pathogenesis of obese patients with PCOS , with the guidance of my instructor Professor Tao and other teachers, we have embarked on this study.[Method} According to the age and Pathogenetic features, a total of 67 cases from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and the second hospital of Chinese medicine in Guangdong Province ,who were consistent with our study standard, were divided into three groups randomly, Chinese Medicine +acupuncture Group, 23 cases, treated with medicine of strengthening the spleen and kidney or resolving phlegm Herbal (mainly Cang Fu Dao Tan Tang), one dose each day for three months, and accept acupuncture (Point catgut embedding) treatment at the same time, once a week for three months; Herbal Medicine Group, 22 cases, treated with strengthening the spleen and kidney or resolving phlegm Chinese Medicine only (mainly Cang Fu Dao Tan Tang), one dose each day for three months , acupuncture Group , 22 cases, accept acupuncture (Point catgut embedding) treatment, once a week for three consecutive months, all treatment were canceled in menstrual period. Before the treatment, we record the age, medical history and body height and weight of each patient, and draw the blood from the patient' s body on the third to five days of the menstrual cycle before the treatment and the first menstrual cycle after stopping the treatment, if amenorrhea, draw the blood when monitoring no advantage follicular larger than 1 cm, then measure the blood content of LH, FSH, T2 by the way of electro-chemiluminescence immunoassay, measure the blood content of insulin (FINS) by RIA, fasting plasma glucose (FPG) value, then save the serum to measure the the blood content of sex hormone binding globulin (SHBG)and Androstenedione (A2 ) by ELISA test once at all on the final. At the same time ,we observed and compared the situation include the weight, menstruation, acne, and hair, infertility and ovulation(BBT) before and after the treatment , then calculate HOMA-IR (FINS*FBG/22. 5) and BMI (weight / height~2), in the end, we analysis the experimental results with statistical software SPSS13.0, counting date by k-square-test, measurement data by t-test or single-factor analysis of variance, explore the mechanism of efficacy and analysis the pathological mechanisms.[Results]1. The change of clinical symptoms such as menstrual abnormalities , single-phase BBT, obesity, acne, infertility, hirsutism:On the acupuncture+Chinese medicines group, nineteen cases were effective, four cases were invalid, the effect of the treatment was 82. 61 percent. On the Chinese medicines group, twelve cases are effective, eleven cases are invalid, the effect of the treatment was 54.5 percent; on the acupuncture group, ten cases are effective, twelve cases are invalid, the effect of the treatment was 45. 5 percent, the effect of the acupuncture+Chinese medicines group is superior to the effect of Chinese medicine group and acupuncture group, the difference is significant (P<0. 05), the efficacy of Chinese medicine group and Acupuncture group have no significant difference (P>0.05). On the acupuncture+Chinese medicines group, after the treatment, nineteen patients from twenty-three cases have better menstrual period, the BBT of thirteen cases changed from single-phase to duplex, five cases from twelve cases of infertility got pregnancy; On the acupuncture +Chinese medicines group, there is no significant difference in acne score, and hair score of the patients after treatment (P>0. 05), and it showed no significant difference with the acupuncture group after the treatment (P>0.05);On the acupuncture+Chinese medicines group, BMI declined significantly after treatment(P<0.05),and the BMI after the treatment is lower than the Chinese medicines group(P<0.01), but it showed no significant Differences with the acupuncture group (P>0.05); On the Chinese medicine group, after the treatment, menstrual of twelve cases got better, BBT of 10 cases changed from single-phase to two-phase, two cases from ten cases of infertility patients got pregnancy; the BMI of Chinese medicine group after treatment have no significant differences with treatment before (P>0. 05), but it is higher than the acupuncture group after the treatment (P<0.01).On the acupuncture group, after the treatment, menstrual of ten cases got better, BBT of five cases changed from single-phase to two-phase, one cases from six cases of infertility patients got pregnancy, the cases with menstrual abnormalities or single-phase BBT decreased (P<0. 05);the difference about infertility, acne and hare score were not significant after the treatment (P>0.05), the BMI of acupuncture group after the treatment have significant differences with it before the treatment(P<0. 05).2. the effect of acupuncture-Catgut embedding and/or traditional Chinese medicine of strengthening the spleen and kidney or resolving phlegm on sex hormones of obese PCOS patients:on the acupuncture+Chinese group , compared with Chinese medicine group and acupuncture group, there were not significant difference in the serum LH, FSH, LH / FSH, T, A2, SHBG content before the treatment, (P>0.05).LH and LH/FSH decline significantly after the treatment, (P<0.05);but FSH have no significant difference with it before the treatment, (P>0. 05); After the treatment, there were no significant difference in LH, FSH, LH/FSH with Chinese medicine group and acupuncture group(P>0. 05), the content of T was significantly decreased after the treatment, (P<0. 05), and it is lower than Chinese medicine group and acupuncture group after the treatment (P<0. 05) ;A2 decreased significantly after the treatment (P<0. 05), and it is lower than Chinese medicine and acupuncture group after the treatment(P<0. 01) ;SHBG increased significantly significant (P<0. 001), and it is higher than Chinese medicine group and acupuncture group after the treatment significantly (P<0. 01); On Chinese medicines group, before the treatment,there is no significant difference on serum LH, FSH, LH/FSH, T, A2, SHBG content with the acupuncture group(P>0.05). after the treatment, on Chinese medicine group, LH, LH/FSH values decline significantly(P<0. 05); after treatment, FSH have no significant difference with the treatment before(P>0.05);After the treatment, LH, FSH, LH/FSH have no significant differences with acupuncture group, (P>0. 05); after the treatment, content of T have no significant difference with it before the treatment, (P>0. 05), and there is no significant difference with Acupuncture group after the treatment(P>0. 05); A2 decreased significantly after the treatment(P<0. 05), it have no significant difference with the acupuncture group after treatment, (P>0.05);SHBG increased after the treatment,the difference with it before the treatment is significant(P<0. 05);compared with acupuncture group, there is no significant difference(P>0.05). after the treatment, on acupuncture group, LH decline significantly(P<0. 05);after the treatment,FSH, LH/FSH have no significant difference with the treatment before (P>0. 05); after treatment, the content of T have no significant difference with it before the treatment, (P>0. 05);after the treatment, blood content of A2 decreased was significantly(P<0.05);after the treatment, SHBG increased significantly (P<0. 05).3. the effect of acupuncture-Catgut embedding and/or traditional Chinese medicine of strengthening the spleen and kidney or resolving phlegm on FBG,FINS,HOMA-IR of obese PCOS patients:on the acupuncture+Chinese group, compared with Chinese medicine group and acupuncture group, there were not significant difference in the FBG,FINS,HOMA-IR content before the treatment (P>0. 05);after the treatment, FINS , HOMA-IR decline significantly (P<0.05);and after the treatment, FINS, HOMA-IR is lower than Chinese medicine and acupuncture group significant(P<0.01);after the treatment,the FBG have not significant difference with acupuncture group(P>0. 05). on the Chinese medicine group, before the treatment, FBG, FINS, HOMA-IR have no significant difference with acupuncture group(P>0. 05); FBG, FINS of Chinese medicine group after the treatment have no significant difference with it before the treatment, (P<0. 05);and it have no significant difference with acupuncture group after the treatment(P<0.01);after the treatment, HOMA-IR decreased(P<0. 05), but it have no significant difference with the acupuncture group after the treatment(P>0.05). On the acupuncture group, after the treatment,BMI decreased(P<0. 05);FINS and HOMA-IR value decreased(P<0. 05);FBG have no significant difference with it before the treatment(P>0. 05).[Conclusion]1. Deficiency of spleen and kidney, with phlegm-dampness reserved in the body together, become the most important pathogenesis of obese women with polycystic ovary syndrome;2. Acupuncture combined with traditional Chinese medicine for strengthening the spleen or kidney and resolving phlegm-plus or minus of Cang Fu Dao Tan Tang is the effective way of treating obesity phlegm-dampness Syndrome patients with polycystic ovary syndrome, compared with the simpler treatment of Chinese medicine or acupuncture treatment, it has a better clinical effect.3. Acupuncture combined with Chinese medicine of strengthening the spleen and kidney or resolving phlegm are good at treating obesity patients with PCOS , it's mechanism include:â‘ this treatment way can reduce the weight significantly;â‘¡this treatment way can reduce the content of T, A2, so as to deal with the hyperandrogenism;â‘¢this treatment way can relive insulin resistance and the compensatory hyperinsulinemia caused by insulin resistance;â‘£this treatment way may reduce the content of LH and LH/FSH, so that the patients have normal menstrual cycle, ovulation restored , and some of infertility patients become pregnant.4. Obese patients with polycystic ovary syndrome have clinical and biochemical indicators such as hyperandrogenism , insulin resistance or hyperinsulinemia , hyperandrogenism and insulin resistance often coexist in obese PCOS patients, them are proportional Serious to a certain extent... |
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