The Clinical Research Of Phenotype And TCM Syndrome Type Distribution Regularities And Related Factors Of Polycystic Ovary Syndrome

Objective:To analyze the distribution regularity of phenotypes and TCM syndrome types of polycystic ovary syndrome(PCOS), as well as the relationship between them, the study collected cases of PCOS patients who once treated in reproductive medicine department of Jiangsu Province Hospital. It also detected sex hormone and glucose metabolism, aiming to analyze the connection of them. In addition, it observed pregnancies of patients to explore the potential link. Through the above research, this study will provide a basis for clinical diagnosis, treatment and evaluation.Methods:Taking PCOS patients of reproductive medicine department of Jiangsu Province Hospital as the object, the study designed clinical cases observation table, gathered basic information of patients, and collected clinical data including indexes of sex hormone and glucose metabolism, then classified patients to different phenotypes and TCM syndrome types, also followed up pregnancies after certain time treatment. Finally, this study drew a conclusion by using SPSS21.0 software package to deal with data processing and analysis.Results:l.The characteristics of distribution:This research included 237 PCOS patients totally.Phenotype distribution:Classical type in 107 cases(45.15%), hyperandrogenic anovulatory type in 20 cases (8.44%), hyperandrogenic ovulatory type in 21 cases (8.86%), and non-hyperandrogenic type in 89 cases (37.55%). Syndrome distribution:Kidney yin deficiency type in 46 cases(19.41%), kidney yang deficiency type in 61 cases (25.74%), liver depression type in 48 cases (20.25%), phlegm dampness type in 46 cases (19.41%), blood stasis type in 36 cases (15.19%).2. The levels of sex hormones:Phenotypes compared:Compared with hyperandrogenic anovulatory type and non-hyperandrogenic type, classical type LH, LH/FSH were the highest (P< 0.05 or P< 0.01); T level order from large to small was:hyperandrogenic anovulatory type> classic type> hyperandrogenic ovulatory type> non-hyperandrogenic type, and there was significant difference between hyperandrogenic anovulatory type and others (P< 0.05 or P< 0.01). DHEAS basically shared the same distribution with T.SHBG of non-hyperandrogenic type was the highest, and classical type as well as hyperandrogenic anovulatory type had significant difference with it (P< 0.01). Syndrome types compared:Kidney yang deficiency type LH, LH/FSH were the highest (P< 0.01); T level in turn from high to low was:kidney yin deficiency type>kidney yang deficiency type> phlegm dampness type> liver depression type> blood stasis type,and the latter two have differences with the front two(P< 0.01 or P< 0.05); liver depression type PRL was the highest (P< 0.01).3. The characteristics of glucose metabolism:Phenotypes compared:Classical type FPG、 INS2h、INS3h、GLU2h、GLU3h、I/G、HOMA-IR were the highest, while hyperandrogenic ovulatory type was the lowest (P< 0.05). And also for the HOMA-β, but with no statistical difference (P> 0.05). Syndrome types compared:Phlegm dampness type FINS, INS2h, INS3h, I/G, HOMA-IR were the highest, and other groups were significantly different (P< 0.01 or P< 0.05).4.Pregnancy:Phenotypes compared:The pregnancy rate from high to low was:non-hyperandrogenic type> hyperandrogenic ovulatory type> hyperandrogenic anovulatory type> classic type, there was significant difference between non-hyperandrogenic type and classic type (P<0.05). Syndrome types compared:The pregnancy rate from large to small was as follows:blood stasis type> liver depression type> kidney yin deficiency type>kidney yang deficiency type> phlegm dampness type,and phlegm dampness type has difference with blood stasis type and liver depression type (P< 0.05).5.The relationship between phenotypes and syndrome types:classical type scattered in phlegm dampness type and kidney yang deficiency mostly, while non-hyperandrogenic type scattered in liver depression type and blood stasis type mostly.6. Correlation analysis:T was positively correlated with DHEAS, LH/FSH, FINS,INS2h, INS3h, FPG, I/G, HOMA-IR (P< 0.01 or P< 0.05), and negatively correlated with SHBG(P< 0.05); FINS was positively correlated with T, DHEAS, FBG, FPG (P< 0.01), and negatively correlated with SHBG (P< 0.01).Conclusion:Different phenotypes and different syndrome types ofPCOS have certain relevance with sex hormone and also glucose metabolism characteristics. Classical type and phlegm dampness type had more obvious abnormal glucose metabolism change. There was a certain relationship between phenotypes and syndrome types distribution,and pregnancy also had a potential rule with them.