Analysis Of Tcm Physical And Clinical Biochemistry Characteristics Of PCOS Patients With Various Tsh Concentrations

Objective:To investigate the traditional Chinese medicine(TCM)physical characteristics of polycystic ovary syndrome(PCOS)patients with different concentrations of thyroid stimulating hormone(TSH),as well as their clinical,endocrine and metabolism characteristics,so as to provide a theoretical basis for TSH routine screening,metabolic status assessment,early intervention,prevention and treatment of PCOS patients.Methods:A retrospective study was conducted with 860 PCOS patients in total,whose information was collected from the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine during a period from November 2013 to June 2018.These PCOS patients were divided into three groups based on their TSH concentrations,specifically Group A(TSH<2.5u IU/ml),group B(2.5u IU/ml≤TSH≤4u IU/ml),and group C(TSH>4u IU/ml).SPSS 20.0 software package was utilized to statistically analyze the distribution of TCM constitution types in PCOS patients and the correlation between different TSH concentrations,and clinical signs and biochemistry indices of PCOS patients.Results:(1)For Group A(TSH<2.5u IU/ml),the main TCM constitution types were phlegm-dampness(39.40%),qi deficiency(20.00%)and mild physical(16.20%).However,Group B(2.5u IU/ml≤TSH≤4u IU/ml)was mainly composed of qi deficiency(23.27%),phlegm-dampness(21.46%)and mild physical(14.91%),Group C(TSH>4u IU/ml)was mainly qi deficiency(22.35%),yang deficiency(17.65%)and qi stagnation(16.47%).(2)There were statistically significant differences in diastolic blood pressure,BMI,PRL,E2,TSH,FT4,FINS,IR,TG,TC,HDL,LDL,apo A,and apo B among PCOS patients in the three groups(P < 0.05).Diastolic blood pressure,BMI,PRL,TSH,FINS,IR,TG,TC,LDL,apo A of group C were all higher than those of group A,while E2,FT4,and HDL of group C were lower than those of group A,and the difference was statistically significant(P <0.05).Group C had higher values of BMI and TSH but lower values of FT4 and E2 compared to group B,with statistically significant differences(P <0.05).Diastolic blood pressure,BMI,PRL,TSH,FINS,IR,TG,TC,LDL,apo A,and apo B in group B were significantly higher than those in group A,while E2 and HDL in group B were significantly lower than those in group A,with statistically significant differences(P < 0.05).Conclusion:(1)Among PCOS patients,phlegm-dampness,qi deficiency,mild physical,and qi stagnation are the main TCM constitution types.For PCOS patients with TSH<2.5u IU/ml,phlegm-dampness,qi deficiency,and mild physical are the main TCM constitution types;for PCOS patients with2.5u IU/ml≤TSH≤4u IU/ml,qi deficiency,phlegm-dampness,and mild physical are the main TCM constitution types;for PCOS patients with TSH>4u IU/ml,qi deficiency,yang deficiency,and qi stagnation are the main TCM constitution types.With the increase of TSH,the proportion of PCOS patients with mild constitution decreased,and the proportion of PCOS patients with Yang deficiency increased.(2)TSH concentration is closely related to sex hormone and lipid metabolism indices in PCOS patients,which may further aggravate endocrine and metabolic disorders in PCOS patients by affecting sex hormone and lipid metabolism indices.(3)The physical characteristics and clinical manifestations of PCOS patients with different TSH concentrations are different.It is expected to prevent and improve the related symptoms of PCOS patients by adjusting the biased constitution through routine screening of TSH concentration and body differentiation therapy,which is of great significance for the prevention and treatment of PCOS patients.