Expression Of Th17/treg Cytokines In Patients With Phlegm-dampness Syndrome Of Polycystic Ovary Syndrome And Intervention Of Traditional Chinese Medicine

Objective:1.To observe the expression of Th17/Treg cytokines:IL-17 and IL-10 in PCOS patients with phlegm-dampness syndrome,and to explore the pathogenesis of PCOS phlegm-dampness syndrome from the perspective of immune inflammation,so as to provide microcosmic basis for TCM syndrome differentiation and treatment of PCOS.2.To observe the clinical efficacy of Qi Gong Wan in the treatment of PCOS phlegm-dampness syndrome and its effect on the expression of IL-17 and IL-10,and to explore the mechanism of action of tradi tional Chinese medicine,so as to provide new theoretical and clinical support for the treatment of PCOS phlegm-dampness syndrome with TCM.Method:40 pat ients with PCOS phlegm-dampness syndrome were randomly divided into treatment group(n=20)and routine group(n=20).There were 20 patients with non-phlegm-dampness PCOS and 20 healthy controls with normal ovulation at the same time.Every patient’ s height,weight,waist circumference and hip circumference were measured and their body mass index(BMI)and waist hip ratio(WHR)were calculated.Sex hormone indexes,fasting blood glucose(FPG)and serum fasting insulin(FINS)were also measured and insulin resistance index(HOMA-IR)was evaluated by steady-state model.The levels of serum IL-17 and IL-10 were measured by enzyme-linked immunosorbent assay(ELISA).The correlation between IL-17,IL-10 and insulin resistance was analyzed.At the same time,the treatment group was treated with Qi Gong Wan combined with metformin,and the routine group was treated with metformin only.The improvement of TCM syndromes and the changes of BMI,WHR,FPG,FINS,HOMA-IR,IL-17 and IL-10 were observed before and after treatment.Results:1.Comparison of general condition and hormone level:BMI,waist circumference,hip circumference and WHR in PCOS phlegm-dampness group were significantly higher than those in non-phlegm-dampness group and control group(P<0.01).The values of LH and T in PCOS group were significantly higher than those in control group(P<0.01),but there was no significant difference in LH and T values between the two groups.The values of FPG,FINS and HOMA-IR in PCOS phlegm-dampness group were significantly higher than those in non-phlegm-dampness group and control group(P<0.01).2.Comparison of IL-17 and IL-10 levels:the levels of IL-17 in PCOS groups were significantly higher than those in control group(P<0.01).The level of IL-17 in PCOS phlegm-dampness group was significantly higher than that in non-phlegm-dampness group(P<0.01).The level of IL-10 in PCOS groups was significantly lower than that in control group(P<0.01),and the level of IL-10 in phlegm-dampness group was significantly lower than that in non-phlegm-dampness group(P<0.05).3.Correlation analysis:the total serum IL-17 level was positively correlated with FPG,FINS and HOMA-IR,while the total IL-10 level was negatively correlated with FPG,FINS and HOMA-IR(P<0.01).4.The clinical effect of Qi Gong Wan on PCOS patients with phlegm-dampness syndrome:Levels of BMI,WHR,FINS,HOMA-IR and the score of TCM syndromes in the two groups were significantly improved after treatment(P<0.01).And the improvement was statistically significant compared with the routine group(P<0.05)。5.The effect of Qi Gong Wan on the levels of IL-17 and IL-10:Levels of IL-17 in both groups were significantly lower than those before treatment(P<0.01),and the levels of IL-10 in both groups were significantly higher than those before treatment(P<0.01).The improvement of IL-17 and IL-10 levels in the treatment group was significantly different from those in the routine group(P<0.05 or P<0.01).Conclusion:1.Patients with PCOS phlegm-dampness syndrome have obvious characteristics of insulin resistance.2.The expression of Th17/Treg cytokines in patients with PCOS phlegm-dampness syndrome was abnormal,the level of IL-17 was positively correlated with PCOS-IR,and the level of IL-10 was negatively correlated with PCOS-IR,suggesting that they may participate in the occurrence and development of phlegm-dampness syndrome of PCOS by promoting or inhibiting the release of inflammatory factors and affecting the inflammatory signaling pathway in the process of IR.3.Compared with western medicine alone,Qi Gong Wan can improve the clinical symptoms and insulin resistance of PCOS patients with phlegm-dampness syndrome better.Its mechanism may be closely related to correcting the imbalance of Th17/Treg cell function and inf lammation.