To Analyze The Endocrine And Metabolic Characteristics,Quality Of Life And Sources Of Stress In PCOS Patients With Kidney Deficiency And Liver Depression Under Different Levels Of Depression

Objective:This study analyzes the differences in clinical characteristics,sex hormone levels,glucose and lipid metabolism indicators and quality of life in PCOS patients with kidney deficiency and liver depression under different levels of depression,and identifies the sources of stress,in order to provide more accurate treatment plans and improve the quality of life of PCOS patients.Methods:Patients newly diagnosed with PCOS in the gynecological clinic of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 2020 to December 2022 selected.Their data had been completely entered into the clinical research information integration system.After TCM syndrome differentiation,Zung self-rating depression scales(SDS)were filled out.Body mass index(BMI),WHR,hirsuticism,acne and acanthosis nigracanthia scores were recorded in 372 PCOS patients with kidney deficiency and liver depression.The quality of life questionnaire(SF-36)was completed by the patients.Fasting blood samples were collected in the morning on the 3rd to 5th day of the natural cycle or progesterone withdrawal bleeding.The levels of sex hormones(FSH,LH,PRL,E2,T,AND,SHBG,DHEAS)and glucose and lipid metabolism indexes(TG,CHOL,HDL,LDL,FPG,FINS,HOMA-IR)were measured.PCOS patients with kidney deficiency and liver depression were divided into two groups according to SDS score.Patients in the depression group(n=81)also completed the source of stress questionnaire.After all the above data were input,SPSS26.0 software was used to analyze the data,and P<0.05 was considered statistically significant.Results:1.Among the 1130 PCOS patients,there were 167 PCOS patients with depression,accounting for 14.78%of the total number of cases,of which 81 cases(48.50%)were mainly with kidney deficiency and liver depression syndrome,followed by 39 cases(23.40%)with spleen deficiency and phlegm dampness syndrome,32 cases(19.20%)with phlegm and blood stasis syndrome.15 cases(9.00%)had kidney deficiency and blood stasis syndrome,and the distribution of depression in PCOS syndromes was statistically significant(P<0.05).2.A total of 372 PCOS patients with kidney deficiency and liver depression were enrolled in this study.According to the Zung self-rating Depression Scale score,they were divided into 291 cases of non-depression group and 81 cases of depression group.In the depression group,70 cases were mild to moderate depression group(50≤depression score<60)and 11 cases were moderate to severe depression group(60≤depression score).3.The BMI,hirsutism and acne scores of the non-depression group were lower than those of the depression subgroup,and the more severe the depression was,the higher the BMI level was,the higher the hirsutism and acne scores were,and the differences were statistically significant(P<0.05).There was no significant difference in age,WHR and acanthosis nigricans score among the three groups(P>0.05).4.The level of LH in the non-depression group was higher than that in the depression subgroup,and the level of T was lower than that in the depression subgroup.The T level of the mild to moderate depression group was lower than that of the moderate to severe depression group,AND the differences were statistically significant(P<0.05).There were no statistically significant differences in the levels of FSH,PRL,E2,AND,SHBG,and DHEAS among the three groups(P>0.05).5.In PCOS patients with kidney deficiency and liver depression,the CHOL and LDL levels in the non-depression group were lower than those in the depression group,while the HDL levels were higher than those in the depression group,and the differences were statistically significant(P<0.05).Different depression scores had no effect on glucose and lipid metabolism levels.There were no significant differences in TG,FPG,FINS and HOMAIR levels among the three groups(P>0.05).6.Depression affects the multi-dimensional quality of life of PCOS patients with kidney deficiency and liver depression.The scores of physical functioning,bodily pain,general health,social functioning,role emotional,and mental health in the non-depression group were higher than those in the depression subgroup,and the scores of physical functioning,social functioning,and role emotional in the mild to moderate depression group were higher than those in the moderate to severe depression group,and the differences were statistically significant(P<0.05).There was no significant difference in physical role and vitality among the three groups(P>0.05).7.PCOS with depression was most closely related to obesity(P=0.034),followed by infertility(P=0.039)and acne(P=0.043).Conclusions:1.PCOS patients with kidney deficiency and liver depression have the highest incidence of depression.2.Depression aggravates BMI,hirsutism and acne in PCOS patients with kidney deficiency and liver depression;3.Depression affects the secretion of LH,T,CHOL,LDL and HDL in PCOS patients with kidney deficiency and liver depression syndrome.4.Depression reduces the multi-dimensional quality of life in PCOS patients with kidney deficiency and liver depression.5.The problems of obesity,infertility and acne associated with PCOS are the main sources of stress for depression.