Clinical Observation And Mechanism Study On Cangfu Daotan Decoction In The Treatment Of PCOS With Phlegm-dampness Syndrome And Abnormal Lipid Metabolis

Objective: To observe the effects of Cangfu Daotan Decoction on body mass index,waisthip ratio,sex hormone level and lipid metabolism in patients with polycystic ovary syndrome with phlegm-dampness syndrome,study the expression of Leptin-AMPK signaling pathway protein in SD female rats,and explore the clinical efficacy and mechanism of Cangfu Daotan Decoction in regulating the lipid metabolism of PCOS with phlegm-dampness syndrome.Materials and methods:1.Clinical study: 102 patients with phlegm-dampness syndrome PCOS complicated with abnormal lipid metabolism were included,and treated with Cangfu Daotan Decoction combined with dydrogesterone for 3 menstrual cycles.The changes of TCM syndrome score,T,LH/FSH,BMI,WHR,TG,TC,LDL,HDL and other related therapeutic indexes were observed before and after treatment.2.Experimental study: 60 female rats with 21-day-old SD were selected,and the model of rats with abnormal lipid metabolism was induced into phlegm wetness,PCOS,and abnormal lipid metabolism,and after grouping according to the experimental requirements,the cangfu guided sputum decoction was given for 28 days,and the changes in body weight,serum T,FFA,TC,TG,Leptin and other indicators of rats in each group were observed,the changes in pathological morphology of the ovaries and liver were observed,and the expression of Leptin,AMPK,ACC and CPT-1 proteins in liver tissue was detected.Results:1.Clinical research1.1 After three months’ treatment with Cangfu Daotan Decoction combined with dydrogesterone,the scores of TCM syndromes of patients decreased significantly(P < 0.05),and the total clinical effective rate reached 93.16%.1.2 After treatment with Cangfu Daotan Decoction combined with dydrogesterone,BMI and WHR levels of patients decreased,and serum T,LH/FSH,TG,TC and LDL decreased(P <0.05),but serum HDL level did not change significantly(P > 0.05).2.Experimental research2.1 After letrozole combined with high-fat emulsion induced PCOS model of phlegm-dampness syndrome in SD rats,the levels of serum T,Leptin,FFA,TG and TG were significantly higher than those in normal group,and the expressions of Leptin,AMPK,CPT-1 protein in liver tissue were down-regulated and ACC protein was up-regulated.2.2 After the intervention of Cangfu Daotan Decoction,the levels of T,Leptin,FFA,TG and TG in serum of rats in Chinese medicine group decreased significantly,and the expression of Leptin,AMPK and CPT-1 protein in liver tissue increased,while the expression of ACC protein decreased.Conclusion:1.Cangfu Daotan Decoction combined with dydrogesterone can effectively improve TCM syndrome scores of PCOS patients with phlegm-dampness syndrome complicated with abnormal lipid metabolism,reduce BMI and WHR levels,down-regulate LH/FSH ratio and T hormone trend,regulate blood lipid metabolism and restore menstrual cycle;2.Cangfu Daotan Decoction may regulate the lipid metabolism of PCOS rats with phlegmdampness syndrome by activating Leptin-AMPK signaling pathway,up-regulate the protein expression of Leptin,AMPK and CPT1 in liver tissue of PCOS rats with phlegm-dampness syndrome,down-regulate the protein expression of ACC in liver tissue,restore the levels of FFA,TG and TC in serum,reduce testosterone,improve leptin resistance,improve polycystic ovary status,reduce body weight and relieve obesity.