Clinical And Empirical Study Of Reproductive Hormones And Glucose And Lipid Metabolism With Wujisan In The Treatment Of Polycystic Ovary Syndrome With Type Of Stagnation Of Phlegm-damp

Objective:To explore the efficacy and possible mechanism of WUJI powder in the treatment of polycystic ovary syndrome(PCOS) with type of stagnation of phlegm-damp by the changes of clinical symptoms and the of the main outcomes of reproductive hormones, glucose and lipid metabolism in this clinical and experimental study.Methods:In clinical study,90 patients with PCOS were enrolled and randomly divided into treatment group and control group. The height, weight, concentration of LH, FSH, T, FINS, 2HINS, FBG, PBG, TG, TC, HDL and leptin in plasma were measured before and after treatment, the symptoms and signs, such as acne and menstrual circle, were recorded at the same time. Patient in treatment group take WUJI powder which need not decocted twice daily. The treatment period is three months and drug need not stopped during the menstrual circle. Patient in control group take Metformin hydrochloride,500mg/d, three times a day for three months.In experiment study, the female SD rat were used. The rats were divided randomly into seven group, which are control group, sham operation group, model group, metformin hydrochloride group, high dose herbal group, medium dosage group and low dose group.24 day-old female Sprague-Dawley rats, after injected 0.3ml/100g chloral hydrate (10%) into abdominal cavity for anaesthesia, Norplant L 18 - methyl levonorgestrel silica gel bars 3 mm each bar were implanted subcutaneously.Three days after implanting, the rats in the model group were injected subcutaneously with 1.5 IU hCG,0.2ml each, twice daily for 9 days to establish polycystic ovarian syndrome rats model induced by levonorgestrel with hCG.The treatment period is 15 days. Before and after treatment, the concentration of FSH, LH, T, TG, TC, HDL, GLU, INS were measured and the pathological changes of bilateral ovary were observed using optical microscope.The data was analyzed with SPSS 17.0 software. Quantitative data was presented as x±s, and One-Way ANOVA was used to compare the differences between groups. Count data was analyzed withX2test.Results:In clinical study, we find that percentage of insulin resistance is 85.56%, which is higher than other reports, infertility 34.44%, obesity 69%. The waist-hip-ratio is higher than normal in 87.78%patient and high cholesterol level was found in 23.3%. These findings indicate that metabolic syndrome occurred early, which should be highly regarded. We also find that herbal medicine was more effective in alleviating symptoms and signs such as acne, diarrhea, bloating abdomen, pale complexion and so on than chemical treatment (P<0.05).No change of hirsutism was observed before and after treatment in both groups. The pregnancy rate in herbal group is higher and abortion rate lower than control group (P<0.05).Three cases in control group discontinued therapy due to side effects of metformin.Herbal treatment is also more effective in lowering,LH,Leptn,TG,TC,FBG,INS,2hINS compared with control group (P<0.05). There was no change in the concentration of HDL before and after treatment in both groups.In experimental study, except low dose group, the vesicle of rats treated with herbal medicine are smaller, layers of granulosa cell and corpus luteum are more than other groups. Compared with chemical treatment group, higher dose herbal medicine has the same effect in lowering concentration of T and INS. Higher dose herbal medicine also can increase FSH, HDL and lowering TG, TC concentration, and chemical drug has no effect. The results also show that the efficacy of herbal medicine is proportional with dosage given.Conclusions:WUJI powder has significantly efficacy in improving the symptoms of PCOS with stagnation of phlegm-damp type, reproductive hormones, glucose and lipid metabolism, enhancing the pregnancy rate, and lowering abortion rate. In the animal model of polycystic ovaries in rats, it can improve polycystic degeneration, ovulation disorders, the secretion of reproductive hormones, glucose and lipid metabolism with no effects. The finding suggests that WUJI powder hss a good comprehensive effects in the treatment of PCOS with stagnation of phlegm-damp type which leads to a novel therapeutic idea with a good efficacy based on the distinct features of traditional Chinese Medicine.