Literature Research On Recent20Years’ Polycystic Ovarian Syndrome (PCOS) Treatment With Chinese Medicine And Integrated Chinese And Western Medicine Therapies

ObjectiveThis research collects and sorts out recent20years’literature about polycystic ovarian syndrome (PCOS) with Chinese Medicine and Integrated Chinese and Western Medicine therapies. By making statistical analysis, concluding and summarizing the etiology, pathogenesis, treatment principles and methods, especially the Chinese Medicine prescriptions, this thesis introduces the syndrome differentiation and treatment rules for PCOS treatment and offers the systematic thoughtways and literature study foundation for future PCOS treatment and further clinical medication.MethodsThis research compares the frequency of usage of various Chinese herbal medicines for PCOS treatment with frequency analysis methods and discusses the etiology, pathogenesis, and medicine application so as to induce the leading tendency for medication. With cluster analysis, this thesis holistically and systematically provides evidence for the syndrome differentiation and treatment rules of PCOS.Research objects:Chinese Medicine and Integrated Chinese and Western Medicine literature related to PCOS in Chinese academic journals published publicly from January1992to December2012.Literature inclusion criteria:the literature content is related to PCOS; the journals are legal journals recognized by General Administration of Press and Publication of the People’s Republic of China from January1992to December2012; the patients are diagnosed as PCOS and there are no less than 20cases in Chinese Medicine treatment group or Integrated Chinese and Western Medicine treatment group reported in the literature; no description of other gynecological diseases is included in the literature; the literature should take random contrast trial as the priority.Prescription inclusion criteria:the prescription should have definite curative effect; Chinese Medicine or Integrated Chinese and Western Medicine medications; the prescription have definite medicine formulation; medicine for PCOS endotherapy can be included.Prescription exclusion criteria:prescription that can’t meet the inclusion criteria; the indications are over complicated and lack of pertinence; prescriptions without titles; single medicine formulations.Database establishment:Use Excel software to set up a database (prescription database, medicine classification database) and set up SPSS database.Statistics:Use Excel and SPSS software and write programmes in order to make frequency and cluster analysis.Results(1) Inclusion of literatureAccording to research aim and inclusion criteria,209articles conforming to the inclusion criteria are selected, including106Chinese Medicine therapy articles and103Integrated Chinese and Western Medicine therapy articles. There are only22articles from1992to2002and there’s a huge Increase after2003.The106articles concerning Chinese Medicine therapy report6048PCOS cases, including4895in the Treatment or Trial Group and1153in the Control Group.3articles has a sample size of over100cases (2.83%of the total),31has a sample size of50-99(29.25%) and72has a sample size of20-49(69.92%). The103articles concerning Integrated Chinese and Western Medicine therapy report7724PCOS cases, including4018in the Treatment or Trial Group and3706in the Control Group.2articles has a sample size of over100cases (1.94%of the total),24has a sample size of50-99(23.30%) and77has a sample size of20-49(74.76%).(2) Etiology and pathogenesis analysisAmong209articles,141articles (67.46%of the total) believe PCOS is related to kidney deficiency;11(5.26%) believe it’s related to spleen among which9believe it’s due to spleen deficiency;22(10.53%) believe it’s related to spleen and kidney deficiency;39(18.66%) believe it’s related to liver.130(62.20%) believe its occurrence is related to phlegm;77(36.84%) believe it’s related to blood stasis;1believes it’s related to phlegm-heat.(3) Medication analysis209articles mention144ingredients. The total application frequency is2037times and on average each prescription adopts9.75ingredients and each ingredient is used14.15times.93ingredients have a frequency of over2and takes place1966times, making up96.51%of the total times.51ingredients have a frequency of twice or less than twice and takes place71times, making up3.49%of the total times.Medicine type analysis:144Chinese herbal medicines for PCOS appear in the literature which belongs to19types. According to the order of Chinese Materia Medica, they are drugs for relieving exterior syndrome, heat-clearing drug, purgation drug, antirheumatic, dampness relieving medicine, diuretics for eliminating dampness, drugs for dispelling internal cold, drugs for regulating Qi flow, medicine for digestion, restringent, drug for invigorating blood circulation and eliminating stasis, medicine for eliminating phlegm and relieving cough and asthma, tranquilizer, drugs for calming liver to stop endogenous wind, drugs for inducing resuscitation, tonics, astringent drug, medicine for insecticide, detoxification, dampness-relieving and antipruritic.The top6medicine with high frequency for PCOS treatment recorded in the literature are tonic (42.75%):The common yang reinforcing medicines are semen cuscutae, herba epimedii, velvet antler (antler glue and gelatinum cornus cervis), radix morindae officinalis, rhizoma curculiginis, psoralens, cistanche, eucommia ulmoides, radix dipsaci, placenta hominis, etc. The common qi reinforcing medicines are codonopsis, astragalus, actractylodes macrocephala, yam, licorice. The common blood reinforcing medicine are angelica, prepared radix rehmanniae, radices paeoniae alba, polygonum multiflorum, etc.The common yin reinforcing medicine are medlar, fructus ligustri lucidi, herba celiptae, etc.; medicine for promoting blood circulation and removing blood stasis (13.70%), including ligustrazin, radix curcumae, red sage root, peach seed, safflower, motherwort, radix achyranthis bidentatae, caulis spatholobi, pangolin, herba lycopi, etc. medicine for relieving fever (8.00%), including prunella, fructus gardeniae, radix scutellariae, root of rehmannia, cortex moutan, radix paeoniae alba, anemarrhena asphodeloides, etc.; medicine for regulating qi (5.99%), including dried tangerine peel, rhizoma cyperi, fructus aurantii immaturus, etc.; medicine for removing phlegm (5.84%), including pinellia ternata, arisaema cum bile, spina gleditsiae, caladium, semen brassicae, etc. medicine for clearing dampness and promoting diuresis (5.35%), including tuckahoe, rhizoma alismatis, plantain seeds, semen coicis, etc. These six kinds of medicine make up81.63%of the total medicine used.Cluster analysis of medicine:According to medicine property theory (property and flavor and channel tropism) and clinical knowledge, the author makes cluster analysis of44medicines that has frequency above15in SPSS18.0database and determines5cluster prescriptions:Cl prescription:radix bupleuri, prunellaC2prescription:arisaema cum bile, fructus aurantii immaturus, pangolin, rhizoma curculiginis, rhizoma cyperi, red sage root, radix paeoniae alba, motherwort, cortex moutan, root of rehmannia, plantain seeds, radices paeoniae alba, rhizoma alismatis。C3prescription:yam, codonopsis, licorice, medlar, radix achyranthis bidentatae, tuckahoe, peach seed。C4prescription:actractylodes macrocephala, astragalus, acorus gramineus soland, atractylodes rhizome, psoralens, pinellia ternata, dried tangerine peel, spina gleditsiae。C5prescription:radix dipsaci, caulis spatholobi, fructus ligustri lucidi, velvet antler, eucommia ulmoides, semen cuscutae, istanche, herba epimedii, radix morindae officinalis, angelica, amethyst, prepared radix rehmanniae, safflower, ligustrazin.Conclusion(1) Kidney deficiency, blood stasis and phlegm are the basic pathogenesis of PCOS.(2) PCOS medicines are generally tonics and medicine for promoting blood circulation and removing stasis.(3) According to the medicine theory and clinical knowledge, the author clusters the medicine into5groups and summarizes the basic prescription for various PCOS types:liver qi stagnation; kidney deficiency, dampness and blood stasis; spleen and kidney yang deficiency and blood stasis; spleen and kidney yang deficiency and phlegm and dampness stagnation; kidney deficiency and blood stasis.