| ObjectiveTo explore the correlation between BMI and the index of glucose and lipid metabolic disorder diseases on infertile patients. And to calculate the influence of BMI on the results of promoting gestation by TCM. This research is to help us to make good treatment strategies when concerning to promote gestation, after that,to obtain a better curative effect.MethodsPaxt 1:In this Part, we made a literature search on the epidemiology of infertility, and preliminarily made a good understanding of the mechanism of infertility from the aspect of both TCM and western medicine. We also made description of "ZiSheYuTai Pill " including its sources, clinical effects etc.Part 2:In this Part, we carried out a clinical retrospective study on 60 cases of infertile patients collected from a private clinic in Taiwan district. They were all going through IVF (in-vitro fertilization) in local hospitals. After the signing of agreement, they were assigned to 3 different groups basing on the index of BMI. The layer standard is:the lower group (BMI <18.5kg/m2);the normal group(18.5kg/m2≤BMI<24kg/m2) and the heavy group (BMI≥24kg/m2), each group contains 20 cases. We reviewed the medical records, made a comparison of before and after the treatment, the parameters being compared including:the normal state of the patients,the height.weight, WC, HC, WHR, the symptoms of TCM, the outcome of IVF and relating metabolic index(TC, TG, HDL-C, LDL-C, APN, FSH, LH, Leptin, Fasting glucose, Fasting insulin). All of the dates were deal with S/5S17.0 software and followed the Principle of statistics. Measurement data conforms to normal distribution with mean soil standard deviation, according to comparison between groups to adopt independent sample t-test, qualitative data compute the ratio and rate, composition ratio and rate comparisons to adopt X2 test.Part 3:In Part 3, we carried out a prospective study on 120 cases in the same private clinic during January,2015 to June,2016. They were also divided into 3 layers according to BMI:the lower group(BMI<18.5kg/m2); the normal group (18.5kg/m2≤BMI<24kg/m2) and the heavy group(BMI≥24kg/m2)) and in each layer, cases were divided into 2 groups randomly (IVF group and "ZiSheYuTai Pill" group), we observed the outcome of the 2 different groups. The detail indexes were similar to above.ResultsIn Part 1, ages showed no differences between 3 groups. The WHR is much smaller in the heavy group than the other 2 groups (P<0.05). In TCM sym/toms, the manifestation of the lower group contributes to "deficiency of kidney energy " and "liver depression", (P<0.05), while in the heavy group, the manifestation is "/falegm-damp" and "muggy" (P<0.05). the estrogen level in the circulation on the heavy group is much lower than the others (P<0.05), and what’s more, the FSH, LH levels show no significant differences between the 3 groups(P>0.05). Dates relating to metabolism showed that compared to the normal weight group, the heavy group showed higher levels of LDL-C, TC, TG, Leptin, resistin and A/bB. The HOMA-IR index was higher (P<0.05). While in the lower group, the level of circulation Leptin and adiponectin is lower (P<0.05). The reasons for unfertilization were no different (P>0.05), also the Gn, and estrogen in the day being injected with HCG.The outcome, the ration of insemination and the ration of mature eggs being obtained can be higher (P<0.05).In Part 3, there are no differences between groups in every parameters before the treatment. After treatment, the estrogen level of all the 3 "ZiSheYuTai Pill" groups were much higher than the IVF groups. In the lower weight+"ZiSheYuTai Pill" group, the serum level of glucose is much lower, while the TC, FT4 level is higher, comparing to the lower weight+IVF grou.P.Conelusions1, BMI level has closely correlation with the constitution of infertility patients, the bias between the different groups have different sex, low restructuring is given priority to with gas mass congestion stasis, overweight obesity group is given priority to with qi depression phlegmy wet mass.2, Reports suggest that a thinner type of infertility patients overweight obesity patients assisted reproductive technology to help pregnant outcomes better [62], this research shows that there were no significant differences between different BMI helps the pregnar’cy outcome, may be related to this study too little cases (20 cases in each group), retrospective study factors such as lack of relevant information. But high BMI and low quality of embryo, offspring situation still need further data accumulation, etc.3, BMI exist different endocrine metabolism in patients with different. Overweight has obvious glucolipid metabolic abnormalities endocrine characteristics, main show is elevated blood lipid (triglyceride, low density lipoprotein, cholesterol, APO B, is on the high side, low high density lipoprotein), impaired glucose tolerance (HOMA IR) obviously, the effect of insulin sensitivity abnormal hormone levels (higher leptin, resistin and adiponectin is low). Low restructuring also has certain endocrine abnormalities, main show is HOMA-IR on the high side, FT4 on the low side, low levels of leptin, adiponectin level is low. BMI is to be able to response to a certain extent endocrine metabolism in the body.4, BMI, endocrine metabolism, as well as the relationship between physical there. Can be further discussed.5, Zishenyutai Pills therapy compared with IVF pregnancy, simply can improve endocrine metabolism, to some extent for overweight, more clear, specific displays in:to lower cholesterol, low density lipoprotein, and TSH. For the normal weight group, reduce fasting blood glucose and lower TSH is obvious;For low restructuring, reduce fasting blood glucose significantly.At the same time, to improve pregnancy rates, especially in the overweight. |
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