The Clinical Comparative Study Of Polycystic Ovary Syndrome Between Pubertal And Child-bearing Period

【Objective】To explore the pathogenesis feature and clinical specificity in pubertalPCOS and in child-bearing period PCOS, by comparing with pathogenesisfeature, clinical manifestation and endocrine feature between pubertaland child-bearing period PCOS, and explore the essential endocrineprinciple of TCM syndrome of PCOS by analyzing the relationship betweenendocrine feature and main syndrome type of PCOS.【Methods】1 110 patients, who satisfied with the PCOS diagnostic standard, weredivided into 2 groups which including group one: pubertal PCOS, 10≦year＜20 and group two: child-bearing period PCOS, 20≦year≦40;2 The clinic data selecting, such as abnormal menstruation,acnes,pilosity,endocrine feature,uniphasic basal temperature and so on, anddata processing, such as using SPSS 12.0 for windows to process clinicaldata.3 Getting results and conclusions by analyzing clinical data and reviewingTCM theories.【Results】(1) Hepatic fire is the main symptom type of pubertal PCOS; Deficiencyof Kidney is important symptom type of pubertal PCOS; Phlegm-damp andsluggishness of qi and blood stasis are minor symptom type of pubertalPCOS.(2) Hepatic fire and deficiency of Kidney are main symptom types ofchild-bearing period PCOS; Phlegm-damp and sluggishness of qi and blood stasis are minor symptom type of child-bearing period PCOS.(3) There are remarkable differences between hepatic fire symptom typeand deficiency of Kidney symptom type in pubertal PCOS but not inchild-bearing period PCOS.(4) There are more delayed menstrual cycle and amenorrhea and lesspreceded menstrual cycle in pubertal PCOS than in child-bearing periodPCOS; There are amenorrhea in pubertal PCOS as 2 times as in child-bearingperiod PCOS not only on hepatic fire but also on deficiency of Kidney;There are preceded menstrual cycle in child-bearing period PCOS as 2 timesas in pubertal PCOS on hepatic fire; There are 4% preceded menstrual cyclein child-bearing period PCOS less than that of in pubertal PCOS ondeficiency of Kidney.(5) It, pilosity and acnes, is a significant symbol of pubertal PCOS;It decrease and obesity increase in child-bearing period PCOS.(6) LH,FSH and LH/FSH means downward in pubertal PCOS and slight upwardin child-bearing period PCOS; PRL,E2 and T means upward in pubertal PCOSand downward in child-bearing period PCOS; E2/T downward in pubertal PCOSand upward in child-bearing period PCOS; LH,FSH,LH/FSH,PRL,E2 and Tmeans remarkable upward,E2/T mean downward in pubertal PCOS and LH,PRL,E2 and T means remarkable upward,FSH,E2/T mean downward,LH/FSHmean almost no change in child-bearing period on hepatic fire; LH,LH/FSH,PRL,E2,T and E2/T means remarkable downward,FSH meanremarkable upward in pubertal PCOS,LH mean slight downward,FSH meanslight upward,LH/FSH and E2/T means upward,PRL,E2 and T meansremarkable downward in child-bearing period PCOS on deficiency of Kidney.(7) LH,FSH,LH/FSH,E2 AND T means in pubertal PCOS are greater thanthose of in child-bearing period PCOS,PRL and E2/T means in pubertal PCOSare smaller than those of in child-bearing period PCOS on hepaticFire; LH,FSH,LH/FSH,E2 and E2/T means in pubertal PCOS are smaller thanthose of in child-bearing period PCOS,PRL and T means in pubertal PCOSare greater than those of in child-bearing period PCOS on deficiency ofKidney; LH/FSH,PRL,T and E2 means on hepatic fire are greater than thoseof on deficiency of Kidney in pubertal PCOS; PRL,T and E2 means on hepaticfire are greater than those of on deficiency of Kidney in child-bearingperiod PCOS,LH/FSH mean on hepatic fire in child-bearing period PCOS andE2/T mean on hepatic fire both in pubertal PCOS and in child-bearing periodPCOS are smaller than those of on deficiency of Kidney.(8) After treating for 3 months and for one year, comparing with before treatment both in pubertal PCOS and in child-bearing period PCOS, we findthat abnormal menstruation,acnes and uniphasic basal temperature areimproved step by step but no any change on Pilosity. There is no differencein statistics between in pubertal PCOS and in child-bearing period PCOS.(9) After treating for one year, comparing with before treatment inchild-bearing period PCOS, we find that there is remarkable differencein statistics on sterility and pregnancy.(10) After treating for one year, comparing with before treatment bothin pubertal PCOS and in child-bearing period PCOS, we find that LH,E2,E2/T,LH/FSH and PRL means downward,FSH and T means upward inpubertal PCOS; LH,FSH,LH/FSH,PRL and T means downward,E2 and E2/Tmeans upward in child-bearing period PCOS; LH,LH/FSH,PRL and E2 meansremarkable downward,E2/T mean downward,FSH and T mean upward inpubertal PCOS and LH,LH/FSH,PRL and T means remarkable downward,FSHmean downward,E2 and E2/T remarkable upward in child-bearing period PCOSon hepatic fire; LH,T,LH/FSH,PRL,E2 and E2/T means remarkabledownward,FSH mean upward in pubertal PCOS and LH,FSH,LH/FSH,PRL and T means remarkable downward,E2 and E2/T means remarkable upwardin child-bearing period PCOS on deficiency of Kidney.【Conclusion】(1) Tiangui nutritional insufficiency, because of insufficiency of Kidney,and hepatic fire. because of the function of govern normal flow of qi ofliver, are main-pathogenesis of pubertal PCOS; Hepatic fire is the mainsymptom type of pubertal PCOS; Low LH,FSH,E2/T and LH/FSH means and highPRL,E2 and T means are very important endocrine feature of pubertal PCOS;Pilosity,aches,delayed menstrual cycle and amenorrhea aremain-clinical findings of pubertal PCOS.(2) The function of Kidney-Tiangui-Chong and Ren Meridians-Uterus systemdisorder, which caused by Liver Meridian function disorder and deficiencyof Kidney, is main-pathogenesis of child-bearing period PCOS; Hepaticfire and deficiency of Kidney are main symptom types of child-bearingperiod PCOS; High LH,FSH,LH/FSH and E2/T means and low PRL,E2 and Tmeans are very important endocrine feature of child-bearing period PCOS;Pilosity,acnes and amenorrhea less than those of pubertal PCOS butobesity and preceded menstrual cycle more than those of pubertal PCOS.(3) There are great differences, not only on pathogenesis feature but alsoon clinical manifestation and endocrine feature, between pubertal PCOSand child-bearing period PCOS. (4) There are some important clinical features which belong to hepaticfire PCOS such as mainly delayed menstrual cycle, sometimes precededmenstrual cycle, mainly pilosity and acnes, LH,FSH,LH/FSH,PRL,E2 andT means upward and E2/T mean downward.(5)There are some important clinical features which belong to deficiencyof Kidney PCOS such as mainly delayed menstrual cycle, sometimes pilosityand acnes, LH,FSH,PRL,E2 and T means downward and LH/FSH and E2/T meansupward.