| Objective:This research is primarily to disguss the metabolic changes of endocrine to PCOS and the mechanism of the insulin and its reportor to PCOS,evaluate the clinical effect on polycystic ovarian syndrome(PCOS) patients and the experimental effect on PCOS model rats by the Metformin and the decoction of tonifying kidney,promoting blood and eliminating sputum,and to disguss the impossible mechanism of the decoction of tonifying kidney,promoting blood and eliminating sputum in treating the insulin resistance on PCOS,which is to privide the basis of experiment in treating PCOS by the method of tonifying kidney,promoting blood and eliminating sputum.Methods:1.In the experiment,the author choosed 38 PCOS patients,and random distributed them to the Chinese herb group,the Western medicine group,ln the Chinese herb group,the author treated 21 patients 3 period of treatment with the therapy i tonifying kidney;promoting blood and eliminating sputum which was consociated to regulate menstrual cycle.In the Western medicine group,the author treated 17 patients 3 period of treatment with Metformin.The author observed all the change of these patients,such as the change of their catamenia cycles and the change of their gestation.2.The author chose 40 PCOS model rats which were created in Poretsky, and partitioned them into 4 groups random:model control group, high-dose group of Chinese herb,mid-dose group of Chinese herb,Western medicine group.The author treated the 4 groups rats respectively with brine,high-dose Chinese herb,mid-dose Chinese herb,Metformin,then lavaged the rats 14 days.after these treatment,the author killed the four groups and a group of normal rats,and observed their difference in estrum,avoirdupois,uterus,ovary exponential,sex hormones of the serum, ovary ultrastructure,the insulin receptor appearing on the ovary and endometrium.Result:1.Clinical observation:in the Chinese herb group the total efficiency of the patients was 90.5%,in the Western medicine group the total efficiency of the patients was 58.8%,the effect difference between the three groups was observable(p＜0.05).In the Chinese herb group and the gestation efficiency was 61.9%,and in the Western medicine group the gestation efficiency was 5.9%,the effect difference between the two groups was observable(p＜0.05).In the Chinese herb group,before the treatment the two-way temperature was 23.8%,and after the treatment it was 76.2%,the effect difference between the two groups was observable (p＜0.05).In the Western medicine group,before the treatment the two-way temperature was 23.8%,and after the treatment it was 52.9%,the effect difference between the two groups was not observable(p＞0.05).2.The sex hormone of the two groups patients changed:Before the treatment the T value,FSH value,FG value,INS value,LH value and E2 value of the two groups were not observable(p＞0.05).Through 3 period of treatment, the T value,INS value,LH value of the serum reduced clearly,and the E2 value increaced clearly,the effect was observable(p＜0.05),and in the Western medicine group,the degree of the reducing of the INS was better than that in the Chinese herb group,but the difference between two groups was not observable(p＞0.05).The FSH value was reduced clearly in the Chinese herb group,the effect was observable(p＜0.05),but it was not reduced clearly in the Western medicine group,the effect was not observable(p＞0.05).The FG value was not reduced clearly in both Western medicine and Chinese herb groups,the effect ware not observable(p＞0.05).3.Through 3 period of treatment,the ovary became bigger,the effect difference between the Chinese herb group and the Western medicine group was observable(p＜0.05),the ovum increased,the effect difference between the Chinese herb group and the Western medicine group was observable (p＜0.05).4.After being lavaged,the all groups increased clearly,but the avoirdupois in the blank group is lightened than in model control (p＜0.05).After the treatment,the avoirdupois in the mid-dose group of Chinese herb,the high-dose group of Chinese herb and the Western medicine group were heavier than the blank group(p＜0.05).5.After being lavaged,Cells appeared on the vaginal smear in the model control group,the estrum of the PCOS model rats in the model control group was ruleless still,7 rats in the high-dose group,5 rats in the mid-dose group and 4 rats in the Western medicine on the estrum were rule,compared to the model control group,the effect was observable(p＜0.05). 6.5.After being lavaged,the estrum of the PCOS model rats in the model control group was ruleless still,but in the high-dose group of Chinese herb and the mid-dose group of Chinese herb,it became disciplinarian. Cells appeared on the vaginal smear in the Western medicine group,but it was few.The estrum of the Combined group of Chinese herb and Western medicine was disciplinarian,and comparing with the blank group the difference was not observable(p＞0.05).6.After being lavaged,the ovaries in the other groups were lighter than these in the model control group,the effect difference between these groups was observable(p＜0.05).7.After being lavaged,in the model control group,the T value,INS value,LH value of the serum increaced clearly,and the E2 value reduced clearly (p＜0.05);compared to the model control group,the T value and INS value in the mid-dose group of Chinese herb,the high-dose group of Chinese herb and the Western medicine group were reduced clearly(p＜0.05);8.After being lavaged,in the the blank group the insulin receptor appearing on the ovary was more than that in the model control group;and in the model control group the insulin receptor appearing on the ovary was less than that in the mid-dose group of Chinese herb,the high-dose group of Chinese herb and the Western medicine group;In the the blank group the insulin receptor appearing on the endometrium was less than that in the model control group,and in the the model control group the insulin receptor appearing on the endometrium was more than that in the mid-dose group of Chinese herb,the high-dose group of Chinese herb and the Western medicine group.Conclusion:1.The PCOS model rats created in Poretsky was jarless,and it was good models to research PCOS with Chinese herb.2.The Chinese herb can improve the enviroment of internal endocrine, improve the quality of follicle and make the endometrium more receptivity, reflected the overall concept of the Chinese medicine.3.The decoction of tonifying kidney,promoting blood and eliminating sputum can adjust the function of the Hypothalamic-pituitary-ovarian axis,and improve the enviroment of internal endocrine of the abnormal hypothalamic and pituitary of the PCOS model rats.4.The mechanism of the decoction of tonifying kidney,promoting blood and eliminating sputum is may reduce the insulin levels,regulate the process of follicle collection,selection and advantages,improve the ovarian function by granulosa cells and theca cells.
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