| BackgroundPolycystic ovary syndrome is a common metabolic abnormalities associated with reproductive and endocrine disorders, and is that the most common cause Leading to menstrual disorders and ovulation disorders infertility in women of childbearing age. polycystic ovary syndrome patients who with endocrine and metabolic dysfunction, including:LH/FSH ratio increased, hyper-androgenism, hyper-insulinemia, insulin resistance and metabolic syndrome. Since 70 years 20th century, the disease was diagnosed from morphology alone and histological changes, changes to focus on the field of biochemical endocrine abnormalities. At present,Polycystic Ovary Syndrome metabolism and endocrine abnormalities in patients with a research focus.PurPoseThrough animal research, we preliminary to explor mechanism of GFW treatment of PCOS rats, according to the indicators of glucose and lipid metabolism and endocrine changes, such as PCOS rat's FPG,FINS,ADG,APN. the research provides a theoretical and clinical basis for GFW modified cure.Through clinical research, clinical efficacy of GFW modified cure polycystic ovary syndrome with phlegm and blood stasis type compared with the efficacy of metformin, by observing Improvement of menstrual cycle, basal body temperature and the number of insulin resistance cases, and level variation of FPG,FINS,T, give an objective appraisal of the treatment and explore its possible mechanism, provide better treatment for the clinical treatment of PCOS.Methods1. Animal experiments:Chosen SD rats as experimental subject, Producted animal models of PCOS using Poretsky modeling method. The experimental rats were randomly divided into four groups:control group, model group, TCM group (GFW group), western medicines group (metformin group). These were feeding in the same conditions, irrigated stomach in 23th day, weighed body weight of rats daily. GFW group irrigated rats stomach in 25 g/(kg. d)-1, metformin group filled rats stomach in 270 mg/(kg. d)-1, the same volume distilled water were given to control group and model group per day.Four groups rats were takeblood 5ml in Orbital vein after irrigated stomach 22d, serum was separated to measured FPG,FINS,ADG,APN, we alculate Insulin resistance index(HOMA-IR) which can evaluated the rats insulin resistance.2. Clinical Research:The research was a prospective controlled trial.Research collect 30 Polycystic Ovarian Syndrome Patients from gynecology outpatient department of the third Affiliated Hospital of Guangzhou Univereity of Chinese Medieine during February 2010 to February 2011, syndrome differentiated ofphlegm and blood stasis type. They were randomly divided into two group:15 patients in Chinese medicine group and the other 15 patients in western medicine group. Chinese medicine group took decoction based in GFW modifing with symptoms, western medicine group took metformin as the control group.The groups were treated for 3 months and observed 3 months after withdrawal, we recorded the menstrual cycle, BBT, ovarian volume and the number of insulin resistance cases,and observed the level variation of FPG,FINS,T.Results1. Animal experiments:(1) The numerical value of FPG,FINS,HOMA-IR after medication:the value of model group and control group had significant difference(P<0.05); both the value of TCM group and western medicine group were lower than model group, with differences significantly(P<0.05); the value difference of FPG,FINS between TCM group and western and western medicine group s were statistically significant (P<0.05); HOMA-IR values of TCM group had no significant difference with western medicine group (P>0.05). (2) The numerical value of ADG:the value of model group and control group had significant difference(P<0.05); the value of TCM group was lower than model group, with differences significantly(P<0.05); the value of TCM group had no significant difference with model group; the differences between TCM group value and western medicine group were statistically significant (P<0.05). (3) The value of APN:the value of model group and control group had significant difference(P<0.05); the value of TCM group were more than model group, with differences significantly (P<0.05); the differences of western medicine group value between model group were extremely significantly(P<0.01); the value of TCM group had no significant differences between western medicine group(P <0.05). (4) IR correlated with ADG:the two had positive correlation; IR correlation analysis with the APN:IR was negatively correlated with the APN.2. Clinical trials:(1) After treatment, the comparison of overall effect between two group:5 patients were cured in TCM group,8 cases in effective, uneffective in 2 cases, the total effective rate was 86.7%; western medicine cured 1 patient, effective in 7 cases, uneffective in 7 cases, the total effective rate was 53.3%. Overall efficacy between the two groups was statistically significant (P<0.05). (2) After treatment, improvement of the menstrual cycle:in TCM group,7 patients recoved normal menstrual cycle whose period less than 40 days,3 patients menstruation period were more 40 days, close to the normal menstrual cycle, the recovery rate of menstruation period were 80%; Western medicine group,1 case returned to normal menstrual cycle, whose period less than 40 days,6 patients menstruation period were more 40 days, close to the normal menstrual cycle, the recovery rate of menstruation period were 46%, difference of the recovery rate of menstruation period was statistically significant (P<0.05). (3) basal body temperature after treatment compared:in TCM group,11 cases recovery diphase, single phase 4 cases; Western medicine group,4 cases recovery diphase,11 patients single-phase. Comparison of the two groups after treatment, difference of basal body temperaturethe was statistically significant (P<0.05). (4) in 3 months after treatment we calculated pregnancy rate,5 patients in TCM group has pregnancy, pregnancy rate was 41.7%; in western medicine group,1 case of pregnancy, the rate was 9%, the difference between the two groups was statistically significant (P<0.05). (5)The comparison of two groups in levels of FPG,FINS,T:the value of TCM group and western medicine group was significantly decreased compared with the treatment before, the difference was statistically significant (P<0.05);After treatment, the value of two groups had extremely significant differences (P<0.01). (6) After treatment with TCM group 2 patients,6 cases of western medicine group, no significant difference between the two. before and after treatment, IR number of patients in TCM group were compared (P<0.01), there are significant differences; there is significant difference between IR number of patients in western medicine group before and after treatment (P<0.05). Conclusion1. Animal experiments:GFW could effectively reduce value of FPG,FINS,ADG,HOMA-IR of PCOS rats, and reduce the rat's FPG,FINand ADG more effective than metformin; GFW could increase PCOS serum value of APN of PCOS rats, increased insulin sensitivity, rectify hypoadiponectinemia of PCOS rats, and had same effect with metformin; APN was negatively correlated with IR.2. Clinical trials:(1)GFW Modified treatment of PCOS patients with phlegm and blood stasis typecan shorten the menstrual cycle, rescoved basal body temperature to diphase, was better than the metformin group comparing in overall efficacy; (2) GFW Modified act on treatment of PCOS patients with phlegm and blood stasis type had higher pregnancy rate than the metformin group, but no significant difference between two groups; (3) GFW Modified could reduced FPG,FINS,the tumber of insulin resistance cases in phlegm and blood stasis type of PCOS patients, regulated the hypothalamus-pituitary-ovarian axis function, significantly improved their insulin resistance and hyperandrogenism, had significantly difference with metformin group。... |
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