Comprehensive Clinical Efficacy Of Kidney-Nourishing And Resolving-Phlegm Therapeutic Method Combined With Metformin For The Treatment Of Patients Of PCOS And IR

Objective The clinical research is aimed to observe the comprehensive clinical effec ts of Kidney-Nourishing and Resolving-Phlegm experienced therapeutic method combined with metformin in the treatment of patients diagnosed with polycystic ovary syndrome(PCOS)with insulin resistance(IR),explore its intervention and influence on menstruation,symptoms of typical TCM syndromes,sex hormone level,glycolipid metabolism and endometrial receptivity,to find out its therapeutic fundamentals of TCM and molecular biological mechanism,exploit the advantages of combination of TCM syndrome differentiation and Western medicine well-directed treatment,to improve clinical efficacy,reduce side effects,prevent long-term complications,in consequence lay foundation for the application and generalization of this decoction,provide both method and experience for further study of PCOS with IR In the foreseeable future.Methods All the cases were selected from patients who were diagnosed at the gynecology clinic of Hospital of TCM from February 2017 to October 2018.64 patients who were eligible for Inclusion of PCOS along with IR were divided into two groups according to the random number table method,32 cases in experimental group,32 cases in control group,respectively.The general data of the two groups were statistically non-significant.The control group was treated by metformin hydrochloride tablets and drospirenone and ethinylestradiol tablets,while 32 cases in the experimental group were treated by Kidney-Nourishing and Resolving-Phlegm prescription on the basis of oral administration of metformin.Both groups were designed for corresponding treatment for 3 menstrual cycles continuously.The changes of menstrual score,TCM syndrome score,luteinizing hormone(LH),follicle stimulating hormone(FSH),LH/FSH,testosterone(T),sex hormone binding globulin(SHBG),fasting insulin(FINS),fasting blood glucose(FPG)and insulin resistance index of homeostasis model assessment(HOMA-IR)were measured before and after corresponding treatment.Endometrial type,thickness and insulin resistance index were compared between the two groups.The blood perfusions during implantation window period,ovulation and pregnancy in each menstrual cycle were assessed to evaluate the safety of the two different treatment,all the pertinent dates were collected for statistical analysis.Results(1)Comparison of comprehensive effect: The total effective rate of the experimental group was 93.33% while that of the control group was 66.67%.The comprehensive effect of the experimental group was significantly higher than that of the control group(P<0.01).(2)Comparison of menstrual score: After the treatment,the menstrual cycle,period and volume scores of the two groups were lower than those before the treatment(P<0.05),indicating that both methods can effectively improve the menstrual quality;each score of the experimental group was lower than that of the control group(P<0.05).(3)Comparison of TCM syndrome scores: After the treatment,TCM syndrome scores in both groups were lower than those before(P< 0.05).The alleviation of representative symptoms of the experimental group was more remarkable than that of the control group,differences between two groups is of statistical significance(P<0.05).(4)Comparison of serum sex hormones levels: After the treatment,the LH,LH/FSH and T of the control group were lower than those before the treatment(P<0.05),the changes of FSH and SHBG were not significant statistically(P>0.05);the LH,T,LH/FSH,FSH and SHBG of the experimental group were significantly different from those before treatment(P<0.05);after treatment,the LH,T,LH/FSH of the experimental group were lower than those of the control group,and the SHBG was higher than that of the control group over the same period(P<0.05);(5)Comparisons of glycolipid metabolism: FPG,HOMA-IR in the control group were lower than those before the treatment(P<0.05);FINS,FPG and HOMA-IR in experimental group were lower than those before treatment(P<0.05);FINS,FPG and HOMA-IR in experimental group were lower than those in control group at the same time(P<0.05);After treatment,the levels of TC,TG and LDL-C in the control group were lower than those before treatment(P < 0.05),and the difference of HDL-C was not significant(P>0.05).The indexes of the experimental group were significantly improved compared with those before treatment.After treatment,the levels of TC,TG,LDL-C and HDL-C in the experimental group were better than those in the control group(P<0.05).(6)Comparisons of endometrial receptivity: the types and hemoperfusion condition of the endometria in the experimental group were better than those in the control group(P<0.05),endometrial thickness was improved in a greater degree than that of the control group(P<0.05).Conclusion The therapeutic method of nourishing kidney and resolving phlegm combined with metformin in the treatment of PCOS with IR has a definite effect,and the clinical symptoms were improved obviously.It can regulate the hormone level and glycolipid metabolism of patients effectively,and improve endometrial receptivity,thus the integrated Chinese and Western medicine therapy is worthy of clinical application and promotion.