Modified Wendan Decoction For Insulin Resistance Of Spleen Deficiency Phlegm-Dampness Polycystic Ovary Syndrome And Lipid Metabolism

Objective:To explore the effect of Jiawei Wendan Decoction on insulin resistance and lipid metabolism of polycystic ovary syndrome(PCOS)with spleen deficiency and phlegm dampness,and analyze its possible influence,so as to provide more powerful evidence for the evaluation of clinical efficacy and safety of traditional Chinese medicine in the treatment of PCOS.Methods:64 cases of PCOS with spleen deficiency and phlegm dampness were randomly divided into two groups,32 cases in each group.On the basis of diet and exercise control,32 cases in the experimental group were treated with modified Wendan Decoction + metformin enteric solution capsule,and 32 cases in the control group were treated with metformin enteric solution capsule alone.During the experiment,there were 4 cases of falling off,including 2 cases in the control group,all of them were patients from other places,who did not go back to the clinic on time after one month of treatment;2 cases in the experimental group,1 case was often on business trip after work change,who did not take medicine on time,and 1 case was transferred to our hospital for gynecology treatment in a short period of time.Therefore,60 patients participated in the experiment for 12 weeks.The TCM symptom score,body mass index(BMI),fasting blood glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR),blood lipid(TC,TG,LDL-C,HDL-C),hypersensitive C-reactive protein(hs-CRP),sex hormone(FSH,LH,LH/FSH,T)and other indexes were observed before and after treatment.Results:(1)The total effective rate of the control group was 66.67%,and that of the experimental group was 83.33%.The difference was statistically significant(P<0.01).(2)After treatment,the score of TCM symptoms in the control group did not decrease significantly,and the difference was not statistically significant(P>0.05).In the experimental group,the score of TCM symptoms significantly decreased,and the difference was statistically significant(P<0.05).After treatment,the difference betweenthe two groups was statistically significant(P<0.05),indicating that the improvement of TCM syndrome score in the experimental group was more significant.(3)The BMI of the experimental group was significantly lower than that of the control group(P<0.05).The BMI of the two groups was still high after treatment,which may be related to the short course of treatment.(4)After treatment,the two groups had significant effects on the regulation of blood lipid,and the TC,TG,LDL-C decreased and HDL-C increased in the experimental group were better than those in the control group,so the difference was statistically significant(P<0.05),indicating that the experimental group had more significant effects on the regulation of blood lipid than the control group.(5)After treatment,both groups showed significant decrease in hs-CRP,and the experimental group returned to normal level,and the experimental group was superior to the control group(P<0.05),indicating that the experimental group had significant improvement effect on hs-CRP in patients with phlegm-dampness polycystic ovary syndrome with spleen deficiency.(6)After treatment,both groups were effective in improving insulin resistance,and the comparison between the two groups showed that the HOMA-IR in the experimental group was significantly improved compared with the control group,with statistically significant difference(P<0.05),indicating that flavor-warming bile decoction could improve blood glucose metabolism and enhance insulin sensitivity.(7)After treatment,the serum levels of LH,LH/FSH and T in the two groups all decreased compared with those before treatment,while the serum levels of FSH increased,which was better in the experimental group(P<0.05),indicating that the decoction had a certain regulating effect on the levels of sex hormones.Conlusions:It can be seen from this study that Jiawei Wendan Decoction can not only improve the total effective rate of polycystic ovary syndrome of spleen deficiency and phlegm dampness type,but also improve the syndrome of traditional Chinese medicine as a whole,regulate endocrine metabolism,provide new ideas for the treatment ofPCOS,and create a reliable clinical application prospect.