Analysis Of Therapeutic Effect Of Yulin Tongbu Decoction Combined With Metformin On PCOS-IR With Deficiency Of Spleen And Kidney And Stagnation Of Phlegm-dampness

Objective:To observe the improvement of clinical efficacy,laboratory index,TCM syndrome and pregnancy rate of PCOS-IR patients with spleen-kidney deficiency and phlegm-dampness stagnation treated with Yulin Tongbu decoction combined with metformin hydrochloride tablets,so as to evaluate the clinical effect of this therapy in the treatment of PCOS and provide clinical basis and data support for the treatment of PCOS.Methods: A total of 62 PCOS-IR patients who met the inclusion and exclusion criteria were selected from the gynecology clinic of Chongqing Hospital of traditional Chinese Medicine from October 2019 to October2020 to participate in this study.After signing the informed consent form,the patients were randomly divided into experimental group(n = 31)and control group(n = 31).The experimental group was treated with Yulin Tongbu decoction combined with metformin tablets,and the control group was treated with ethinylestradiol cyproterone tablets(Daying-35)combined with metformin tablets.All patients were treated with 3-month menstrual cycle,and the pregnancy was followed up for 3 months after termination of treatment.The indexes of sex hormone,glucose metabolism,lipid metabolism,clinical symptoms,TCM symptoms and pregnancy were observed before and after treatment,and the therapeutic effect was evaluated by data statistics and analysis.Results:1.The effective rate of the experimental group was 86.7%,while that of the control group was 62.10%.The effective rate of the experimental group was higher than that of the control group,and the difference was significant(P < 0.05).2.The pregnancy rate of the experimental group was 40%,while that of the control group was 13.80%.The pregnancy rate of the experimental group was higher than that of the control group(P < 0.05).3.After the completion of treatment in the two groups,the scores of TCM symptoms in the experimental group were lower than those in the control group(P < 0.05).The improvement of TCM symptoms in the experimental group was better than that in the control group(P < 0.05).4.After treatment,the body weight and BMI of the two groups decreased,but there was no significant difference between the two groups(P > 0.05).5.After treatment,there was no significant improvement in hirsutism,acanthosis nigricans and waist-to-hip ratio in the two groups(P > 0.05).6.After treatment,the values of LH,LH/FSH and T in the two groups were lower than those before treatment(P < 0.05.The changes of),FSH,PRL and E2 in the two groups were not significant(P > 0.05),and there was no significant difference in sex hormone indexes between the two groups after treatment(P > 0.05).7.After treatment,the fasting insulin(FINS)and homeostasis model insulin resistance index(HOMA-IR)of the two groups decreased,but the fasting blood glucose(FPG)had no significant change(P > 0.05),and there was no significant difference in the indexes of glucose metabolism between the two groups(P > 0.05).8.After treatment,there was no significant decrease in TC,TG,HDL,LDL,APO-An and APO-B between the experimental group and the control group,and there was no significant difference in curative effect between the two groups.Conclusion:Yulin Tongbu decoction combined with metformin is effective in treating PCOS-IR patients with spleen-kidney deficiency and phlegm-dampness stagnation,which can effectively improve their TCM clinical symptoms,reduce androgen,adjust sex hormone levels,correct abnormal glucose metabolism,so as to restore normal physiological state,promote ovulation and improve pregnancy rate,which is worthy of clinical promotion and reference.