The Study On The Intervention Of Ling-Zhu Granule Combined With Food Exchange Serving On The Metabolic Abnormality Of Polycystic Ovary Syndrome

ObjectiveThe clinical effect and mechanism of Ling-zhu granule combined with food exchange serving on endocrine and glycolipid metabolism abnormality in obese polycystic ovary syndrome were studied to exploring the weight management mode of obese PCOS.Methods90 obese PCOS patients who met the requirements in department of gynaecology or reproductive center clinic of GuangDong Provincial Hospital of Traditional Chinese Medicine from January 2019 to March 2020 were randomly divided into three groups:the intervention group(Ling-zhu granule combined with food exchange serving),the control group(metformin)and basic treatment group(without other interventions).There were 30 cases in each group.All patients were given health education to control the body weight in the ways of diet control and exercise.The differences of the body weight,BMI,waist circumference,WHR,LH,LH/FSH,T,FPG,FINS,HOMA-IR,TG,TC,HDL-C,LDL-C,TCM syndrome score of the three groups were compared before and after receiving three months of treatment.ResultsBefore treatment,there were no statistically significant differences in age,body weight,BMI,waist circumference,WHR,HOMA-IR、LH、LH/FSH、T between the three groups,which were comparable.Comparison of observation indexes of three groups before and after treatment:① anthropometric index:Ling-zhu granule combined with food exchange serving could reduce the body weight(P<0.001),BMI(P<0.001),waist circumference(P<0.001)and WHR(P<0.001)of obese PCOS patients;metformin could reduce the body weight(P<0.001),BMI(P<0.001)and waist circumference(P<0.001),and it was not found that metformin could reduce WHR(P=0.240);basic treatment could reduce weight(P=0.002),BMI(P=0.002),waist circumference(P<0.001)and WHR(P<0.001).②Serum sex hormone:Ling-zhu granule combined with food exchange serving could reduce LH(P<0.001),LH/FSH(P<0.001),T(P=0.003)of obese PCOS patients;metformin could not be considered to reduce LH(P=0.309),LH/FSH(P=0.747),T(P=0.582)of obese PCOS patients;basic treatment could reduce T(P=0.011),which could not be considered to reduce LH(P=0.384),LH/FSH(P=0.799).③Glucose metabolism:Ling-zhu granule combined with food exchange serving could reduce serum FINS(P<0.001)and HOMA-IR(P<0.001)in obese PCOS patients,but it could not be considered that it can reduce FPG(P=0.948);metformin could reduce serum FINS(P=0.004)and HOMA-IR(P=0.001)in obese PCOS patients,but it could not be considered that it can reduce FPG(P=0.658).It could not be considered that the basic group can reduce the serum FPG(P=0.895),FINS(P=0.609),HOMA-IR(P=0.534).④ Lipid metabolism:Ling-zhu granule combined with food exchange serving could reduce TG(P=0.019)in obese PCOS patients,but it could not be considered that it can reduce TC(P=0.585),LDL-C(P=0.625),and increase HDL-C(P=0.173);metformin could increase HDL-C(P=0.002)in obese PCOS patients,but it had not been found that it can reduce TG(P=0.053),TC(P=0.559),LDL-C(P=0.219).It was not found that basic treatment could reduce TG(P=0.550),TC(P=0.205),LDL-C(P=0.168)and increase HDL-C(P=0.535)in obese PCOS patients.⑤TCM syndrome score:the three groups could reduce the TCM syndrome score of obese PCOS patients,P values were<0.001,0.008,0.013,the difference was statistically significant(P<0.05).The comparison of the difference between the three groups before and after treatment:①anthropometric index:the difference of body weight in the three groups was statistically significant(P<0.001);the difference of BMI in the three groups was statistically significant(P<0.001);the difference of waist circumference in the three groups was statistically significant(P<0.001);the difference of WHR in the three groups was statistically significant(P<0.001).②Serum sex hormone:the difference of LH in three groups was statistically significant(P=0.021);the difference of LH/FSH in three groups was statistically significant(P=0.023);the difference of T in three groups was statistically significant(P<0.001).③Glucose metabolism:the difference of FPG in three groups was not statistically significant(P=0.874);the difference of FINS in three groups was statistically significant(P=0.010);the difference of HOMA-IR in three groups was statistically significant(P=0.007).④Lipid metabolism:there was no statistical significance in TG difference of the three groups(P=0.215);there was no statistical significance in TC difference of the three groups(P=0.447);there was no statistical significance in HDL-C difference of the three groups(P=0.073);there was no statistical significance in LDL-C difference of the three groups(P=0.347).⑤TCM syndrome score:the difference of TCM syndrome score among the three groups was statistically significant(P<0.001).Comparison among three groups after treatment:①anthropometric index:after treatment,there was statistical significance between the body weight groups of the three groups(P=0.054);after treatment,there was statistical significance between the BMI groups of the three groups(P=0.014);after treatment,there was statistical significance between the waist circumference groups of the three groups(P=0.037);after treatment,there was statistical significance between the WHR groups of the three groups(P<0.001).②Serum sex hormone:after treatment,the difference between the LH groups of the three groups was statistically significant(P<0.001);after treatment,the difference between the LH/FSH groups of the three groups was statistically significant(P<0.001);after treatment,the difference between the T groups of the three groups was statistically significant(P=0.001).③Glucose metabolism:there was no significant difference between the three groups of FPG(P=0.717);there was significant difference between the three groups of FINS(P=0.007);there was significant difference between the three groups of HOMA-IR(P=0.009).④Lipid metabolism:there was no significant difference among TG groups(P=0.179),TC groups(P=0.630),HDL-C groups(P=0.144),LDL-C groups(P=0.165).There was significant difference between the three groups of HDL-C(P=0.312).⑤TCM syndrome score:after treatment,there was significant difference among the three groups(P<0.001).ConclusionLing-zhu granule combined with food exchange serving can effectively achieve weight management,regulate sexual hormone disorder,improve glycolipid metabolism abnormality,reduce clinical symptoms,reduce TCM syndrome score and is of high safety.In terms of reducing weight,BMI,waist circumference,WHR,LH,LH/FSH,T,TCM syndrome score,Ling-zhu granule combined with food exchange serving is better than metformin and the basic treatment.In the aspect of reducing FINS and HOMA-IR,the curative effect of Ling-zhu granule combined with food exchange serving is better than that of the basic treatment.