Analysis Of Tcm Syndrome Types And Clinical Features Of Polycystic Ovary Syndrome With Hyperandrogenemia

Objective:To explore the distribution law of TCM syndromes of PCOS patients with hyperandrogenism,and analyze and compare the differences of external signs and biochemical indexes among different TCM syndromes,so as to guide the syndrome differentiation and treatment of PCOS patients with HA and provide obj ective basis for its curative effect evaluation.Methods:Anthropometric indexes and clinical biochemical indexes of patients with Polycystic ovary syndrome were retrospectively analyzed from January 2014 to January 2022 in the clinical scientific research information integration platform of the department of gynecology outpatient department of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine.According to T and AND values,551 PCOS patients with hy perandrogeni sm were selected.According to PCOS TCM syndrome differentiation standard,they were divided into spleen deficiency phlegm dampness syndrome,kidney deficiency liver depression syndrome,kidney deficiency blood stasis syndrome and phlegm stasis syndrome.The indexes of different syndromes were statistically analyzed.Results:1.The distribution proportion of TCM syndromes in PCOS patients with HA was 14.2%(78/551)of spleen deficiency phlegm dampness syndrome,31.4%(1 73/55 1)of kidney deficiency liver depression syndrome,20.7%(114/551)kidney deficiency blood stasis syndrome,33.7%(1 86/55 1)of phlegm stasis syndrome.The syndrome of interaction of phlegm stasis is the main TCM syndrome type of PCOS patients with HA.2.In the comparison of basic information among TCM syndromes of PCOS patients with HA,the age of menarche of kidney deficiency liver depression syndrome was later than that of patients with phlegm stasis syndrome,the difference was statistically significant(P<0.05).The body weight,BMI,WC and HC of spleen deficiency phlegm dampness syndrome and phlegm stasis syndrome were higher than those of kidney deficiency liver depression syndrome and kidney deficiency blood stasis syndrome,and the differences were statistically significant(P<0.05).The WHR and systolic blood pressure of patients with phlegm stasis syndrome were higher than those with kidney deficiency liver depression syndrome and kidney deficiency blood stasis syndrome,the difference was statistically significant(P<0.05).The diastolic blood pressure of patients with phlegm stasis syndrome was higher than the other three groups,the difference was statistically significant(P<0.05).The incidence of acanthosis nigricans in patients with phlegm stasis syndrome was higher than that in patients with spleen deficiency phlegm dampness syndrome and kidney deficiency liver depression syndrome,and the incidence of acanthosis nigricans in patients with kidney deficiency blood stasis syndrome was lower than that in patients with spleen deficiency phlegm dampness syndrome and phlegm stasis syndrome,with statistical significance(P<0.05).3.In comparison of sex hormone indexes among TCM syndromes of PCOS patients with HA,FSH value of kidney deficiency liver depression syndrome was higher than that of spleen deficiency phlegm dampness syndrome,with statistical significance(P<0.05).FSH value of phlegm stasis syndrome was lower than that of patients with spleen deficiency phlegm dampness syndrome,with statistical significance(P<0.05).AND value of kidney deficiency blood stasis syndrome was higher than that of kidney deficiency liver depression syndrome,with statistical significance(P<0.05).4.In comparison of glucolipid and insulin indexes among TCM syndromes of PCOS patients with HA,TC value of patients with kidney deficiency blood stasis syndrome was higher than that of patients with kidney deficiency liver depression syndrome,the difference was statistically significant(P<0.05).The LDL-C value of patients withkidney deficiency liver depression syndrome was lower than the other three groups,the difference was statistically significant(P<0.05).The APOA value of kidney deficiency liver depression syndrome was higher than that of phlegm stasis syndrome,and the difference was statistically significant(P<0.05).The APOB and APOB/APOA values of patients with phlegm stasis syndrome were higher than those of kidney deficiency blood stasis syndrome and kidney deficiency liver depression syndrome,with statistical significance(P<0.05).The values of FINS and HOMA-IR in patients with kidney deficiency liver depression syndrome were higher than those in patients with spleen deficiency phlegm dampness syndrome and phlegm stasis syndrome,while the values of FINS and HOMA-IR in patients with kidney deficiency blood stasis syndrome were lower than those in patients with phlegm stasis syndrome,with statistical significance(P<0.05).Conclusion:1.The syndrome of phlegm stasis is the main TCM syndrome type of PCOS patients with HA.2.Compared with the other two groups,PCOS patients with HA phlegm stasis syndrome and spleen deficiency phlegm dampness syndrome have higher body weight,BMI,WC and HC,and are more prone to abdominal obesity,and the incidence of acanthosis nigricans is also higher.3.The glucose and lipid metabolism disorders of PCOS patients with HA phlegm stasis syndrome and spleen deficiency phlegm dampness syndrome are more serious than those of the other two groups.Comprehensive early intervention and long-term management should be carried out to prevent long-term complications.