Study On The Intervention Effect Of Cangfu Daotan Decoction On Polycystic Ovary Syndrome With Phlegm-dampness Syndrome Based On Intestinal Flora And Blood Lipid Metabolis

Objective: To observe the clinical efficacy of Cangfu Daotan decoction in the treatment of phlegm-dampness syndrome PCOS complicated with abnormal lipid metabolism,to analyze the role of intestinal flora in abnormal lipid metabolism of PCOS,and to explore the efficacy and mechanism of Cangfu Daotan decoction in the treatment of phlegm-dampness PCOS complicated with abnormal lipid metabolism,so as to provide reference for clinical treatment in the future.Methods:1.Clinical trial: 98 patients with phlegm-dampness syndrome PCOS complicated with abnormal lipid metabolism in the gynecology clinic of affiliated Hospital of Liaoning University of traditional Chinese Medicine from September 2019 to December 2020 were treated with Cangfu Daotan decoction for 3 consecutive menstrual cycles.The changes of traditional Chinese medicine(TCM)syndrome score,BMI,WHR,LH,FSH,T,LH/FSH,TC,TG,LDL-C and HDL-C before and after treatment were analyzed to observe the clinical efficacy of Cangfu Daotan decoction in the treatment of phlegm-dampness syndrome PCOS complicated with abnormal lipid metabolism.2.Animal experiment: 60 21-day-old SD female rats were randomly divided into blank group(n = 12)and model group(n = 48).After the model group was made with letrozole and high-fat emulsion as PCOS rat model of phlegm-dampness syndrome,the rats were randomly divided into model group and Cangfu Daotan decoction high,middle and low dose groups(n= 12 each).After 28 days of intervention with Cangfu Daotan decoction.The changes of body weight,body length,tail length,serum FFA,TG,TC,T,liver pathomorphology and intestinal flora were observed in the five groups.Results:1 Clinical trial 1.1 After three menstrual cycles treated with Cangfu Daotan decoction combined with Di qu progesterone,the scores of TCM syndrome and primary and secondary symptoms were significantly lower than those before treatment(p<0.05).The total effective rate was 92.86%.1.2 After three-month menstrual cycle treatment with Cangfu Daotan decoction and didroxyprogesterone,BMI,WHR,T,LH/FSH,TG,TC and LDL-C decreased,while HDL-C increased.2 Animal experiment 2.1 The PCOS rat model of phlegm-dampness syndrome established by letrozole combined with high-fat emulsion showed a significant increase in body mass,body length,tail length,T,FFA,TG and TC as compared with those in the normal group,and differences in the composition of intestinal flora.2.2 After intervention with Cangfu Daotan decoction,the degree of obesity and the levels of T,FFA,TG and TC in PCOS rats with phlegm-dampness syndrome decreased significantly(p<0.05).2.3 Cangfu Daotan decoction could improve the abundance of probiotics such as Ruminococcus,Lactobacillus,Prevotella,Romboutsia and Lachnospiraceae UCG-008,inhibit the abundance of pathogens such as Prevotellaceae Ga6A1 group,Blautia,Phascolarctobacterium,Turicibacter,Bacteroides and Lachnoclostridium.Conclusion:1.Clinical trial: Cangfu Daotan decoction in the treatment of phlegm-dampness syndrome PCOS complicated with abnormal lipid metabolism can reduce body weight,reduce BMI,improve abnormal lipid metabolism and hyperandrogenemia,down-regulate LH/FSH ratio,alleviate TCM syndrome,and restore menstrual cycle,indicating that Cangfu Daotan decoction is effective and safe in the treatment of phlegm-dampness syndrome PCOS patients with abnormal lipid metabolism.2.Animal experiment: The intestinal flora of rats with phlegm-dampness syndrome PCOS complicated with abnormal lipid metabolism established by letrozole combined with high-fat emulsion showed that the imbalance of intestinal flora may be an important link in the pathogenesis of PCOS,and a variety of probiotics and pathogens that may be closely related to PCOS were found.Cangfu Daotan decoction can improve the levels of serum FFA,TC,TG and T in the rat model of phlegm-dampness syndrome PCOS with abnormal lipid metabolism,reduce body weight,alleviate obesity,improve lipid metabolism and reduce the level of high androgen by regulating the structure of intestinal flora,so as to achieve the purpose of treating PCOS with abnormal lipid metabolism,and provide a theoretical basis for clinical treatment of PCOS with abnormal lipid metabolism in the future.