Effects of Bushenshugan Method on Hyperandrogenism and Hyperinsul Inemia in Polycystic Ovary Syndrome
|School||Hubei University of Chinese Medicine|
|Course||Traditional Chinese Medicine|
|Keywords||PCOS Shuganbushen Method Clinical effect Hyperandrogenism Hyperinsulinemia|
Objective:Polycystic ovary syndrome (PCOS),one of the most common endocrine diseases affecting women of reproductive age,plays an important role in anovulatory infertility. In the view of Traditional Chinese Medicine (TCM),PCOS classifies to "menopathy", "infertility" and "Zhengjia", its occurrence exists a close relationship with dysfunction of liver,kidney,spleen and further inducing deficiency,sputum,sluggish,and fire. Many scholars insist that pathogenesis of PCOS is a renal deficiency plus phlegmatic hygrosis.According to the clinical observation,we found that there was heterogeneity among different patients of PCOS. Quite a number of PCOS patients,besides be responsibled for deficiency of the kidney, the occurrence of many patients were caused by stagnation of liver-QI,hepatic fire or accompanying wet.The research aims to explore the clinical features of PCOS,evaluate the therapeutic effect of Shuganbushen Method on treating patients with PCOS and hyperandrogenism and hyperinsulinemia,and investigate the therapeutic mechanism. In order to provide some clinical new ideas and methods.Methods:In the fisrt part of clinical sutdy,selecting 45patients with PCOS accompanied hyperandrogenism and hyperinsulinemia(Age distribution in 18-36).The selective data included the pattern of their mensturation、simultaneous phenomenon,signs such acne、haimess and so on. The information also recorded their age weihgt(kg)、beihgt(m)、waistline(cm)、buttock line (cm).The study assessed serum LH、FSH、PRL、E2、T、FINS、FBG;calculated waist-hip rate(WHR)、body mass index(BMI).Classify them into two groups-the treatment group(30 patients)treated with Chinese traditional medicine,the control group(15 patients) treated with Metformin. Treatment group with Shuganbushen Method for the treatment of primary party to add, the TCM artificially cycle therapy:Monthly menstrual cycle in the first half,based on the main method in using invigorating spleen and resolving phlegm Method. The remaining cycle,, in the main method basis assistant to cooling blood by clearing away heat and promoting blood circulation. The course of treatment should be last 2 treatment (A treatment for 3 months). The effect is not clear with a treatment can be added.Western medicine group of patients taking metformin, a dose of 0.5 g, twice for 6 months.Since the forth month start add to oral taie-35, the first day in menstrual cycle or after taking metformin 3 months and 7 days,a dose of 1 pill in fixed time, once for 3 months, or drug discontinuation after diagnosis of pregnancy. After discontinuation of 7 days,repeated to medicine.If not menstruation, in the senventh day after discontinuation,repeated to medicine. Before and after the treatment,the clinical symptoms, reproductive hormones,serum insulin levels(FINS),FBG,insulin resistance homa model (HomaIR) and body mass index(BMI)were observed. Results:In the clinical symptoms,western medicine group and the Chinese traditional medicine group before menstruation,there were irregular menstruation 30 cases,respectively in 15 cases,the infertility 6 and 3,obesity 7 and 4,acne 5 and 3,hairness 3 and 2,monophase of BBT 25 and 12. Therapeutic effects displayed that Shuganbushen Method could improve menstruation,acne and BBT in Chinese traditional medicine group,after treatment of 2,normal menstruation 24 cases,acne 3 were cured,BBT restore duplex 25 cases,notable differences(P<0.05).Symptoms of hairness without obvious improvement after treatment both the Chinese traditional medicine group and western medicine group,three cases infertility in the Chinese traditional medicine group were pregnant after treatment in 6 cases infertility prior treatment.Three patients by western medicine therapy still no pregnancy. Treatment group and control group,10.00%、0 respectively for pregnant rate.The levels of serum fasting insulin(FINS)、fasting blood glucose (FBG)、and LH/FSH were lower than those of pretherapy(all P<0.05),no difference was found between two groups.Reduce T and improve acne, and ovarian morphological observation under ultrasound,before and after the treatment,Chinese traditional medicine group was significant difference (P<0.05),but western medicine group was no significant (P>0.05).Better curative effect in treatment group than in control group.Conclusion:(1) Kidney deficiency and liver stagnation syndrome not only was the major symptom type of PCOS,but also was one of the most important pathogenesis in PCOS.Few menstruation was the most common symptom. Secondly is amenorrhea.Early and disorder menstruation a low incidence. Acne was the major symptom of hyperandrogenism, a low incidence of hairy.(2) Shuganbushen Method was proved efficient in the clinical research. It may treat patients with PCOS and hyperandrogenism and hyperinsulinemia not only through improving menstruation,lower testosterone,LH and LH/FSH、precipitating ovulation, pregnancy, but also reducing serum insulin level and LH/FSH, improving acne,regulating the balance of incretion. Reducing testosterone (T) and insulin levels,improving insulin resistance to achieve remedial purposes.