Effect of Modified Cangfu Daotantang on Metabolism and Pregnancy in Patients with Polycystic Ovary Syndrome
10.13422/j.cnki.syfjx.20210532
- VernacularTitle:加减苍附导痰汤对多囊卵巢综合征脾虚痰湿证代谢和受孕情况的影响
- Author:
Peng-peng XIE
1
;
Lei ZENG
2
;
Jing-wei YU
3
;
Yan-hong FU
4
Author Information
1. Guangzhou Women and Children's Medical Center，Guangzhou 511400，China
2. The First Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510405，China
3. Panyu Maternal and Child Care Service Centre of Guangzhou，Guangzhou 511400，China
4. Maternal and Child Health Hospital of Huadu District in Guangzhou，Guangzhou 510800，China
- Publication Type:Research Article
- Keywords:
polycystic ovary syndrome;
infertility;
spleen deficiency and phlegm dampness syndrome;
Cangfu Daotantang;
metabolic abnormalities;
insulin-like growth factor-1;
growth differentiation factor-9
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2021;27(14):87-92
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the effect of modified Cangfu Daotantang on metabolism and pregnancy in patients with spleen deficiency and phlegm-dampness type polycystic ovary syndrome （PCOS）. Method:One hundred and twelve patients were randomly divided into control group and observation group according to the random number table. Both groups took non-pharmacological interventions， oral metformin hydrochloride， 500mg/time， 3 times/day； oral ethinyl estradiol and cyproterone tablets， 1 tablet/time， 1 time/day， starting from the third to fifth day of menstruation and lasting for twenty-one days， for a total of 3 menstrual cycles. Patients in control group additionally took Erchen pills orally， 10 g/time， 2 times/day， while patients in observation group additionally took modified Cangfu Daotantang orally， 1 dose/day. The course of treatment was six menstrual cycles in both groups （or termination after conception）. The waist-to-hip ratio （WHR）， body mass index （BMI）， insulin resistance index （HOMA-IR）， pancreatic β-cell function （HOMA-β）， triglycerides （TG）， low-density lipoprotein （LDL） and non-high-density lipoprotein （nHDL） elevation after treatment were compared. The number of ovulation cycles monitored by B-ultrasound （6 menstrual cycles）， ovulation rate， human chorionic gonadotropin （HCG） day endometrial thickness， follicle diameter， cervical mucus score>8 points and endometrial morphology type A rate were measured and recorded. The recovery of menstruation， pregnancy and early miscarriage were recorded. Luteinizing hormone （LH）， estradiol （E2）， follicle stimulating hormone （FSH）， dehydroepiandrosterone sulfate （DHEAS）， testosterone （T）， anti-Müllerian hormone （AMH） levels， and insulin before and after treatment -Like growth factor-1 （IGF-1）， leptin （LP）， adiponectin （APN）， growth differentiation factor-9 （GDF-9） and tumor necrosis factor-α （TNF-α） levels were detected. Result:WHR， BMI and HOMA-IR levels of the observation group were lower than those of the control group （P<0.05， P<0.01）. HOMA-β level was higher than that in the control group （P<0.01）. The increase rates of LDL， TG， and nHDL in the observation group were 19.61%（10/51），25.49%（13/51），23.53%（12/51）， respectively， lower than 41.18%（21/51），47.06%（24/51），45.10%（23/51）respectively in the control group （χ2=5.607， χ2=5.131， χ2=5.263， P<0.05）. The menstrual recovery rate in the observation group was 90.20% （46/51）， higher than 72.55% （37/51） in the control group （χ2=5.239，P<0.05）. The observation group had more ovulation cycles than the control group （P<0.01）. The pregnancy rate in the observation group was 50.98% （26/51）， higher than 31.37% （16/51） in the control group （χ2=4.047，P<0.05）. On HCG day after treatment， the endometrial thickness and follicle diameter in the observation group were better than those in the control group （P<0.01）. The proportion of patients with cervical mucus score> 8 points was 78.43% （40/51） in the observation group， higher than 56.86% （29/51） in the control group （χ2=5.420，P<0.05）. The intimal morphology type A rate in the observation group was 52.94% （27/51）， higher than 31.37% （16/51） in the control group （χ2=4.864，P<0.05）. The levels of AMH， E2， DHEAS， LH， T ， IGF-1， LP and TNF-α in the observation group were lower than those in the control group （P<0.01）， while the APN and GDF-9 levels were superior to those in the control group （P<0.01）. Conclusion:On the basis of conventional western medicine intervention， modified Cangfu Daotantang can regulate abnormal metabolism and reproductive endocrine in patients with PCOS， improve conception， and regulate the expression of IGF-1， GDF-9， adipocytokines and inflammatory factors， improve ovulation and improve pregnancy rate.
