[Effects of resolving method of Chinese medicine on the lipid metabolism in polycystic ovary syndrome accompanied with non-alcoholic fatty liver disease].

OBJECTIVE: To observe the therapeutic effect of resolving method of Chinese medicine (CM) on the lipid metabolism in polycystic ovary syndrome (PCOS) patients accompanied with non-alcoholic fatty liver disease (NAFLD), to analyze the correlation between PCOS and NAFLD, and to study its mechanisms. METHODS: Totally 70 female PCOS patients in the reproductive age (20 -40 years old) were recruited. Among them, 35 PCOS patients accompanied with NAFLD were recruited as Group A, and 35 PCOS patients without complicated NAFLD were recruited as Group B. At the same time, 20 healthy female volunteers were recruited as the control group. All subjects had their personal medical records after relevant questionnaire. Their clinical data including body height (BH), body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), testosterone (T), prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), leptin, fasting blood glucose (FBG), fasting insulin (FINS), 2 h postprandial blood glucose (2 h PBG), homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), etc. were detected. Patients in Group A were treated by the resolving method for 3 months. The follow-up was continued for 6 months after ending treatment. RESULTS: The levels of BW, BMI, WHR, T, LH, LH/FSH, leptin, FINS, 2 h PBG, HOMA-IR, and LDL-C were significantly higher in Group B than in the control group (P < 0.05). The level of FSH was significantly lower in Group B than in the control group (P < 0.05). The levels of BW, BMI, WC, HC, waist-hip-ratio (WHR), leptin, FINS, 2 h PBG, HOMA-IR, TG, LDL-C, ALT, and AST were significantly higher in Group A than in Group B (P < 0.05). The HDL-C level was significantly lower in Group A than in Group B (P < 0.05). In Group A after treatment by resolving method of CM, the menstrual cycle was recovered in 83.87% patients (26/31 cases), reduced fatty liver degree or disappearance of fatty liver degree occurred in 32.26% patients (10/31 cases), with the total effective rate being 85.71% (24/28 cases).48.28% (14/29) patients were pregnant. The levels of BW, BMI, FBG, leptin, TG, ALT, and AST significantly decreased when compared with those before treatment (P < 0.05). The level of SHBG significantly increased (P < 0.05). There was no significant difference in the levels of HOMA-IR, FINS, T, FSH, LH, or LH/FSH between before and after treatment (P > 0. 05). CONCLUSIONS: The metabolic disorder of glycolipid exists in PCOS patients, and more serious in PCOS patients accompanied with NAFLD. Resolving method can effectively restore the metabolic disturbance in PCOS patients accompanied with NAFLD, recover their fatty liver degrees, recover normal menstrual cycles, and elevate their pregnancy rates. Further studies are necessary on whether its mechanisms lie on lowering leptin levels and correcting lipid metabolisms to relieve patient's clinical symptoms.

[The Chinese medicine syndrome typing mode at the same level is the key point to explore the syndrome laws of disease. An inspiration from studying Chinese medicine syndrome laws of polycystic ovarian syndrome].

Chinese medicine (CM) syndrome typing methods not only provides information on the diagnosis and treatment of diseases, but also embodies the whole process of their occurrence, development, and prognosis. Standard syndrome typing methods can provide a testing platform for clinical efficacy assessment and scientific research work. By my 16 years' clinical experience, inter-group comparison of polycystic ovarian syndrome (PCOS) patients of different CM syndrome types at the same level (reproductive endocrinology and metabolism) was conducted. They were also compared with the healthy subjects. Results showed that homogeneity and heterogeneity exist in PCOS patients of different CM syndromes in the reproductive endocrine and metabolic characteristics, which is important to understand the laws between the pathological changes and syndrome types of PCOS. It is also a good inspiration to understand and clarify the correlation between the asthenia of Zang-Fu organs in CM theories and PCOS. Therefore, I believe that it is necessary to explore the laws of each CM syndrome type at the same level of syndrome typing, thus finding out the pathogenesis of PCOS. Only in this way could the clinical efficacy and the research level of integrative medicine be effectively improved.

[Study on the correlation between different Chinese medicine syndrome types and endocrine metabolism of polycystic ovarian syndrome].

OBJECTIVE: To explore the correlation between different Chinese medicine syndrome types and endocrine metabolism of polycystic ovarian syndrome (PCOS). METHODS: 223 PCOS patients were recruited. Of tem, 109 patients were classified as Pi deficiency type (PDT), 56 as Gan deficiency type (GDT), and 58 as Shen deficiency type (SDT). And twenty healthy females of the same age ranges were enrolled as the control group. The body mass index (BMI) and waist hip ratio (WHR) were measured. Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), prolactin (PRL), sex hormone binding globulin (SHBG), fasting blood sugar (FBG), fasting insulin (FINS), lipids [total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL)], and leptin were detected. The intergroup difference of each index was compared. RESULTS: Higher results of leptin, FINS, HOMA-IRI, T, LH/FSH ratio were obtained in the three PCOS groups than in the control group, while the level of SHBG was lower in the three PCOS groups than in the control group (P<0.05, P<0.01). There was no statistical difference in the leptin level among the three PCOS groups. Higher levels of FINS and HOMA-IRI were shown in the PDT group than in the SDT group and the GDT group (P<0.05, P<0.01). Higher T and LH/FSH were shown in the SDT group than in the PDT group and the GDT group (P<0.05). Higher PRL levels were obtained in the GDT group than in the PDT group and the SDT group (P<0.01). CONCLUSION: Disorders of serum leptin and SHBG were the common pathological manifestations in different syndrome types of PCOS, while different syndrome types had specific endocrine metabolic features.

[Study on the relation between Pi-deficiency pattern and metabolic syndrome in patients with polycystic ovarian syndrome].

OBJECTIVE: To evaluate the relation between Pi-deficiency syndrome (PDS) pattern and metabolic syndrome (MS) in patients with polycystic ovarian syndrome (PCOS), for exploring their internal pathologic mechanism. METHODS: Among the 102 PCOS patients, 22 complicated with MS (PCOS-MS) and 80 not complicated with MS (PCOS-NMS), the Chinese medicine syndrome pattern was differentiated as PDS in 50 patients and non-PDS in 52. The clinical data, in terms of fasting blood glucose (FBG), fasting insulin (FINS), waistline, body weight (BW), stature, blood pressure (BP), etc. was collected and compared and the relation between data was analyzed. RESULTS: Levels of FINS and homeostasis model of assessment for insulin resistence index (HOMA-IR), in PCOS-MS patients were significantly higher than those in PCOS-NMS patients, also higher in patients of PDS pattern than those of non-PDS pattern (P < 0.01); the occurrences of MS and PDS were highly positively correlated with levels of FINS and HOMA-IR (P < 0.01); incidence of MS in patients of PDS pattern was significantly higher than those in patients of non-PDS pattern (P < 0.05); presenting of PDS was positively related with the existence of MS (P < 0.05), but in case of the FINS or HOMA-IR factor being controlled, statistical meaning of the relativity between them turned to insignificant (P > 0.05). CONCLUSIONS: PCOS patients of PDS pattern are the high-risk population of MS, which might be related with the insulin resistance. So, early treatment of PCOS, especially on patients of PDS pattern, is of important significance for preventing the complication, as MS, of the disease.

[Clinical observation on treatment of 43 women with polycystic ovary syndrome based on syndrome differentiation].

OBJECTIVE: To investigate the therapeutic effect of treatment based on syndrome differentiation and its influence on the serum levels of testosterone and insulin in women with polycystic ovary syndrome (PCOS). METHODS: Forty-three women, diagnosed with PCOS as well as syndrome of kidney yin deficiency or syndrome of spleen qi deficiency, were enrolled in the study. Twenty-five PCOS women with syndrome of kidney yin deficiency were treated with traditional Chinese herbs for nourishing yin to reduce fire (nourishing yin group), and 18 PCOS women with syndrome of spleen qi deficiency were treated with herbs for invigorating spleen and replenishing qi (replenishing qi group). Body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and the serum levels of insulin and testosterone before and after treatment were detected. RESULTS: Among the 43 cases, 20 cases had high serum testosterone level, in which 13 cases with syndrome of kidney yin deficiency, 7 cases with syndrome of spleen qi deficiency, but the difference had no statistic significance; 17 cases had high serum insulin level, in which 11 cases with syndrome of spleen qi deficiency, 6 cases with syndrome of kidney yin deficiency, the difference had statistic significance (P<0.05). In nourishing yin group, the serum levels of insulin and testosterone declined after treatment (P<0.05), and BMI, WHR and WC showed no significant changes. In replenishing qi group, the serum level of insulin declined after treatment (P<0.01), and BMI, WHR, WC and the serum level of testosterone showed no significant changes. CONCLUSION: Traditional Chinese herbs for nourishing yin to reduce fire can significantly reduce the serum levels of testosterone and insulin in PCOS women with syndrome of kidney yin deficiency, and herbs for invigorating spleen and replenishing qi can significantly reduce the serum level of insulin in PCOS women with syndrome of spleen qi deficiency.