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Article de Chinois | WPRIM | ID: wpr-906334

RÉSUMÉ

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 <italic>β</italic>-cell function (HOMA-<italic>β</italic>), 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 (E<sub>2</sub>), 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-<italic>α</italic> (TNF-<italic>α</italic>) levels were detected. Result:WHR, BMI and HOMA-IR levels of the observation group were lower than those of the control group (<italic>P</italic><0.05, <italic>P</italic><0.01). HOMA-<italic>β</italic> level was higher than that in the control group (<italic>P</italic><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 (<italic>χ</italic><sup>2</sup>=5.607, <italic>χ</italic><sup>2</sup>=5.131, <italic>χ</italic><sup>2</sup>=5.263, <italic>P</italic><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 (<italic>χ</italic><sup>2</sup>=5.239,<italic>P</italic><0.05). The observation group had more ovulation cycles than the control group (<italic>P</italic><0.01). The pregnancy rate in the observation group was 50.98% (26/51), higher than 31.37% (16/51) in the control group (<italic>χ</italic><sup>2</sup>=4.047,<italic>P</italic><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 (<italic>P</italic><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 (<italic>χ</italic><sup>2</sup>=5.420,<italic>P</italic><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 (<italic>χ</italic><sup>2</sup>=4.864,<italic>P</italic><0.05). The levels of AMH, E<sub>2</sub>, DHEAS, LH, T , IGF-1, LP and TNF-<italic>α</italic> in the observation group were lower than those in the control group (<italic>P</italic><0.01), while the APN and GDF-9 levels were superior to those in the control group (<italic>P</italic><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.

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