补肾填精汤治疗多囊卵巢综合征-胰岛素抵抗伴维生素D缺乏临床研究OA

Objective:To observe the clinical efficacy of Kidney-Supplementing and Essence-Replenishing Decoction on Polycystic Ovary Syndrome(PCOS)with insulin resistance(IR)and vitamin D deficiency.Methods:A total of 90 patients with PCOS-IR were divided into the TCM group,the Western medicine group,and the combined TCM and Western medicine group according to random number ta-ble method,with 30 cases in each group.The Western medicine group was treated with Metformin Extended-Release Tablets,the TCM group was treated with Kidney-Supplementing and Essence-Replenishing Decoction,and the combined TCM and Western medicine group was treated with Metformin Extended-Release Tablets combined with Kidney-Supplementing and Essence-Replenishing Decoc-tion.The fasting serum insulin(FINS),fasting blood-glucose(FBG),serum 25-(OH)D3 level,sex hormones[(Estradiol(E2),Folli-cle stimulating hormone(FSH),Luteinizing hormone(LH),Testosterone(T)],and inflammatory factor levels[(Interleukin-6(IL-6),Tumor necrosis factor-α(TNF-α)]in the two groups before and after treatment were measured.HOMA-IR was calculated.The changes in the clinical efficacy,HCG levels,uterine content morphology,endometrial thickness,Salle score,and TCM syndrome scores before and after treatment in the two groups were compared.The correlation between body mass index,serum indicators,and 25-hydroxyvitamin D was analyzed.Results:The effective rate of the TCM group was 90.0％,while that of the combined TCM and Western medicine group was 93.4％,and that of the Western Medicine group was 86.7％.There was no statistically significant difference among the three groups(P＞0.05).After treatment,the TCM syndrome scores of all patients were lower than those before treatment(P＜0.05),and there was no statistically significant difference between the TCM group and the combined TCM and Western medicine group(P＞0.05).The difference between the combined TCM and Western medicine group,the TCM group,and the Western medicine group was statistically significant(P＜0.05).After treatment,there was no statistically significant difference in serum indicators between the same group compared with those before treatment(P＞0.05).Compared with the TCM group,the T and HOMA-IR levels in the com-bined TCM and Western medicine group decreased after treatment;and the 25(OH)D level in the combined TCM and Western medi-cine group was higher than that in the Western medicine group,and the TNF-α level was lower,and all the differences were statistically significant(P＜0.05).Correlation analysis was conducted between all patients'BMI,sex hormones,HMOA-IR,inflammatory factors,and 25-(OH)D3 before treatment.The results showed that HOMA-IR was positively correlated with 25-(OH)D3(P＜0.05).Further a-nalysis showed that after treatment,the level of 25-(OH)D3 was increased and the level of T was decreased in the TCM group and the combined TCM and Western medicine group,and it was negatively correlated with 25-(OH)D3(P＜0.05).The Salle score was higher in the combined TCM and Western medicine group than that in the TCM group and the Western medicine group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in endometrial thickness among the groups(P＞0.05);the A-type endometrial rate in the combined Chinese and Western medicine group was higher than that in the Western medicine group and the TCM group,and the difference was statistically significant(P＞0.05).Conclusion:Kidney-Supplementing and Essence-Replenishing Decoction alone or its combination therapy can improve the clinical symptoms of PCOS-IR patients with kidney deficiency to different degrees,lower the levels of inflammatory factors,LH,and T,improve insulin resistance and 25-(OH)D3 deficiency,have a positive impact on endometrial thickness,and the observation shows that insulin resistance,T,and 25-(OH)D3 levels are correlated,which is worth further researching.