滋肾调肝活血调周法治疗多囊卵巢综合征肾虚肝郁证临床研究OA

Objective To observe the comprehensive clinical efficacy of nourishing kidney,regulating liver,activating blood circulation and regulating cycle therapy in treating patients with polycystic ovary syndrome(PCOS)of kidney deficiency and liver depression syndrome type.Methods A multi-center,randomized controlled design was employed.A total of 256 patients with PCOS of kidney deficiency and liver depression syndrome were enrolled from the outpatient clinics of Ningbo Municipal Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University and Women and Children's Hospital of Ningbo University between February 2024 and February 2025.They were divided into a control group(128 cases)and an observation group(128 cases)with block randomization method.Both groups received lifestyle interventions.The control group was administered metformin hydrochloride tablets,while the observation group received the nourishing kidney,regulating liver,activating blood circulation and regulating cycle therapy.The treatment duration for both groups was 3 months.Clinical effective rates of both groups were observed.TCM syndrome scores,pregnancy rate,fasting insulin(FINS),fasting plasma glucose(FBG),homeostatic model assessment of insulin resistance(HOMA-IR),leptin,visfatin,anti-Müllerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),LH/FSH ratio,testosterone(T),ovarian volume,and ovarian stromal area to total area ratio(SA/TA)before and after treatment of both groups were compared.Results Totally 20 and 12 cases dropped out from the control and observation groups,respectively.The clinical effective rate was 81.03%(94/116)in the observation group and 54.63%(59/108)in the control group,indicating that the clinical efficacy of the observation group was superior to that of the control group(P<0.05).Compared with before treatment,the TCM syndrome scores significantly decreased in both groups after treatment(P<0.05).The post-treatment TCM syndrome score in the observation group was lower than that in the control group(P<0.05).The pregnancy rate was 41.07%(23/56)in the observation group and 9.43%(5/53)in the control group,which was higher in the observation group than in the control group(P<0.05).In the non-pregnant cases who completed the treatment,compared with before treatment,the serum FINS and HOMA-IR decreased in both groups after treatment(P<0.05);the serum FINS and HOMA-IR in the observation group was lower than that in the control group(P<0.05).Compared with before treatment,the levels of leptin and visfatin in the two groups decreased(P<0.05);after treatment,the serum leptin level in the observation group was lower than that in the control group(P<0.05).Compared with before treatment,the levels of serum AMH,LH,LH/FSH and T in the two groups decreased after treatment(P<0.05),while the level of serum FSH increased(P<0.05);after treatment,the levels of serum AMH,LH and LH/FSH in the observation group were lower than those in the control group(P<0.05),and the level of serum FSH in the observation group was higher than that in the control group(P<0.05).Compared with before treatment,ovarian volume and ovarian SA/TA in the two groups decreased(P<0.05);after treatment,the ovarian volume and ovarian SA/TA in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Nourishing kidney,regulating liver,activating blood circulation and regulating cycle therapy demonstrates significant clinical efficacy in treating PCOS patients with kidney deficiency and liver depression syndrome.It can effectively alleviate TCM symptoms related to kidney deficiency and liver depression,improve glucose metabolism and adipokine secretion,regulate sex hormone levels,promote the restoration of ovarian morphology,and increase pregnancy rates.