Effects of Shugan Bushen Decoction Combined with Laparoscopic Surgery on Ovarian Volume,Serum HOXA10 Expression and Pregnancy Rate in Patients with Refractory Polycystic Ovary Syndrome
Objective To investigate the effects of Shugan Bushen Decoction combined with laparoscopic surgery on ovarian volume,serum homeobox gene A10(HOXA10)expression and pregnancy rate in patients with refractory polycystic ovary syndrome(PCOS).Methods A total of 80 patients with refractory PCOS of liver stagnation and kidney deficiency type were randomly divided into an observation group and a control group,with 40 cases in each group.The control group was given conventional laparoscopic surgery and conventional medicine treatment.The observation group was treated with Shugan Bushen Decoction on the basis of treatment for the control group.One menstrual cycle constituted one course of treatment,and 3 continuous courses of treatment were given.The changes of traditional Chinese medicine(TCM)syndrome scores,ovarian volume,follicular diameter,serum HOXA10 expression and levels of sex hormones of luteinizing hormone(LH),estradiol(E2),progesterone(P),follicle stimulating hormone(FSH)and testosterone in the two groups before and after treatment were observed.Moreover,the pregnancy outcomes of the two groups during the follow-up for half a year were monitored.Results(1)After treatment,the ovarian volume in the two groups was decreased to different degrees(P<0.05),and the follicular diameter was increased to different degrees(P<0.05).The intergroup comparison showed that the decrease of ovarian volume and the increase of follicular diameter in the observation group were significantly superior to those in the control group(P<0.01).(2)After treatment,the levels of LH,FSH and testosterone in the two groups were significantly lower than those before treatment(P<0.05),and the levels of HOXA10,E2 and P were significantly higher than those before treatment(P<0.05).The decrease of LH,FSH and testosterone levels and the increase of HOXA10,E2 and P levels in the observation group were significantly superior to those in the control group(P<0.05 or P<0.01).(3)After treatment,the overall TCM syndrome scores and the scores of the syndrome manifestations of abnormal menstrual volume,abnormal menstrual cycle,soreness and weakness of waist and knees,darkish red tongue,deep and unsmooth pulse in the two groups were significantly lower than those before treatment(P<0.05),and the decrease of overall TCM syndrome scores and the scores of each of the syndrome manifestations in the observation group was significantly superior to that in the control group,the differences being statistically significant(P<0.01).(4)The pregnancy rate of the observation group was 55.00%(22/40),which was significantly higher than that of 32.50%(13/40)in the control group,and the difference was statistically significant(P<0.05).Conclusion For the treatment of refractory PCOS of liver depression and kidney deficiency type,Shugan Bushen Decoction combined with laparoscopic surgery can effectively improve the ovarian function of the patients,promote the recovery of sex hormone levels,increase the expression level of HOXA10,improve the endometrial receptivity,and enhance the pregnancy rate of the patients.