Clinical effect of Bushen Huatan Huoxue Decoction treating polycystic ovary syndrome with insulin resistance infertility
[Objective]To observe the clinical effects of Bushen Huatan Huoxue Decoction(BHHD)in the treatment of polycystic ovary syndrome with insulin resistance(PCOS-IR)infertility and its effect on endometrial receptivity.[Methods]A randomized controlled trial was conducted,62 PCOS-IR infertility patients with kidney deficiency and phlegm stasis were divided into treatment group Ⅰ and treatment group Ⅱ,31 in each group.On the premise of routine intervention,metformin was used in group Ⅰ,and BHHD was used in group Ⅱ.The treatment and follow-up period were 3 months.The cycle ovulation rate and clinical pregnancy rate were recorded.The body mass index(BMI),traditional Chinese medicine(TCM)syndrome score,glucose metabolism indexes[fasting blood glucose(FBG),fasting insulin(FINS),insulin resistance index(HOMA-IR)],sex hormone levels[testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),LH/FSH,estradiol(E2),prolactin(PRL)],three-dimensional ultrasound parameters of endometrium[thickness,classification,volume,vascularization index(Ⅵ),flow index(FI),vascularization-flow index(VFI)]during implantation(6-9 days after ovulation)and adverse effects rate were detected and compared between the two groups of patients before and after the treatments.[Results]Compared with before treatment in the same group,the levels of TCM syndrome score,BMI,FINS,HOMA-IR,LH and LH/FSH of patients in two groups were reduced(P<0.01,P<0.05),and TCM syndrome score in group Ⅱ was obviously reduced(P<0.01).There was no significant difference in cycle ovulation rate between the two groups(P>0.05),and the level of Ⅵ and VFI in group Ⅱ were significantly improved compared with the group Ⅰ(P<0.05).The clinical pregnancy rate of group Ⅱ was 61.54%(16/26)and 73.08%(19/26)after treatment and follow-up,which was significantly higher than the clinical pregnancy rate at the corresponding time point in treatment group Ⅰ[33.33%(8/24)and 41.67%(10/24)](P<0.05),and the embryo abortion rate was lower(P<0.05).The adverse reaction rate of group Ⅱ was significantly lower than that of group Ⅰ(15.38%vs 41.67%,P<0.05).[Conclusion]BHHD could improve the clinical symptoms of PCOS-IR infertility patients with kidney deficiency and phlegm stasis,improved insulin resistance and obesity signs,regulated reproductive endocrine disorders,significant increased endometrial blood perfusion during implantation,promoted clinical pregnancy rate,improved pregnancy outcome and reduced the incidence of adverse reactions,and is worthy of clinical popularization and application.