Objective:To analyze the differences in efficacy of clomiphene in the treatment of polycystic ovary syndrome infertile women with different traditional Chinese medicine(TCM)syndromes.Methods:A total of 973 infertile patients with polycystic ovary syndrome were divided into kidney deficiency and liver stagnation syndrome,kidney deficiency and blood stasis syndrome,spleen deficiency and phlegm dampness syndrome,and phlegm dampness and blood stasis syndrome.Then demographic characteristics,sex hormone levels,glucolipid metabolism levels and reproductive outcomes of patients with different TCM syndromes were compared before and after clomiphene intervention or without clomiphene intervention.Results:Compared with control group,clomiphene significantly decreased luteinizing hormone and follicle stimulating hormone levels in patients with kidney deficiency and liver stagnation syndrome,spleen deficiency and phlegm dampness syndrome,and phlegm dampness and blood stasis syndrome,and significantly increased progesterone,estradiol,total testosterone and sex hormone binding globulin in each syndromes,significantly decreased free testosterone index of patients with spleen deficiency and phlegm dampness syndrome,significantly decreased antimullerian hormone level of patients with phlegm dampness and blood stasis syndrome(P＜0.01,P＜0.05);Compared with control group,clomiphene significantly increased fasting blood glucose,fasting insulin and insulin resistance index of patients with kidney deficiency and blood stasis syndrome(P＜0.01);Compared with control group,clomiphene significantly increased high-density lipoprotein and apolipoprotein A of patients with Kidney deficiency and blood stasis syndrome(P＜0.05);Compared with control group,clomiphene significantly increased rate of ovulation in each syndromes,significantly increased rate of conception,pregnancy and live birth in patients with kidney deficiency and liver stagnation syndrome,spleen deficiency and phlegm dampness syndrome,and phlegm dampness and blood stasis syndrome(P＜0.01,P＜0.05).Conclusion:Clomiphene can reduce gonadotropin level,improve sex hormone level and improve reproductive outcome in infertile patients with polycystic ovary syndrome with kidney deficiency and liver stagnation syndrome,spleen deficiency and phlegm-dampness syndrome and phlegm-stasis syndrome,while although clomiphene can increase sex hormone level in patients with kidney deficiency and blood stasis syndrome,it aggravates glucose metabolism and does not improve the end point of reproductive outcome.
Traditional Chinese medicine syndrome differentiation and classificationPolycystic ovary syndrome(PCOS)InfertilityClomipheneGlucolipid metabolismReproductive outcome
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