RESUMO
OBJECTIVE： To systematically evaluate therapeutic efficacy of modified Cangfu daotan decoction （MCDD） combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， and to provide evidence-based reference for clinical decision. METHODS： Retrieved from PubMed， Embase， Cochrane Library， CJFD， Wanfang database， VIP and CBM， randomized controlled trials （RCTs） about MCDD combined with chemical medicine [ethynestradiol cycloprogesterone （Diane-35）， clomiphene， metformin] （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation with Cochrane 5.1.0 bias risk evaluation tool and Jadad scale， Meta-analysis was conducted for total response rate， serum hormone level （FSH， LH， LH/FSH， testosterone）， BMI， ovulation rate and physical signs （hirsutism， acne） by using Stata 14.0 software. Trial sequential analysis（TSA）was conducted by using TSA 0.9 software. RESULTS： A total of 20 RCTs were included， involving 1 484 patients. Results of Meta analysis showed that total response rate [RR＝1.13，95％CI （1.02，1.24），P＜0.05]， serum hormone level {FSH [WMD＝－0.59，95％CI（－0.98，－0.20），P＜0.05]，LH [WMD＝－0.95，95％CI（－1.41， －0.52），P＜0.05]，LH/FSH [WMD＝－1.04，95％CI（－1.78，－0.33），P＜0.05]，testosterone [WMD＝－0.93，95％CI（－1.38，－0.28），P＜0.05]}， BMI [SMD＝－1.01，95％CI （－1.76，－0.27），P＜0.05]， ovulation rate [RR＝1.17，95％CI（1.02，1.34），P＜0.05] and physical signs {hirsutism [WMD＝－0.48，95％CI（－0.86， －0.10），P＜0.05]， acne [WMD＝－1.16，95％CI（－1.56，－0.75），P＜0.05]} of trial group were all better than those of control group， with statistical significance. TSA showed that there are reliable evidences for MCDD combined with chemical medicine in the treatment of PCOS. CONCLUSIONS： Versus chemical medicine alone in the treatment of PCOS， MCDD combined with chemical medicine can improve total response rate and ovulation rate， reduce serum hormone levels， BMI and physical signs.
RESUMO
OBJECTIVE:To investigate the effects of Cangfu daotan decoction combined with Clomiphene citrate capsule on sex hormone level and endometrial receptivity in patients with polycystic ovary syndrome (PCOS) combined infertility. METH-ODS:A total of 116 PCOS patients with infertility in the First Affiliated Hospital of Guiyang College of TCM from Jan. 2014 to Dec. 2014 were divided into observation group and control group according to random number table,with 58 cases in each group. Both groups received hormone regulation therapy since the fifth day of menstruation. Control group was given Clomiphene citrate capsule 50 mg,qd;observation group was additionally given one dose of Cangfu daotan decoction,400 mL after decocted with wa-ter,bid,on the basis of control group. Both groups were treated for 3 cycles of menstruation. The levels of serum sex hormone (E2,LH),endometrial thickness(Em),endometrial spiral arterial pulsatility index(PI)and resistance index(RI)were compared between 2 groups before and after treatment. The ovulation rate and pregnancy rate were compared between 2 groups after 1-year follow-up. RESULTS:Before treatment,there was no statistical significance in E2,LH,Em,PI or RI between 2 groups (P>0.05). After treatment,the levels of E2 and LH as well as Em in 2 groups were increased significantly,while PI and RI were de-creased significantly;the observation group was significantly better than the control group,with statistical significance(P0.05). The pregnancy rate of observation group was 41.38％,which was significantly higher than that of control group (22.41％),with statistical significance (P<0.05). CONCLUSIONS:Cangfu daotan decoction combined with Clomiphene citrate capsule can effectively regulate serum sex hormone levels of PCOS patients with infertility,and improve endometrial receptivity so as to increase pregnancy rate.
RESUMO
OBJECTIVE:To explore the effects of Cangfu daotan decoction on expression of organic anion transporting poly-peptide(oatp4a1)and level of sex hormone in the endometrium and ovary tissues of rats with obesity-type polycystic ovarian syn-drome(PCOS). METHODS:Obesity-type PCOS rat models were established. 50 rats were randomized into a normal control(iso-metric normal saline)group,a model(isometric normal saline)group,a metformin(0.043 g/kg)group and Cangfu daotan decoc-tion high-dose and low-dose [5.68 and 1.42 g(medicinal materials)/kg] groups. The rats were given drugs ig once a day for 14 con-secutive days. The expression of oatp4a1 protein in the endometrium and ovaries of the rats was determined by ECL and Western blot. The levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)and estradiol(E2)in rat’s se-rum were detected by ELISA. RESULTS:Compared to the normal control group,those in the model group had weaker expression of oatp4a1 protein in the endometrium and ovaries,higher levels of serum LH,LH/FSH and T,lower levels of serum FSH and E2. There were statistical significances(P<0.01). Compared to the model group,those in metformin group,Cangfu daotan decoction high-dose and low-dose group had higher expression of oatp4a1 protein in the endometrium and ovaries,lower levels of LH/FSH and T,higher levels of serum E2;those in metformin group and Cangfu daotan decoction high-dose group had lower levels of serum LH,higher levels of serum FSH. There were statistical significances(P<0.01 or P<0.05). CONCLUSIONS:Cangfu daotan decoc-tion can increase the expression of oatp4a1 in the endometrium and ovaries of obesity-type PCOS model rat,alleviate phlegmy dampness and regulate the level of sex hormone.