Zhang Ning, Li Chang, Guo Ying, Wu Hai-Cui
Shandong University of Traditional Chinese Medicine, Jinan 250355, China.
Affiliated Hospital of Shandong University of Chinese Medicine, Jinan 250011, China.
Evid Based Complement Alternat Med. 2020 Sep 29;2020:6389034. doi: 10.1155/2020/6389034. eCollection 2020.
This was a population-based cohort study, to compare the type and structure of intestinal flora in patients with polycystic ovary syndrome (PCOS) with phlegm-dampness syndrome, nonphlegm-dampness syndrome, and normal population. Besides, changes in the intestinal flora and the clinical curative effects of Jiawei Qi Gong Wan on phlegm-dampness syndrome in patients with polycystic ovary syndrome (PCOS) were evaluated. . A total of 22 patients with PCOS with phlegm-dampness syndrome, 21 PCOS patients with nonphlegm-dampness syndrome, and 20 control volunteers were selected for this study. The general index, sex hormone index, fasting blood glucose (FPG), and serum fasting insulin (FINS) were determined in each of the groups. The intestinal flora of each group was determined by the 16s rDNA high-throughput sequencing technique. Besides, the PCOS with phlegm-dampness syndrome group was treated with Jiawei Qi Gong Wan, and the changes in TCM syndrome, sex hormone index, BMI, WHR, FPG, FINS, HOMA-IR, and intestinal flora were determined before and after treatment.
PCOS patients with phlegm-dampness syndrome showed characteristics of obesity and insulin resistance. There were several differences in both structure and function of the intestinal flora between PCOS patients with phlegm-dampness syndrome, PCOS patients with nonphlegm-dampness syndrome, and the control group. An imbalance in the intestinal flora may be a key factor in the pathogenesis of PCOS with phlegm-dampness syndrome and also has a specific influence on glucose and lipid metabolism, obesity, and the menstrual cycle in PCOS patients with phlegm-dampness syndrome. Besides, the imbalance is associated with a decrease in the number of butyrate-producing bacteria, an increase in the number of lipopolysaccharide-producing bacteria, and an increase in proinflammatory bacteria. The intestinal flora in PCOS patients with phlegm-dampness syndrome was found to be linked to obesity, impaired glucose tolerance, and hyperandrogenemia. Treatment with Jiawei Qi Gong Wan was found to increase the diversity of intestinal flora, increase the number of intestinal probiotics, and improve the structure and functional genes of intestinal flora which improved the state of insulin resistance, regulated endocrine metabolism, and improved the overall symptoms.
Intestinal flora imbalance is a key factor in the pathogenesis of PCOS with phlegm-dampness syndrome. Besides, Jiawei Qi Gong Wan improves insulin resistance which is linked to the status of the intestinal flora in PCOS patients with phlegm-dampness syndrome.
本研究为基于人群的队列研究，旨在比较多囊卵巢综合征（PCOS）痰湿证患者、非痰湿证患者及正常人群的肠道菌群类型及结构。此外，评估PCOS痰湿证患者肠道菌群的变化及加味启宫丸对其的临床疗效。本研究共纳入22例PCOS痰湿证患者、21例PCOS非痰湿证患者及20名对照志愿者。测定各组的一般指标、性激素指标、空腹血糖（FPG）及血清空腹胰岛素（FINS）。采用16s rDNA高通量测序技术测定各组肠道菌群。此外，对PCOS痰湿证组给予加味启宫丸治疗，测定治疗前后中医证候、性激素指标、BMI、腰臀比、FPG、FINS、HOMA-IR及肠道菌群的变化。
PCOS痰湿证患者表现出肥胖及胰岛素抵抗的特征。PCOS痰湿证患者、PCOS非痰湿证患者及对照组在肠道菌群的结构和功能上均存在差异。肠道菌群失衡可能是PCOS痰湿证发病机制的关键因素，对PCOS痰湿证患者的糖脂代谢、肥胖及月经周期也有特定影响。此外，这种失衡与产丁酸菌数量减少、产脂多糖菌数量增加及促炎菌数量增加有关。发现PCOS痰湿证患者的肠道菌群与肥胖、糖耐量受损及高雄激素血症有关。加味启宫丸治疗可增加肠道菌群多样性，增加肠道益生菌数量，改善肠道菌群的结构和功能基因，从而改善胰岛素抵抗状态，调节内分泌代谢，改善整体症状。
肠道菌群失衡是PCOS痰湿证发病机制的关键因素。此外，加味启宫丸可改善胰岛素抵抗，这与PCOS痰湿证患者的肠道菌群状态有关。
