To investigate the distribution rules of TCM Syndromes in polycystic ovary syndrome (PCOS) with insulin resistance and the characteristics of clinical endocrinology and glycolipid metabolism. Methods:A total of 78 PCOS patients with insulin resistance were grouped according to TCM syndrome type and 26 cases of healthy women of the same age were selected as control subjects. The general body condition, clinical endocrine and metabolic indices, including age, height, weight, waist circumference, hip circumference, fasting blood glucose, fasting insulin, total cholesterol (CHOL), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), apolipoprotein A-1 (ApoA-1), apolipoprotein B (ApoB), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and the testosterone (T) were observed and the differences of the parameters were compared between the groups. Results:The syndromes of patients with spleen deficiency and phlegm dampness, kidney deficiency, and liver qi stagnation accounted for 52.56%, 23.08%, and 24.36% respectively in the 78 cases of PCOS patients. Body mass index (BMI), waist-to-hip ratio (WHR), homeostasis model of assessment for insulin resistance index (HOMA-IR), LH, LH/FSH, T, CHOL, TG, HDL, LDL, APOA-1, and APOB of the spleen deficiency and phlegm dampness group were significantly higher than those of the normal control group (P<0.05). WHR, HOMA-IR, LH, LH/FSH, and T of liver qi stagnation group were significantly higher than those of the normal control group (P<0.05). HOMA-IR, LH, LH/FSH, and TG of kidney deficiency were significantly higher than those of the normal control group (P<0.05). BMI and WHR of the kidney deficiency and liver qi stagnation group, and TG of liver qi stagnation group were significantly lower than those of the spleen deficiency and phlegm dampness group (P<0.05). Conclusion:The incidence of IR in spleen deficiency and phlegm dampness syndrome was higher than in the syndromes of kidney deficiency and liver qi stagnation for PCOS patients. Obesity and endocrine and lipid metabolism disorder in spleen deficiency and phlegm dampness syndrome were more obvious.