多囊卵巢综合征患者诊治过程中的膳食调控及体重管理

Dietary regulation and weight management of polycystic ovary syndrome patients in the course of diagnosis and treatment

目的应用食物交换份法对多囊卵巢综合征（PCOS）患者进行个性化膳食调控和体重管理，探讨饮食干预对PCOS患者体重减少及治疗结局的前后对比。对象：收集2011年9月～2013年12月在广州市妇女儿童医疗中心妇科门诊就诊的81例（年龄19—45岁）PCOS患者入组观察。方法通过对81例PCOS患者采用食物交换份法进行个性化膳食调控及体重管理6个月，比较干预前、后排卵及妊娠情况，观察体重、体重指数（BMI）、腰围／臀围（WHR）及空腹血糖、空腹胰岛素、胰岛素抵抗指数（HOMA—IR）、睾酮、黄体生成素／卵泡刺激素（LH／FSH）的干预前后对比情况。结果81例PCOS患者入组观察治疗期间成功妊娠13例（16．05％），完成全程6个月观察42例，其中恢复排卵12例（12／42）。干预后体重、体重指数（MBI）、腰围／臀围（WHR）及空腹血糖、空腹胰岛素、胰岛素抵抗指数（HOMA—IR）、血脂代谢指标（TC、HDL—C、LDL—C）等指标变化有显著性差异（均P〈0．05），干预前后LH／FSH、睾酮，TG变化无显著性差异（均P〉0．05）结论采用食物交换份法对PCOS患者进行膳食调控疗效确切，实用性强，负作用小，患者依从性一般。

Objective To conduct individual dietary regulation and weight management among polycystic ovary syndrome （PCOS） patients by food exchange method, explore the effect of dietary regulation on weight and outcome of PCOS patients. Methods Eighty-one PCOS patients aged 19-45 years old were collected from Gynecological Outpatient in the hospital, then the patients received individual dietary regulation and weight management for six months by food exchange method; the ovulation, pregnancy rates, weight, body mass index （BMI）, waist-hip ratio （WHR）, fasting blood glucose, fasting insulin, HOMA-IR, testosterone, luteinizing hormone （LH） /follicle- stimulating hormone （FSH） levels before and after intervention were compared. Results In the course of treatment, 13 patients got pregnancy successfully, the pregnancy rate was 16. 05%, 42 patients completed the follow-up, 12 patients restored natural ovulation. After intervention, BMI, WHR, fasting blood glucose, fasting insulin, HOMA-IR, blood lipid metabolic indexes （total cholesterol, high-density lipopretein cholesterol, low-density lipoprotein cholesterol） changed significantly （P 〈 0. 05 ）, but there was no statistically significant difference in LH/FSH, testosterone, and triglyceride levels between before and after intervention （P〉 0. 05 ） . Conclusion Dietary regulation by food exchange method has the advantages of good effect, strong practicality, and little side effects for PCOS patients, the compliance of the patients is general.