多囊卵巢综合征患者生活方式管理的最佳证据总结

Best evidence summary for lifestyle management in patients with polycystic ovary syndrome

目的总结与多囊卵巢综合征(PCOS)患者生活方式管理有关的最佳证据,为临床医护工作者提供循证依据及参考。方法依据PIPOST模型,针对PCOS患者生活方式管理提出循证问题,参照“6S”证据等级金字塔,利用计算机逐层进行证据检索。根据纳入/排除标准遴选文献,由两名研究员对纳入研究的文献分别独立进行质量评价及证据提取,最后综合证据并评定级别。结果共纳入22篇文献,其中临床决策1篇,指南8篇,系统评价9篇,专家共识4篇,最终总结出34条证据,涵盖适宜人群、管理时机、评估与监测、管理团队、管理目标、饮食管理、运动管理、行为管理、教育支持、效果评价10个方面。结论临床医护工作者应结合医院管理政策,全面评估患者状况,明确管理目标,制定个体化的饮食运动方案,并加强行为管理和教育支持、定期评价干预效果,最终帮助PCOS患者终身依从健康生活方式,提高远期生存质量。

Objective:To summarize the best evidence related to lifestyle management of patients with polycystic ovary syndrome(PCOS),and provide evidence-based reference for clinical healthcare workers.Methods:Based on the PIPOST model,evidence-based problems were proposed for the lifestyle management of patients with PCOS.Referring to the“6S”evidence hierarchy pyramid,the computer is used to retrieve the evidence layer by layer.Literatures were selected according to the inclusion/exclusion criteria.Two researchers independently evaluated the quality of the included literatures,and extracted the evidence,and finally synthesized the evidence and evaluated their grade.Results:A total of 22 literatures were selected,including 1 clinical decision,8 guidelines,9 systematic reviews,and 4 expert consensuses.Finally,34 items of best evidence were summarized into 10 categories including suitable population,management time,evaluation and monitoring,management team,management goal,diet management,exercise management,behavior management,education support and effect evaluation.Conclusions:Clinical medical workers should in combination with hospital management policies,evaluate patients’conditions comprehensively,define management objective,formulate individualized diet and exercise program,strengthen behavioral management and education support,and regularly evaluate intervention effects,so as to help PCOS patients adhere to a healthy lifestyle and improve long-term quality of life finally.