Clinical Study on the Therapeutic Effect of Combined Traditional Chinese Medicine with Acupoint Injection and Herbal Paste Application in Treating Ovulatory Dysfunction in Polycystic Ovary Syndrome (PCOS)

Objective: To observe the therapeutic effect of combined traditional Chinese medicine (TCM) therapy with acupoint injection and herbal patch application on patients with ovulatory dysfunction associated with polycystic ovary syndrome (PCOS). Methods: A total of 80 PCOS patients who received treatment at the First Affiliated Hospital of Guangxi University of Chinese Medicine between October 2022 and March 2024 were enrolled in this study. They were randomly divided into a control group (n = 40) and an observation group (n = 40). The control group received conventional Western medical treatments, while the observation group was administered TCM combined with acupoint injection and herbal patch application. Pre- and post-treatment conditions were compared between the two groups. Results: After treatment, the overall effective rate was significantly higher in the observation group compared to the control group (P 0.05). Following treatment, both ovulation and pregnancy rates increased in both groups, but the increase was more evident in the observation group, showing a statistically significant difference (P < 0.01). Conclusion: For patients with oligoovulation or anovulation due to PCOS, the combined use of TCM, acupoint injection, and herbal patch application appears to be effective in improving systemic symptoms and achieving notable clinical outcomes.

Research Progress of Non-drug Therapy of Traditional Chinese Medicine in the Treatment of Obese Polycystic Ovary Syndrome

Polycystic ovarian syndrome(PCOS)as a relatively common clinical reproductive endocrine disease,the incidence is increasing year by year and the treatment is difficult,among which obese PCOS accounts for nearly 50%of the total.In recent years,non-drug therapy of traditional Chinese medicine(TCM)has been effective in the treatment of PCOS.This article summarizes the relevant literature in the past ten years from acupuncture,acupoint embedding,moxibustion,and auricular points,and observes the effects of TCM non-drug therapy on endocrine and glucose and lipid metabolism in obese PCOS patients.The impact of various indicators such as body mass index,body mass index,etc.,and discuss the problems in such treatments,as well as put forward suggestions to achieve the purpose of better guiding the clinical treatment of obese PCOS.

Meta Analysis of the Efficacy of Nonpharmaceutical Chinese Medicine Therapy in the Treatment of Obese Polycystic Ovary Syndrome

Objective:To systematically evaluate the effects of acupuncture,auricular point sticking,acupoint catgut embedding,cupping and other non-pharmaceutical Chinese medicine therapies on sex hormone as well as glucose and lipid metabolism in patients with obese polycystic ovary syndrome.Method:The databases such as China National Knowledge Infrastructure were searched by computer to collect the literature on the treatment of obese polycystic by non-pharmaceutical Chinese medicine therapy combined with western medicine or lifestyle change,and the literature quality of the included literature was evaluated,and finally the data were analyzed.A total of 15 randomized controlled trial(RCT)literature were included in this study,with a total of 1263 patients.Results:Non-pharmaceutical Chinese medicine therapy combined with metformin or lifestyle can reduce body mass index,insulin resistance index,fasting plasma insulin,fasting blood glucose,luteinizing hormone,ratio of luteinizing hormone to follicle stimulating hormone,testosterone,but it has no obvious advantage over follicle stimulating hormone(FSH).Conclusion:Compared with simple application of metformin or lifestyle change,traditional Chinese medicine non drug therapy combined with metformin or lifestyle change can better improve sex hormone and blood glucose metabolism in obese PCOS patients.

Integrative techniques using acupuncture,Chinese herbal medicine,diet,and supplements for polycystic ovary syndrome:a case report

Patients with a diagnosis of polycystic ovary syndrome （PCOS） are on the rise. About 4%-12% of women are currently estimated to have this condition. It is hypothesized that PCOS appears in women who have long-standing insulin resistance （1R）, which leads to high androgen and testosterone levels; this ultimately disrupts their menstrual cycles. Some researchers attribute IR to genetic factors, although there have been only minute changes in the human genome in the past 20 000 years. However, even with a stable gene pool, genes can be turned on and offby the environment, food and air quality and toxin exposure.

Text mining and data analysis identify potential drugs and pathways for polycystic ovary syndrome treatment

Objective:Polycystic ovarian syndrome(PCOS)is a common endocrine disorder affecting women of reproductive age.This study aimed to use text mining and microarray data analysis to identify drugs that target genes and potential pathways associated with PCOS.Methods:We extracted a common set of genes associated with PCOS using text mining and the microarray dataset GSE48301.Next,we performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses of these genes,as well as protein–protein interaction(PPI)network analysis.Additionally,we used MCODE and cytoHubba to cluster significant common genes in the PPI network and performed gene–drug interaction analyses to identify potential drugs for further investigation.Finally,we annotated pathways associated with the genes identified.Results:Text mining and microarray analysis yielded 696 text mining genes(TMGs)and 2804 differentially expressed genes(DEGs).Among these,a set of 77 genes was found in both TMGs and DEGs.Interestingly,67 of these genes participated in constructing the PPI network.Seven common hub genes were selected using the MCODE and CytoHubba methods.Finally,five out of seven genes were targeted by 15 existing drugs.Conclusion:Four genes(FASLG,IL13,IL17A,andIL2RA),which are mainly related to the cytokine–cytokine receptor interaction pathway,could be prioritized as targets for PCOS.

Unraveling the complexity of polycystic ovary syndrome with animal models

Polycystic ovary syndrome (PCOS) is a highly familial and heritable endocrine disorder. Over half of the daughters born to women with PCOS may eventually develop their own PCOS-related symptoms. Progress in the treatment of PCOS is currently hindered by the complexity of its clinical manifestations and incomplete knowledge of its etiopathogenesis. Various animal models, including experimentally induced, naturally occurring, and spontaneously arising ones, have been established to emulate a wide range of phenotypical and pathological traits of human PCOS. These studies have led to a paradigm shift in understanding the genetic, developmental, and evolutionary origins of this disorder. Furthermore, emerging evidence suggests that animal models are useful in evaluating state-of-the-art drugs and treatments for PCOS. This review aims to provide a comprehensive summary of recent studies of PCOS in animal models, highlighting the power of these disease models in understanding the biology of PCOS and aiding high-throughput approaches.

Efficacy of an Yinyanghuo(Herba Epimedii Brevicornus)-Xianmao(Rhizoma Curculiginis)drug pair in a rat model of polycystic ovary syndrome

OBJECTIVE:To identify active compounds in an Yinyanghuo(Herba Epimedii Brevicornus)-Xianmao(Rhizoma Curculiginis)drug pair(ECD)and investigate its efficacy on polycystic ovary syndrome(PCOS),and its possible mechanism in a rat model of PCOS.METHODS:A network pharmacology approach involving a characteristic drug assessment,active compound and target prediction,PCOS gene collection as well as network analysis was employed.The ovary morphology after treatment was observed using an animal model and western blotting and real-time PCR were used to verify AKT1 as the molecular target.RESULTS:Six networks were constructed,an active compound-target network for the ECD(C-T network),a drug-target network(D-T network),a related genes network,a targets interaction network,a key genes interaction network,and a gene-pathway network.A total of 41 compounds and 261 targets were identified for the ECD,232 PCOS-related genes,31 cogenes,and 14 pathways.These pathways may be involved in the efficacy of ECD on PCOS.The proteins most involved in the signal pathways for all targets were AKT1,IL6,INSR,ESR,and GSK3B.The AKT1 target was selected for experimental verification.Based on the Western blot and real-time PCR results,the expression of AKT1 in the PCOS model varied after treatment with ECD.CONCLUSIONS:Our findings suggest that the ECD can reverse the negative morphological changes in ovarian tissue that occur in model rats of PCOS.AKT1 may be a key mediator of the observed ability of the ECD to protect against PCOS in the model rats.

奥利司他对多囊卵巢综合征伴胰岛素抵抗患者的疗效及安全性

目的 探讨奥利司他对多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)患者的治疗效果及安全性。方法 依据稳态模型法评估的胰岛素抵抗指数(HOMA-IR)选取2020年8月至2023年8月泰州市中医院收治的104例PCOS-IR患者,按随机数字表法分为对照组52例(失访2例)和试验组52例(失访5例)。对照组患者给予炔雌醇环丙孕酮,试验组患者给予奥利司他,两组均治疗3个月。对比两组患者机体测量学指标、糖脂代谢水平、激素水平及产生的不良反应。结果 治疗后,试验组患者BMI、体质量、腰围[分别为(25.74±1.08) kg·m^(-2)、(59.23±2.80) kg、(94.10±5.13) cm]均低于对照组[分别为(26.23±1.26) kg·m^(-2)、(60.51±2.31) kg、(96.5±5.20) cm](t=2.050、2.462、2.287,均P<0.05),总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、HOMA-IR[分别为(3.86±0.73) mmol·L^(-1)、(1.68±0.72) mmol·L^(-1)、(3.75±0.88) mmol·L^(-1)、(1.61±0.37)]均低于对照组[分别为(5.12±0.13) mmol·L^(-1)、(1.98±0.43) mmol·L^(-1)、(4.78±0.35) mmol·L^(-1)、(2.78±0.43)](t=12.007、2.508、7.659、14.323,均P<0.05);两组患者治疗后卵泡雌激素(FSH)差异无统计学意义[(6.71±0.69) mIU·mL^(-1) vs(6.79±0.72) mIU·mL^(-1),t=0.558,P>0.05)],试验组总睾酮(T)、血清黄体生成素(LH)、LH/FSH[(1.38±0.22) nmol·L^(-1)、(6.24±0.78) IU·L^(-1)、(0.93±0.15)]均低于对照组[(1.84±0.27) nmol·L^(-1)、(7.12±0.83) IU·L^(-1)、(1.05±0.17)](t=9.165、5.373、3.677,均P<0.05);两组不良反应发生率差异无统计学意义(8.50%vs 10.00%,χ^(2)=0.064,P>0.05)。结论 奥利司他治疗PCOS-IR患者能有效减重,调节糖脂代谢及性激素水平,改善胰岛素抵抗,且安全性良好。

国医大师夏桂成论中医女性生殖节律理论的“节”和“律”

分述女性生命中五种节律(昼夜节律、周节律、月节律、年节律、生命节律)特征以及夏桂成教授基于生殖节律理论治疗妇科临床疾病的经验。昼夜节律是生命节律的基本单位,白天活动振奋阳气,夜间安睡静养阴血是最基本的养生准则。七为少阳数,女性的经期常持续7天,阴分充足“锦丝带”(像锦缎一样的阴道分泌物)也可达7天,更有助成孕。月经周期节律上应月下应潮,夏教授提出了经典的四期月经周期节律学说,后为了更好地描述阴阳变化,又将经典的四期分为七期,以更好地指导临床。并附验案1则。

雌孕激素序贯治疗联合吡格列酮二甲双胍对多囊卵巢综合征的作用效果

目的 探究雌孕激素序贯治疗联合吡格列酮二甲双胍对多囊卵巢综合征(PCOS)的作用效果。方法 选取濮阳市安阳地区医院2019年4月至2022年4月收治的196例PCOS患者进行研究。将196例患者以抛硬币法进行分组,各98例。对照组接受雌孕激素序贯治疗,观察组接受雌孕激素序贯治疗联合吡格列酮二甲双胍方案。观察治疗总有效率、雌二醇、孕酮、雄性激素及胰岛素抵抗指数、月经周期、子宫内膜厚度、不良反应、排卵率以及妊娠率。结果 观察组总有效率(93.88%)高于对照组(84.69%)(P<0.05)。治疗前,两组雌二醇、孕酮水平、雄性激素、胰岛素抵抗指数、月经周期、子宫内膜厚度相比,差异无统计学意义(P>0.05);治疗后,两组雌二醇水平提高(P<0.001),孕酮水平降低(P<0.001),且观察组雌二醇高于对照组,孕酮低于对照组,差异有统计学意义(P<0.05)。两组雄性激素及胰岛素抵抗指数降低(P<0.001),且观察组低于对照组,差异有统计学意义(P<0.001)。两组子宫内膜厚度增厚(P<0.001),月经周期降低(P<0.001),且观察组子宫内膜厚度厚于对照组,月经周期短于对照组,差异有统计学意义(P<0.05)。两组不良反应差异无统计学意义(P>0.05)。观察组排卵率[82/98(83.67%)]、妊娠率[60/98(61.22%)]高于对照组[68/98(69.39%)、42/98(42.86%)],差异有统计学意义(P<0.05)。结论 雌孕激素序贯治疗联合吡格列酮二甲双胍疗效良好,能够改善PCOS患者性激素水平,改善胰岛素抵抗,提升排卵率与妊娠率,恢复情况良好,相对安全。

Is Acupuncture Actually Not Effective for Polycystic Ovary Syndrome?--Analysis of the Trial Published in JAMA

In recent years, acupuncture has been applied to treat more and more patients suffering from polycystic ovary syndrome(PCOS). On June 27, 2017 a paper titled 'Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomized clinical trial' was published in Journal of the American Medical Association(JAMA). The results did not support acupuncture as an effective therapy for improving the live births in PCOS. The aim of this article was to analyze the therapeutic regimen and design of the clinical trial. The primary outcome and the conclusion of the paper were discussed as well. There are 5 doubts in the paper.(1) The therapeutic regimen decided by trigger points in the paper was different from that of the traditional Chinese acupuncture.(2) The live birth as the primary outcome was limited during the PCOS recovery.(3) In addition the period of the treatment was too short to reflect the therapeutic effect.(4) Although there was no significant difference between active acupuncture and control acupuncture, the conclusion that acupuncture was not effective for PCOS was not confirmed because the control acupuncture plus clomiphene was also more effective than that of clomiphene alone.(5) The proposal and the statistics were not in accordance with the one planned before. Therefore the result was worth to be discussed so as to provide some suggestions and references for improving the clinical research of acupuncture.

Progress of Integrative Chinese and Western Medicine in Treating Polycystic Ovarian Syndrome Caused Infertilit

Polycystic ovarian syndrome （PCOS） is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine （ICWM）. It can be seen from these materials that using traditional Chinese medicine （TCM） recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.

Therapeutic efficacy of moxibustion plus medicine in the treatment of infertility due to polycystic ovary syndrome and its effect on serum immune inflammatory factors

Objective:To explore the effects and related mechanism of heat-sensitive moxibustion plus clomifene citrate capsules for infertility due to polycystic ovary syndrome(PCOS).Methods:A total of 70 patients were randomized into a control group and an observation group by the random number table method,with 35 cases in each group.The control group was treated with clomifene citrate capsules,while the observation group was treated with heat-sensitive moxibustion on the basis of the medications in the control group.The treatment course lasted for 6 menstrual cycles.The endometrial thickness and ovarian volume of the patients were measured before and after treatment.The levels of serum sex hormones,tumor necrosis factor-α(TNF-α)and nuclear factor-κB(NF-κB)were detected.Follow-up was performed for 1 year after treatment,and the pregnancy rate was recorded.Results:After treatment,the endometrium of the patients in both groups was significantly thickened,the ovarian volume was significantly reduced,and the intra-group differences were statistically significant(all P<0.05).The endometrium thickness and ovarian volume in the observation group were significantly different from those in the control group(both P<0.05).After treatment,the levels of serum testostrn(T)and luteinizing hormone(LH)in both groups decreased significantly,the level of estradiol(E2)increased obviously,and the intra-group differences were statistically significant(all P<0.05).The levels of serum T and LH in the observation group were lower than those in the control group,and the E2 level in the observation group was higher than that in the control group,and the between-group differences were statistically significant(all P<0.05).After treatment,the levels of serum TNF-αand NF-κB of the patients in both groups decreased,and the intra-group differences were statistically significant(all P<0.05).The levels of serum TNF-αand NF-κB in the observation group were significantly lower than those in the control group(both P<0.05).After 1-year follow-up,the pregnancy rate was 20.0%in the control group,versus 51.5%in the observation group.The pregnancy rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The treatment of heat-sensitive moxibustion plus clomifene citrate capsules can increase the endometrium thickness,reduce the ovarian volume,improve the status of serum sex hormone disorders,and increase the conception rate in patients with infertility due to PCOS,which may be related to the adjustment of the levels of immune inflammatory factors such as serum TNF-αand NF-κB.

Acupuncture Treatment for 26 Cases of Polycystic Ovary Syndrome

Polycystic ovary syndrome （PCOS） is a commonly encountered disease in fertile women, clinically manifested by polymorphous comprehensive symptoms such as irregular menstruation, infertility, polytrichosis and obesity, and manifested by high levels of androgen, and no ovulation constantly shown by monophasic basal body temperature （BBT）. The therapeutic methods are medication for promoting ovulation and surgery, but, even certain therapeutic effect can be achieved, there is certain side effect and high cost. The author had treated 26 cases of PCOS by acupuncture. Now, the report is given in the following.

苍附导痰丸加减配合针刺治疗多囊卵巢综合征脾虚痰湿型临床观察

目的:观察苍附导痰丸加减配合针刺治疗多囊卵巢综合征脾虚痰湿型的临床疗效。方法:75例按照随机数字表法分为实验组38例和对照组37例,对照组给予常规西药治疗,实验组给予苍附导痰丸加减配合针刺治疗。结果:实验组总有效率及排卵率较对照组高(P<0.05),中医证候积分、激素水平、卵巢体积及药物不良反应发生率较对照组低(P<0.05)。结论:苍附导痰丸加减配合针刺治疗多囊卵巢综合征脾虚痰湿型疗效较好,可升高排卵率,减少卵巢体积,不良反应少。

Effect of electroacupuncture on anti-Mullerian hormone expression in rats with polycystic ovarian syndrome

Objective: To observe whether the effect of electroacupuncture (EA) on improving sex hormone disorders and follicle development is by decreasing the expression of anti-Mullerian hormone (AMH) in rats with experimental polycystic ovarian syndrome (PCOS). Methods: Forty rats were randomly divided into four groups, a normal group (NG), a model group (MG), an EA at acupoints group (EAAG), and an EA at non-acupoints group (EANAG), with 10 rats in each group. The rats in the EAAG and EANAG were intervened by EA treatment for consecutive 14 d. Zhongji (CV 3) and Guanyuan (CV 4) were selected as the acupoints in the EAAG, and the tip of the tail and 1 cm up from the tail tip were selected as the non-acupoints in the EANAG. After treatment, the histomorphological changes of the ovary, the levels of aromatase P450 (P450arom)/ testosterone and estradiol in the ovarian tissues, and the expressions of follicle stimulating hormone (FSH) and AMH were observed. Results: After treatment, compared with the MG and EANAG, the expression of AMH decreased (P<0.05), the levels of P450arom and estradiol in creased sign ifica ntly, and the level of testostero ne decreased sign ifica ntly (all P<0.01) in the EAAG. Additionally, several normal follicles were present and the number of cystically dilated follicles decreased in the EAAG. Compared with the MG and EANAG, the EAAG obviously had more follicular granulosa cells. Con elusion: EA can dow n-regulate the abn ormally in creased expressi on of AMH to improve sex hormone disorders and follicle development in PCOS rats.

Mechanism Study on Acupuncture for Non-insulin Resistant Polycystic Ovary Syndrome

Objective： To investigate the action mechanism of acupuncture for non-insulin resistant polycystic ovary syndrome （PCOS）. Methods： A total of 46 cases with non-insulin resistant PCOS were randomly allocated into an observation group of 23 cases and a control group of 23 cases. Cases in the observation group were treated by needling bilateral Weiwanxiashu （Ex-B 3）, whereas those in the control group were treated by needling bilateral Sanyinjiao （SP 6）. After 3-month treatments, a comparison was made on the changes of ovulations rates, Follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone （T）, fasting insulin and body mass index （BMI）. Results： There were statistical differences in ovulation rates and LH/FSH before and after the treatment in the observation group （P〈0.05）, along with a statistical difference in testosterone changes （P〈0.01）. There were also statistical differences in LH and LH/FSH before and after the treatment in the control group （P〉0.05）; however, there were no statistical differences in ovulation rates and testosterone changes （P〈0.05）. There was significant difference in testosterone changes between the two groups after the treatment （P〈0.01）, along with a statistical difference in ovulation rates between the two groups （P〈0.05）. However, there were no statistical differences in LH/FSH and BMI between the two groups. Conclusion： Needling Weiwanxiashu （Ex-B 3） and Sanyinjiao （SP 6） can both improve the endocrine disorder of patients with non-insulin resistant PCOS; however, needling Weiwanxiashu （Ex-B 3） can obtain a better result than Sanyinjiao （SP 6） in increasing the insulin sensitivity and preventing insulin resistance.

基于肠道菌群探讨中医治疗多囊卵巢综合征

多囊卵巢综合征(PCOS)是一种生殖内分泌紊乱和代谢异常的疾病,常见于育龄期女性。近年研究表明PCOS可表现为不同程度的肠道菌群异常。肠道菌群参与了PCOS的高雄激素血症、卵泡发育异常、胰岛素抵抗、肥胖和生殖内分泌异常等多个环节。基于肠道菌群的PCOS干预主要体现在饮食、运动等生活方式以及益生菌对肠道菌群的调节作用,中医药包括中草药、针灸以及其他中医特色疗法,可通过干预肠道菌群治疗PCOS。本综述为下一步PCOS肠道菌群临床研究和临床治疗PCOS提供了参考依据。

基于网络药理学及分子对接技术探讨金匮肾气丸“异病同治”多囊卵巢综合征和甲状腺功能减退的作用机制

目的 以中医“异病同治”理论为依据,采用网络药理学与分子对接方法探究金匮肾气丸对多囊卵巢综合征和甲状腺功能减退的作用机制。方法 自2022年3—10月通过中药系统药理学数据库与分析平台(TCMSP)检索获取金匮肾气丸活性成分及潜在靶点,利用DrugBank、GeneCards数据库获取疾病靶点,将两者取交集获取共有靶点,通过STRING11.5数据库构建蛋白质-蛋白质相互作用(PPI)网络,使用Cytoscape 3.7.1构建金匮肾气丸“药物-疾病-靶点”网络,利用R语言对共有靶点进行富集分析,运用SYBYL-X 2.0软件进行分子对接。结果 筛选得到疾病与药物共有靶点65个,核心靶点主要涉及血管内皮生长因子A(VEGFA)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、胱天蛋白酶-3(CASP-3)、细胞肿瘤抗原p53(TP53)、基质金属蛋白酶-9(MMP-9)等,潜在靶点主要富集在AGE-RAGE信号通路、癌症的途径、PI3K-Akt信号通路、胰岛素抵抗、JAK-STAT信号通路等多条信号通路中。结论 金匮肾气丸中多种活性成分通过多靶点、多途径发挥抑制炎症反应及细胞凋亡、促进组织血管生成等作用,初步揭示了金匮肾气丸“异病同治”多囊卵巢综合征与甲状腺功能减退的潜在靶点与现代生物学机制,为深入研究开展实验及临床应用提供参考。

基于伏邪的多囊卵巢综合征代际效应中医理论内涵探讨

多囊卵巢综合征(PCOS)是一种复杂的生殖代谢紊乱性疾病,具有一定的遗传倾向性,其相关症状可在代际间传递。中医所言的伏邪乃藏伏于体内而不立即发病的病邪,其致病模式与PCOS代际效应的病理机制具有相似性。将中医学伏邪理论与现代医学PCOS代际效应机制相结合,可为中医临床早期识别及治疗PCOS提供新思路。