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 on Mechanism of Ovulation Disorder in Polycystic Ovary Syndrome

Polycystic ovary syndrome(PCOS)is a reproductive endocrine disease characterized by ovulation disorder,hyperandrogenism and/or polycystic ovary.Follicular development disorder caused by PCOS accounts for up to 75%of anovulatory infertility,which is a common cause of infertility and affects up to 15%of reproductive aged women worldwide.Oxidative stress,chronic inflammation,endoplasmic reticulum stress and other pathological conditions coexist in the ovarian microenvironment of PCOS,which are further aggravated under the action of high levels of androgens,synergistically deteriorating the follicular microenvironment,leading to ovulation disorders in PCOS patients.This paper briefly reviewed the research on the mechanism of PCOS ovulation disorder in recent years.

Thyroid Disorders in Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the common endocrinopathies of women in the reproductive age group. Thyroid hormones have various effects on the reproductive system of female. PCOS and thyroid dysfunction are linked to each other since several years. Objective: To evaluate and detect the thyroid dysfunction in patients with PCOS attending in a tertiary care hospital in Bangladesh. Methodology: This was a prospective cross sectional study conducted from November 2018 to October 2019 at Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on one hundred and fifty (150) PCOS women of reproductive age (15 - 45 years). All data of the study subjects regarding socio-demographic, anthropometric and clinical manifestations were recorded accordingly. Their thyroid function tests (serum level of FT3, FT4, TSH) were done at the hospital laboratory and results were recorded. Result: Mean (±SD) age of the study subjects was 24.57 ± 4.27 years. The maximum numbers [108 (72.0%)] of PCOS women were between 18 - 25 years age group. Among total (150) study population, 51 (34.0%) were overweight, 36 (24.0%) were obese and 63 (42.0%) were within normal weight level. Hirsutism was found in 87 (58%) study subjects while 24 (16%) subjects had acne in their face, 54 (36%) subjects had oligomenorrhea and 45 (30%) subjects had irregular periods. Among 150 PCOS women, 120 (80%) were married and 30 (20%) were single;of them primary infertility was detected in 58 (48.33%) women followed by the normal fertility status [51 (42.5%)] and 11 (9.17%) had secondary infertility. Among total (150) study subjects, 105 (70%) were in euthyroid state, hypothyroidism was found in 33 (22.0%) subjects and hyperthyroidism was detected in 12 (8%) subjects. Conclusions: Present study demonstrated that, thyroid disorders are prevalent in 30.0% of PCOS patients. Hypothyroidism is almost three-fold more prevalent than hyperthyroidism.

Increased risk of psychiatric disorders in Chinese women with polycystic ovary syndrome

Objective:To assess the psychological health status and quality of everyday life of women with polycystic ovary syndrome(PCOS). Methods:A total of 846 patients were assessed with Self-Rating Anxiety Scales(SAS) and Self-Rating Depression Scales(SDS)(292 of PCOS patients,294 of non-PCOS infertile patients and 260 of healthy control).Specific questionnaires were employed to rate the quality of everyday life and adverse effects of different psychiatric factors. Results:The scores of SDS and SAS of PCOS patients were higher than those of non-PCOS infertile patients and healthy control.In addition,the negative psychiatric and psychological impact of PCOS was severe.The quality of everyday life in PCOS patients was undermined to certain extents. Conclusions:The features of polycystic ovary syndrome bring stress to patients,causing psychological disorder. The quality of everyday life in affected women is impaired partly.These results implicate that psychological support should be considered in the treatment of PCOS-associated infertility.

Protective and therapeutic effect of protocatechuic acid in assessment of letrozole- induced polycystic ovary syndrome in rats

Objective:To investigate the potential activity of protocatechuic acid in female Wistar rats with letrozole-induced polycystic ovary syndrome(PCOS).Methods:Thirty rats were divided into five groups of six each.Group 1 received 0.5%carboxy methyl cellulose orally and served as the normal control group;group 2 was treated orally with 1 mg/kg of letrozole daily for 21 days and served as the PCOS induced group;group 3 was orally administered with letrozole of 1 mg/kg for 21 days and further administered with standard drug of clomiphene citrate at a dose of 1 mg/kg body weight in 0.5%carboxy methyl cellulose per oral and served as the standard group;groups 4 and 5 were administered with letrozole of 1 mg/kg for 21 days and further treated with protocatechuic acid orally at low dose of 5 mg/kg body weight and high dose of 15 mg/kg body weight respectively for 15 days.At the end of the study period,rats were subjected for the estimation of invasive blood pressure and heart rate,biochemical estimations and antioxidant assay.In addition,ovarian histomorphology was examined.Results:The PCOS was confirmed in the letrozole induced rats with increased concentration of androgen,abnormal lipid levels,glucose,glycosylated haemoglobin and also depletion of antioxidants.After protocatechuic acid treatment,the increased levels of testosterone due to induction of PCOS were restored to normal levels.Additionally,there was a consistent decrease in luteinizing hormone and follicle stimulating hormone levels in the treatment groups,followed by decrease in the number of cysts after treatment with protocatechuic acid.Histopathological observations showed a remarkable recovery of the ovarian tissue and the presence of normalized structure of antral follicle.Protocatechuic acid treatment restored all the parameters to normalcy and abolished cysts formation in ovaries of female rats.Conclusions:Protocatechuic acid shows potential protective effects in letrozole-induced PCOS rats.The protective effect is comparable to that of clomiphene citrate and thus shows its potential in the treatment of PCOS.

Pharmacological efficacy of the traditional Chinese medicinal formula Kun-Tai-1A in the treatment of letrozole-induced polycystic ovary syndrome

Background:Polycystic ovary syndrome(PCOS)is an endocrine disorder that occurs in women of child-bearing age.Moreover,PCOS patients have decreased pregnancy rates and clomiphene citrate resistance.The traditional Chinese medicine formula Kun-Tai-1S(KT1S),consisting of the seahorse species hippocampus,has been reported to elicit therapeutic effects in patients with PCOS.However,given the limited resources and global demand for wild hippocampus,whether KT1S with or without hippocampus can elicit similar therapeutic effects has not been confirmed.Methods:KT1S and Kun-Tai-1A(KT1A,KT1S without dry hippocampus)were used to treat a letrozole-induced rat model of PCOS with an established disease.The serum levels of testosterone,luteinizing hormone,anti-Müllerian hormone,and estradiol were determined,the luteinizing hormone/follicle-stimulating hormone ratio was determined,and the ovarian pathology was evaluated.Results:Similar to the therapeutic effects of cyproterone acetate,both the KT1S and KT1A treatments reduced the body weight and ovarian and uterine indices in the rats with PCOS.The serum levels of testosterone,anti-Müllerian hormone,and luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio were significantly lower in the KT1S and KT1A treatment groups compared to the model group(P<0.01 and P<0.05,respectively).Moreover,the histopathological assessment results suggested that both the KT1S and KT1A treatments significantly ameliorated the PCOS pathology in the rats with an established disease,with a reduced number of cystic and atretic follicles and an increased number of corpora lutea being observed in the ovaries.Notably,there was no obvious difference in the disease outcomes between the KT1S and KT1A-treated groups.Network pharmacology analysis revealed that 4’,7-dihydroxyflavanone,sinpemine A,quercetin,8-isopentenyl-kaempferol,and luteolin in KT1A may promote estrogen signaling;furthermore,the nitric oxide regulation pathway is also closely involved.Conclusion:KT1A and KT1S treatments both significantly ameliorated the PCOS-related pathology in rats,suggesting that the hippocampus component is dispensable for KT1S-mediated amelioration.Given the limited resources and global demand for wild hippocampus for use in complementary medicines,our findings may help conserve this species.Together,our results suggest that KT1A is a promising approach for treating PCOS.

Management strategy of infertility in polycystic ovary syndrome

Polycystic ovary syndrome(PCOS)is the most common endocrine and metabolic disease in women of reproductive age.PCOS is characterized by ovulatory disruption,which can lead to infertility.Patients with PCOS are also more likely to have poor pregnancy outcomes.For obese women,lifestyle interventions are recommended first,which have general health benefits.For women who have difficulty changing their lifestyle,drugs for the treatment of obesity or bariatric surgery could be considered.Clomiphene citrate is the first-line medication after weight loss that has been utilized in the past.Letrozole is supplanting clomiphene as the best option for ovulation induction for now,particularly in patients with PCOS.Metformin can improve ovulation and pregnancy rates;however,it has minimal effects in terms of raising live birth rates.Second-line therapies include gonadotropins and laparoscopic ovary drilling.In vitro fertilization can be utilized as a third-line treatment for patients with PCOS who have failed ovulation induction therapy or have other infertility factors.In summary,to achieve fertility,patients with PCOS require standardized individualized therapy.

Simultaneous Letrozole and Clomiphene Citrate versus Letrozole Alone in Clomiphene Citrate Resistant Polycystic Ovary Syndrome: A Randomised Controlled Trial

Background: Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility. The therapeutic strategies for clomiphene citrate (CC)- resistant patients include the addition of corticosteroids, extended duration of clomiphene, gonadotrophin therapy, laparoscopic ovarian drilling, in vitro fertilization or the use of aromatase inhibitors recently. Letrozole decreases estrogen levels in the body, so it releases the hypothalamus and/or pituitary gland from the negative feedback of estrogen. This increases levels of gonadotrophins, which stimulates follicular growth. Objectives: To evaluate the role of letrozole alone and simultaneous use of letrozole and clomiphene citrate (CC) for ovulation induction in patients with clomiphene citrate-resistant PCOS (CCR-PCOS). Patients and Methods: This open-label randomised controlled study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt during the period from February 2018 to June 2019. The study included 60 CCR-PCOS patients who were randomly allocated by independent personnel into two arms: group A (letrozole alone) or B (letrozole + CC). In either group, monitoring the mean follicular diameter and endometrial thickness in the days 10, 12, and 14 of the cycle by transvaginal ultrasound and Measurement of serum Progesterone (ng/ml) 7 days after the expected time of ovulation. Results: We investigated various clinical and sonographic factors that may predict the outcome of the method of induction of ovulation in CCR-PCOS with no significant affection for the results. There was a non-significant difference between the studied groups regarding ovulation and pregnancy per cycle or per patient. Conclusion: Letrozole alone or simultaneous use of letrozole and CC offers a good second-line option for induction of ovulation in CCR-PCOS patients. However, the combination of CC and letrozole did not add any benefit over the use of letrozole alone regards ovulation rate, follicular volume, endometrial thickness, pregnancy rate and live birth rate.

Effect of Rosiglitazone on Endocrine, Metabolism and Ovulatory Performance in Patients with Polycystic Ovary Syndrome and Insulin Resistance

The effect of rosiglitazone on endocrine, metabolism and ovulatory performance in the paitents with polycystic ovary syndrome(PCOS) and insulin resistance was investigated. Twenty-five patients diagnosed as having polycystic ovary syndrome (PCOS) combined with insulin resistance were treated with rosiglitazone for 12 weeks. Before and after treatment, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), androstenedione (A), sex hormone binding globulin (SHBG), insulin and glucose concentration, total cholesterol, triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholestero (LDL-C), apolipoprotein A, apolipoprotein B levels and ovulatory performance were determined. The results showed that after treatment serum insulin levels was decreased significantly (P<0.01). The HDL-C was increased while LDL-C decreased significantly (P<0.05, P<0.01). The serum LH, T, A concentrations and the ratio of LH/FSH were decreased, while SHBG levels increased significantly (P<0.01). The ovulation rate during clomiphene citrate therapy was 72 %, significantly higher than that before treatment. It is likely that reduction of hyperinsulinemia that is produce by rosiglitazone may effectively improve the endocrine, metabolism and ovulatory performance in the patients with PCOS and insulin resistance.

Use of metformin during pregnancy for women with polycystic ovary syndrome

Objective: The purpose of this article is to review the literature assessing foetal and maternal pregnancy outcomes in women with PCOS who used metformin during pregnancy. Study Design: A literature search was conducted using MEDLINE, with analysis of 25 studies that recorded neonatal and maternal outcomes in women who used metformin during pregnancy. The outcomes assessed in this review include congenital deformities, miscarriages, preterm labour, gestational diabetes (GDM) and pregnancy induced hypertension (PIH). Results: We found that the use of metformin throughout pregnancy correlated with decreased rates of preterm labour, GDM and PIH. Conflicting evidence exists over whether metformin use during pregnancy reduced miscarriage rates. The use of metformin during pregnancy did not increase teratogenicity risks. Conclusion: The use of metformin throughout pregnancy is associated with decreased rates of preterm labour, GDM, and PIH. However, more randomised controls involving larger numbers of participants are required for more definitive results.

An overview of the physiopathology and various treatment strategies for polycystic ovary syndrome

Polycystic ovary syndrome(PCOS),a common endocrine disorder with metabolic and reproductive consequences,affects a significant percentage of women of reproductive age.Because of its complexity and impact on the quality of life,PCOS requires timely diagnosis and screening for complications.The most common clinical manifestations of PCOS are hirsutism,hyperandrogenism,acne,irregular cycles,amenorrhea,and anovulation.Although PCOS has different clinical manifestations in women,hyperandrogenism,and anovulation are the most common symptoms.A good medical history,examination,blood tests,and ultrasound findings facilitate the diagnosis of PCOS.Novel treatments have also undergone clinical trials to improve the symptoms of PCOS.However,comprehensive review articles investigating the different communities of this disease are limited,and this review aimed to collect data on the different etiologies of PCOS along with the latest diagnostic methods and the most common and up-to-date treatments for this disease.

中药复方干预肥胖型多囊卵巢综合征糖脂代谢异常的Meta分析

目的:通过文献研究阐述中药干预肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者代谢异常的有效性及安全性。方法:计算机检索国内外主流医药数据库中关于中医、中西医结合对比单纯西药治疗PCOS的随机对照试验(randomized controlled trial,RCT)。参照Cochrane系统评价手册对全文的设计方案进行质量评价,采用RevMan 5.4软件进行Meta分析。结果:纳入22项RCT进行Meta分析,中药或中西药联合治疗不仅在提升排卵率这一主要研究指标上优于单纯西药治疗(P<0.05),还在改善胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、空腹胰岛素(fasting insulin,FINS)、体质量指数(body mass index,BMI)、三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)等方面优于单纯西药治疗(均P<0.05),但在调节空腹血糖(fasting blood glucose,FBG)和腰臀比(waist-to-hip ratio,WHR)方面与西药治疗差异无统计学意义(均P>0.05)。结论:中药或中西药联合干预肥胖型PCOS糖脂代谢异常,具有多途径、多靶点调控作用,无严重不良反应,优于单纯西药治疗。

来曲唑片联合炔雌醇环丙孕酮片调节多囊卵巢综合征患者性激素水平改善排卵效果的临床研究

目的评估来曲唑片(在达英-35治疗的基础上)对多囊卵巢综合征患者性激素调节及排卵改善的效果。方法选择2020年1月至2022年12月西安市人民医院(西安市第四医院)收治的多囊卵巢综合征患者80例,按随机数字表法分组分为对照组(40例,接受常规治疗+达英-35治疗)、观察组(40例,接受联合来曲唑片治疗)。2组均治疗3个疗程,随访6个月,分析比较2组临床疗效,血清催乳激素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、睾酮、抗苗勒管激素(AMH)、人体抑制素B(INHB)、丝氨酸蛋白酶抑制剂(Vaspin)水平,排卵率、妊娠率、成熟卵泡、最大卵泡直径、子宫内膜厚度,不良反应发生情况。结果观察组总有效率较高;治疗后2组血清PRL、FSH、LH、睾酮、AMH、INHB、Vaspin水平降低,且观察组较低;观察组子宫内膜厚度较厚,排卵率、妊娠率较高,最大卵泡直径较长,成熟卵泡数量较多,差异有统计学意义(P<0.05)。结论应用来曲唑片有助于调节多囊卵巢综合征性激素及疾病相关因子水平,改善排卵功能,提高妊娠率,且不易增加不良反应发生风险,效果显著。

金哲辨治未破裂卵泡黄素化综合征经验

总结金哲教授治疗未破裂卵泡黄素化综合征(LUFS)经验。根据B超下卵泡大小,LUFS可分为小卵泡型、卵泡滞留型和卵泡持续增大型,其中卵泡滞留型多合并子宫内膜异位症和多囊卵巢综合征,不同分型的LUFS各有其特点,金教授认为应分型辨证。治疗上,需总体把握种子调经这一核心思想辨证论治,并根据月经周期的阴阳消长规律进行分期论治。创立“育卵三法”分期论治小卵泡型LUFS;卵泡滞留型LUFS合并子宫内膜异位症者,以化瘀为首,合并多囊卵巢综合征者,以利湿化痰、散瘀调经为主;对于持续增长型LUFS,则以化痰消癥为法,分期治疗。

不同预处理方案联合促排卵治疗多囊卵巢综合征致不孕症的效果

目的:分析不同预处理方案联合促排卵治疗多囊卵巢综合征(PCOS)致不孕症的效果。方法:选取2022年1月—2023年6月东莞东华医院生殖医学科收治的PCOS致不孕症患者90例为研究对象,采用随机数字表法分为对照组和观察组,各45例。在促排卵治疗前,对照组采用炔雌醇环丙孕酮片联合二甲双胍进行预处理干预,观察组采用炔雌醇环丙孕酮片联合肌醇进行预处理。比较两组血清性激素水平、周期排卵率及妊娠率。结果:治疗后,两组睾酮、黄体生成素下降,观察组低于对照组(P<0.05);治疗后,两组促卵泡刺激素、雌二醇水平比较,差异无统计学意义(P>0.05)。观察组周期排卵率高于对照组(P=0.003)。观察组妊娠率高于对照组(P=0.002)。结论:炔雌醇环丙孕酮片联合肌醇预处理在PCOS所致不孕症患者中的疗效较好,相比联合二甲双胍预处理效果更佳,可降低睾酮、黄体生成素水平,提高排卵率和妊娠率。

多囊卵巢综合征病因及其发病机制的研究进展

多囊卵巢综合征(PCOS)是一种异质性疾病,与女性生殖内分泌障碍有密切关联。PCOS的病因和发病机制目前尚未明确。PCOS是内分泌代谢紊乱、遗传和环境相互作用的结果。高雄激素血症(HA)和胰岛素抵抗(IR)是PCOS发病的基础病理生理学改变,二者相互作用加重PCOS患者的临床表现。家族聚集性和双胞胎的研究证实PCOS具有遗传倾向,且全基因组关联研究(GWAS)已经确定部分PCOS的风险位点和候选基因。不健康的生活习惯和环境内分泌干扰物在PCOS的进展中也发挥着重要作用,同时肠道菌群也参与PCOS的发病过程。现对近年来PCOS的相关研究进行全面的回顾性分析,从内部因素和外部因素两方面对PCOS病因和发病机制进行综述。

脐带间充质干细胞治疗多囊卵巢综合征的作用及机制

背景:目前对多囊卵巢综合征的治疗大多是超指征用药,对其治疗仍面临很大的挑战。研究证明人脐带间充质干细胞可修复卵巢功能,但鲜有研究报道其对多囊卵巢综合征的治疗作用。目的:观察人脐带间充质干细胞对多囊卵巢综合征的治疗作用,并初探线粒体自噬与人脐带间充质干细胞改善多囊卵巢综合征症状的相关性。方法:C57BL/6J小鼠皮下连续注射20 d脱氢表雄酮构建多囊卵巢综合征模型,通过尾静脉注射人脐带间充质干细胞(2×10^(6)),治疗后连续10 d取阴道内分泌物检测小鼠的发情周期。治疗后2周,采用ELISA检测小鼠外周血性激素水平,包括黄体生成素和卵泡刺激素;苏木精-伊红染色进行卵巢组织病理学评估,最后通过透射电镜观察卵巢组织中线粒体自噬反应。结果与结论:(1)经人脐带间充质干细胞治疗后,多囊卵巢综合征小鼠卵巢中出现了处在原始卵泡、初级卵泡、次级卵泡等各阶段的卵泡,而且可见黄体组织,说明小鼠排卵功能明显改善;(2)经人脐带间充质干细胞治疗后,多囊卵巢综合征小鼠性激素水平恢复至正常;(3)未经治疗的多囊卵巢综合征小鼠长期处在动情期,缺乏动情间期和动情前期,经过人脐带间充质干细胞治疗的多囊卵巢综合征小鼠动情周期恢复到正常水平;(4)经人脐带间充质干细胞治疗后,多囊卵巢综合征小鼠卵巢组织中的线粒体自噬明显减少;(5)结果表明,人脐带间充质干细胞可有效改善多囊卵巢综合征小鼠内分泌紊乱,促进排卵,这可能与抑制线粒体自噬相关。

益肾祛浊方对比二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗的随机对照研究

背景多囊卵巢综合征合并胰岛素抵抗(PCOS-IR)是PCOS中治愈难度最大的亚型,病机复杂,个体差异性大。二甲双胍作为一线用药,虽然能够降低血糖和改善胰岛素敏感性,但是对于调节激素失衡、改善卵巢功能等PCOS核心病理作用有限,且胃肠道反应大,患者难以坚持服用。目的评价益肾祛浊方对比二甲双胍治疗PCOS-IR的有效性与安全性。方法前瞻性选取2022年6月—2023年10月首都医科大学附属北京中医医院妇科门诊的102例PCOS-IR患者为研究对象,按照2∶1比例随机分为试验组(n=68)、对照组(n=34)。试验组以益肾祛浊方治疗,对照组以二甲双胍治疗,比较两组患者的排卵率、妊娠率、性激素[卵泡刺激素、促黄体生成素、LH/FSH、睾酮、抗苗勒管激素];糖脂代谢指标;BMI、腰臀比及不良反应发生率。结果治疗后试验组基础体温排卵率较治疗前升高(P<0.05)。试验组有生育需求患者13例,妊娠5例,对照组有生育需求患者5例,妊娠1例。治疗后两组妊娠率比较,差异无统计学意义(χ^(2)=1.154,P>0.05)。治疗后两组患者LH/FSH均较治疗前降低(P<0.05)。治疗后两组患者空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油均较治疗前降低(P<0.05)。治疗后两组患者低密度脂蛋白胆固醇、高密度脂蛋白胆固醇与治疗前比较,差异均无统计学意义(P>0.05)。治疗后对照组腰围少于试验组(P<0.05)。治疗后两组患者BMI、腰围、臀围、腰臀比均较治疗前降低(P<0.05)。治疗后试验组患者ALT、尿酸较治疗前降低,对照组UA较治疗前升高(P<0.05)。治疗后两组患者其他指标与治疗前比较,差异均无统计学意义(P>0.05)。治疗期间,患者出现低血糖、乏力、胃脘不适及腹泻等不良反应,试验组不良反应发生率(5/68,7.35%)低于对照组(15/31,48.39%)(χ^(2)=20.404,P<0.001)。结论益肾祛浊方调节激素失衡、改善糖脂代谢异常,治疗PCOS-IR的有效性与二甲双胍相当,对肝肾功能有保护作用,且在减少不良反应方面优于二甲双胍,鉴于二甲双胍的胃肠道反应,患者对益肾祛浊方有更好的耐受度和接受度,值得临床推广应用。

基于“卵巢微癥瘕”理论认识郭志强教授治疗多囊卵巢综合征排卵障碍

多囊卵巢综合征不仅会引起女性排卵障碍、不孕等常见生殖内分泌疾病,还会诱发多种危害人体健康的远期并发症。目前,西医对多囊卵巢综合征的病因研究尚未完全明了,治疗亦存在局限之处。本文通过探讨郭志强教授论治多囊卵巢综合征排卵障碍的中医病机,基于“卵巢微癥瘕”理论,从肾虚络阻病机入手,以补肾通络消癥为治法治疗多囊卵巢综合征排卵障碍,获得良效,以期对多囊卵巢综合征的临床治疗提供更多的思路和方法。

针刺治疗多囊卵巢综合征代谢紊乱的机制研究进展

多囊卵巢综合征(PCOS)是涉及多系统多环节的一组综合紊乱症候群,稀发排卵、高雄激素血症和肥胖是其主要临床特征,已严重影响女性生活质量及身心健康。而PCOS性代谢紊乱是加重高雄激素血症及肥胖的重要环节,中医针刺技术在改善PCOS代谢紊乱方面疗效显著。通过文献研究,笔者发现针刺可能通过局部穴位效应改善脾虚水湿停滞及肾虚水泛的病理状态,从而促进机体细胞代谢,作用机制可能与影响IRS-1/PI3K/Akt/GLUT4、下丘脑NFκB及Toll样受体信号通路转导有关。现就研究内容进行详尽阐述,以期为PCOS代谢病因研究提供理论思路。