Clinical effect of under the diaphragm by stasis soup combinated with point thread-embedding on infertility patients with obesity-type polycystic ovary syndrome

Objective:To study the clinical effect of under the diaphragm by stasis soup combinated with point thread-embedding on infertility patients with obesity-type polycystic ovary syndrome (PCOS) and evaluate the the rate of ovulation and pregnancy.Method:Selecting 100 infertility patients with obesity-type PCOS, then they were randomly divided into control group (n=80) and observation group (n=80). The control group patients were given metformin+ under the diaphragm by stasis soup, the observation group were given metformin + exenatide + point thread-embedding, they were treated 3 months. Before and after treatment, we observed the changes of body mass index (BMI), waist-to-hipratio (WHR), fasting plasma glucose (FBG), 2-hour postprandial blood glucose (2hPBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma insulin (FINS), follicule-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, estrogen (E2), and testosterone (T). At last, we assessed the rate of ovulation and pregnancy.Results: After the treatment, the FBG, 2hPBG, TC, LDL-C, TG, BMI, WHR, HOMA-IR, FINS, LH, LH/FSH, E2, and T were lower than before treatment in both groups, and the difference had statistical significance, and the observation group were lower than control group, and the difference had statistical significance;the HDL-C and FSH were higher than before treatment in both groups, and the difference had statistical significance, and the observation group were higher than control group, and the difference had statistical significance. The rate of ovulation and pregnancy in the observation group were higher than control group, and the difference had statistical significance.Conclusions:Under the diaphragm by stasis soup combinated with point thread-embedding can improve the metabolize of carbohydrate and lipid, and the abnormity of sex hormones, through this process, the rate of ovulation and pregnancy can be raised.

Endometrial Thickness as a Predictor of Endometrial Hyperplasia in Infertile Patients with Polycystic Ovary Syndrome

Background: Women with polycystic ovary syndrome (PCOS) are at higher risk of developing endometrial hyperplasia (EH). This study determined the prevalence of EH among women with infertility due to PCOS and assessed the predictive value of endometrial thickness (ET) measurement by trans-vaginal scan (TVS). Study Type & Population: This was a prospective study on infertile women with and without PCOS in which clinical data, hormonal profile, ET and endometrial biopsy (EB) for histopathological examination were collected. Methods: Thirty-seven women with PCOS and 23 women without PCOS presenting with infertility and/or abnormal uterine bleeding underwent TVS, hysteroscopy, laparoscopy and EB. Results: The overall prevalence of EH was 23.3 % while in PCOS group: 18.3 %. The mean ET (14.8 mm) was significantly higher in patients with EH (t = -2.74, P value = 0.009). The lower value of ET among women with EH was 10 mm. A cut-off point of 9.5 mm was set. An ET of >9.5 mm had 92.9% sensitivity and 51.85% specificity for the presence of EH. Women with ET ≥ 9.5 mm were 1.28 times more at risk of EH than women with ET 9.5 mm. Women with oligomenorrhea and irregular cycles were 5.5 and 13.7 times more at risk of EH compared to those with regular cycles, respectively. ET was positively correlated with insulin resistance (r = 0.439, P = 0.007). Conclusion: ET ≥ 9.5 mm predicts EH in infertile women with PCOS, with a high degree of sensitivity and a moderate degree of specificity. In PCOS patients with oligomenorrhea or irregular cycles, the risk of EH is higher than women with regular cycles.

Association between Metal(loid)Exposure and Risk of Polycystic Ovary Syndrome Mediated by Anti-Müllerian Hormone among Women Undergoing In Vitro Fertilization and Embryo Transfer

Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively.Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk.Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.

Correlation between IL-1β,IL-1Ra gene polymorphism and occurrence of polycystic ovary syndrome infertility

Objective:To explore the relationship between IL-1β.IL-1Ra gene polymorphism and the occurrence of polycystic ovary syndrome(PCOS) infertility.Methods:A total of 59 PCOS infertility cases visiling the reproductive center of our hospital from Mar.2010 to Mar.2012 and 56 healthy women were selected.ELISA method was used lor the detection of IL-1β.IL-1Ra lewis,and the levels of serum supersensitivity C reaction protein(US-CRP).insulin(FINS),follieule-stimulating hormone(FSH) and fasting blood—glucose(FRG) were detected.PCR analysis technology was adopted to detect the gene polymorphism of the.511 site of IL-1βand the second introne of IL- 1Ra.Results:The levels of IL-1β.IL-1Ra.US-CRP.FINS and FBG in blood scrum of patients in PCOS group were significantly higher than those in control group(P【0.05 or P【0.01).The level of FSH in PCOS group was significantly lower than that in control group(P【0.05).The genotypic frequency of T/T.the 511 site of IL-1βin PCOS group was 42.37%.significantly higher than 1250%in control group 【P【0.01).The frequency of T allele was also significantly higher than that in control group(P【0.01).The genotypic frequency ofⅠ/Ⅴ.the second introne of IL-1Ra in PCOS group was 20.34%,signicianlly higher than 3.57%in control group(P【0.05).The frequency of V allele in PCOS group was significantly higher than that in control group(P【0.05).Conclusions: T allele of the 511 site of IL-1βgene and V allele of the second inlrone of IL-1Ra gene might be the genetic basis of the rising of IL-1β.IL-1Ra and US-CRP levels in blood serum of PCOS patients,and are associated with the infertility occurrence of PCOS patients.

Mental Health Status Assessment in Polycystic Ovarian Syndrome Infertility Patients: A Pilot Study

Polycystic ovary syndrome（PCOS） is a major endocrine disorder afflicting women of reproductive age. Women with PCOS are more likely to suffer from mental health disturbances than healthy women. The ＂infertility＂ suffered by PCOS patients would also lead to mental health disturbances. Symptom Checklist 90（SCL-90） and questionnaire which includes patients＇ socio-economic and demographic data were used to assess the mental health status of PCOS（n=103） and non-PCOS（n=110） infertile patients. Logistic regression analysis and t-tests were used for comparative analysis. The data demonstrated that scores of depression, interpersonal sensitivity, obsessive-compulsive, and hostility symptoms in PCOS infertile patients were significantly higher than those in the non-PCOS infertile patients（P〈0.05）. Logistic regression analysis revealed that acne had negative effect on mental health status（P〈0.05）. Secondary infertile PCOS patients were more easily to suffer from somatization, interpersonal sensitivity, obsessive-compulsive, anxiety, hostility and paranoid ideation symptoms than the primary infertile PCOS patients（P〈0.05）. The results suggested that the PCOS patients especially the secondary infertile PCOS patients had obvious mental health disturbances. The acne might play an importance role in the occurrence of mental health disturbances in PCOS patients. PCOS related symptoms may be risk factors of mental health status in PCOS patients with infertility. More attention should be paid to the PCOS infertile patients, and mental health therapy should be considered if necessary.

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.

Polycystic Ovary Syndrome-Related Infertility Based on the Theory of“Liver and Kidney Homology”

Polycystic ovary syndrome(PCOS)is an endocrine disorder caused by hypothalamic-pituitary-ovarian(HPO)axis dysfunction.In the field of gynecology and reproduction,PCOS has emerged as both a research hot spot and a challenging area of study.According to Chinese medicine,this disease is related to kidney deficiency,phlegm and dampness obstruction,blood stasis and interconnection,Chong pulse impassability,the lack of Ren pulse,and the loss of uterine nourishment,all of which affect the normal development and maturation of eggs as well as the duration at which menstrual blood stores.In this paper,based on the theoretical basis of“liver collects blood,regulates the flow of qi,and is the master of drainage,”we explore the rationality of the treatment of this disease from the perspective of“liver and kidney have the same origin”and the development of PCOS-related infertility in relation to dysfunctional internal organs.We also explore the feasibility of treatment from the perspective of“liver and kidney homology,”expand the ideas for treatment,as well as develop and innovate the application of organ identification in PCOS in relation to infertility.

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.

Endocrine Indices of PCOS in Women with Polycystic Ovaries but without Diagnostic Features of PCOS: A Study of an Infertility Clinic Population

Background: The presence of polycystic ovarian morphology (PCO) without the other characteristics of the polycystic ovarian syndrome (PCOS) is insufficient for the diagnosis of PCOS and there is little justification for follow up in endocrine clinics for women with PCO morphology alone. A few studies have been reported regarding the endocrine features of asymptomatic women with PCO with conflicting data about endocrine profiling. The aim of this study was to assess whether women with PCO, but who have no symptoms of PCOS differ, endocrinologically, from women with normal ovaries.?Methods: We analysed the results of ultrasound and endocrine investigations in 576 consecutive women who attended the infertility clinic between 1993 and 1995 at the Reproductive Medicine Unit of St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK. Results: Three hundred and twenty eight women had PCO and 248 had normal ovaries. Among the 328 women with PCO, 169 (51.5%) had PCOS according to Rotterdam criteria. The remaining women with PCO had no symptoms of the syndrome (n = 159);they had a history of regular menses, had proven ovulatory cycles and had neither clinical nor biochemical evidence of hyperandrogenism. However, these women had higher timed LH [median (IQR) 5.3 (4.2) IU/l vs 4.8 (3.4) IU/l, respectively;p = 0.044] and testosterone [2.0 (0.8) nmol/l vs 1.8 (0.8), respectively;p = 0.009] compared with women with normal ovaries (although by definition within the normal range). There was no difference in BMI or FSH between the two groups. Among the 169 women with PCOS, 45.0% (n = 76) were anovulatory without hyperandrogenism, 34.3% (n = 58) fulfilled the NIH criteria and 20.7% (n = 35) were ovulatory with hyperandrogenism. The proportion of hyperandrogenism among anovulatory women with PCO is 43.3% (58 out of 134).?Conclusions: Women with PCO, but no symptoms of the syndrome, differ endocrinologically compared with women with normal ovaries: they had higher timed LH and testosterone (although by definition within the normal range). These data suggest that despite the lack of symptoms of PCOS, women presenting to an infertility clinic with PCO represent a milder phenotype of those with overt PCOS, but fall on the same spectrum.

Polycystic Ovary Syndrome (PCOS) and Fertility

The polycystic ovary syndrome (PCOS) is defined as a combination of hyperandrogenism (hirsutism and acne) and anovulation (oligomenorrhea, infertility, and dysfunctional uterine bleeding), with or without the presence of polycystic ovaries on ultrasound. It represents the main endocrine disorder in the reproductive age, affecting 6% - 15% of women in menacme. It is the most common cause of infertility due to anovulation, and the main source of female infertility. When in the presence of a menstrual disorder, the diagnosis of PCOS is reached in 30% - 40% of patients with primary or secondary amenorrhoea and in 80% of patients with oligomenorrhea. PCOS should be diagnosed and treated early in adolescence due to reproductive, metabolic and oncological complications which may be associated with it. Treatment options include drugs, diet and lifestyle improvement.

Polycystic Ovarian Syndrome and Female Infertility

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, associated with chronic anovulation and hyperandrogenism. The cause of PCOS is multi-factorial and the mechanism is still unclear. A number of complications are closely related with PCOS such as infertility, hairy and obesity. Approximately up to one-third of females with PCOs have issues with infertility. Obesity is an independent factor which exacerbates infertility in PCOS, reduces the efficacy of infertility treatment and provokes a greater risk of miscarriage. Preconception counseling and guidelines play an initial major role in infertility treatment. The option of the most appropriate treatment depends upon various factors such as age, tubal patency, quality of sperm, experience, and duration of previous treatments and the level of anxiety of the couple. Tubal patency test and semen analysis are mandatory to decide the suitable treatment. Treatment modalities have two measures—non-pharmacological and the pharmacological. Oral clomiphene citrate remains the first line treatment to trigger ovulation. Gonadotrophin and laparoscopic ovarian drilling (LOD) surgery are the other treatment option. In vitro fertilization (IVF) and embryo transfer are the third line treatment and IVF remains the first option in the patient with diagnosed and established bilateral tubal occlusion and/or concentration of recovered motile sperm less than or equal to 5 million. Here, etiology, pathophysiology and molecular mechanisms of PCOS are reviewed, and perspectives are given for further research. The recent development, treatment, and diagnosis of PCOS are also highlighted. The summary will be of guiding significance in the prevention and treatment of PCOS.

Clinical effectiveness of the various approaches for infertility treatment in women with PCOS and hyperprolactinemia

【Objective】To evaluate the clinical efficiency of different treatments cancellation and infertility in women with PCOS and hyperprolactinemia.【Method】We performed retrospective analysis of 502consecutive case histories during 5 years of reproductive results of treatment of women is with anovulatory infertility,caused by different factors.Aim of the study was to determine the efficiency of conservative and surgical treatment.【Result】Differentiated application of conservative medical therapy allows to attain the effect of proceeding in a fertile function in 33,8%of patients.It is found that surgical induction of ovulation by ovarian laparoscopic partial degradation is an option in the management of female infertility associated with PCOS,especially as a second-line treatment after the failure of clomiphene citrate treatment,enhancing the efficiency of complex infertility treatment to 40%.【Conclusions】It is feasible to develop an algorithm differentiated use of infertility treatments in women with PCOS and hyperprolactinemia.

Induction of Ovulation with Clomiphene Citrate Combined with Bromocriptine in Polycystic Ovary Syndrome Patients with Infertility: A Prospective, Randomized, and Controlled Clinical Trial

Background:To investigate the therapeutic effects of bromocriptine(BCT)combined with clomiphene citrate(CC)in the induction of ovulation in polycystic ovary syndrome(PCOS)patients with infertility.Methods:A prospective,randomized,and controlled clinical trial was performed on 100 PCOS patients with infertility.Patients were randomly divided into two groups(n=50),patients in control group were treated with 50 mg CC from day 3 to day 7 of the menstrual cycle,and those in observation group(CC+BCT)were given 50 mg of CC from day 3 to day 7 of the menstrual cycle along with 2.5 mg of BCT daily for the full cycle.Patients in both groups were treated for one cycle.Blood was extracted from patients on day 3 of the menstrual cycle,the day of human chorionic gonadotrophin(hCG)injection,and day 7 after hCG injection to measure serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E_(2)),total testosterone(T)and progestin(P).Vaginal ultrasound was used to determine the thickness of endometrium and follicle size and count.Results:There was no significant difference in basal hormone levels between two groups.The success rate of ovulation induction in control group and observation group was 72.0%and 75.4%,respectively,no significant difference was found between two groups(P>0.05).The ongoing pregnancy rate(18.4%)in observation group was significantly higher than that in control group(8.0%).On the day of hCG injection,no significant differences in the levels of FSH,E_(2),and P were found between two groups,while LH was lower,and levels of PRL and T were significantly lower in observation group than those in control group(all P=0.00).On day 7 after hCG injection,no significant differences in the levels of E_(2) and P were found between two groups,while PRL level was significantly lower in observation group than that in control group,and the endometrial thickness in observation group(10.20±1.92 mm)was significantly higher than that in control group(9.22±1.88 mm)(P=0.01).Conclusions:Compared with the use of CC alone,BCT combined with CC can increase the success rate of ovulation induction-assisted pregnancy in PCOS patients,decrease the levels of PRL,LH,and T and increase the endometrial thickness in implantation window.Those data suggest that dopamine agonist BCT may reduce the pituitary hormone and androgen levels,reduce endometrial vascular resistance,and increase endometrial blood supply to improve the infertility outcomes of PCOS patients with infertility.

班氏促卵助孕汤改善多囊卵巢综合征小鼠卵母细胞的质量

背景:班氏促卵助孕汤改善多囊卵巢综合征卵母细胞质量的分子机制亟待完善补充。目的:探讨班氏促卵助孕汤对多囊卵巢综合征小鼠卵母细胞质量的影响和分子机制。方法:21 d龄雌性昆明小鼠颈部皮下注射硫酸脱氢表雄酮构建多囊卵巢综合征模型,连续给药21 d,记录动情周期及妊娠情况,ELISA检测血清性激素水平,Annexin V染色检测卵母细胞凋亡率,DCFH-DA荧光探针检测卵母细胞内活性氧水平,免疫荧光法观察卵母细胞纺锤体及染色体情况,网络药理学及分子对接验证班氏促卵助孕汤核心有效成分与卵母细胞成熟相关因子(生长分化因子9和骨形态发生蛋白15)结合活性,实时荧光定量PCR和Western blot检测卵母细胞中生长分化因子9和骨形态发生蛋白15的mRNA及蛋白表达水平。结果与结论:①班氏促卵助孕汤中的成分(槲皮素、山奈酚、β-谷甾醇)与生长分化因子9、骨形态发生蛋白15具有良好的结合活性;②班氏促卵助孕汤能恢复小鼠动情期,改善性激素紊乱和妊娠情况,降低细胞凋亡率、活性氧水平、纺锤体组装异常率、染色体丢失率(P<0.01,P<0.05),促进生长分化因子9、骨形态发生蛋白15 mRNA和蛋白表达(P<0.01,P<0.05)。结果表明,班氏促卵助孕汤可能通过调控生长分化因子9和骨形态发生蛋白15的基因表达,改善多囊卵巢综合征小鼠卵母细胞质量,提高生育力。

温肾化痰方联合西药治疗对肾虚痰湿型PCOS伴IR不孕症患者性激素、糖代谢、排卵率、妊娠率、疗效及不良反应的影响

目的 分析温肾化痰方联合西药治疗对肾虚痰湿型多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)不孕症患者性激素、糖代谢、排卵率、妊娠率、疗效及不良反应的影响。方法 选取2022年12月至2023年7月河南省中医院生殖医学科门诊收治的61例肾虚痰湿型PCOS伴IR不孕症患者作为研究对象,随机分为试验组(31例)和对照组(30例)。对照组给予盐酸二甲双胍片、来曲唑片进行治疗,试验组在此基础上加用温肾化痰方治疗,两组均治疗3个月经周期。观察治疗前后患者血清睾酮(T)、促黄体生成素(LH)、卵泡刺激素(FSH)水平、LH/FSH比值、体质量指数(BMI)、空腹血糖(FBG)、空腹胰岛素(FINS)、稳态指数模型(HOMA-IR)、排卵率、妊娠率和疗效情况,并进行安全性评估。结果 治疗前两组BMI、HOMA-IR、LH/FSH比值及血清T、LH、FSH、FBG、FINS水平比较,差异均无统计学意义(P>0.05);治疗后,两组BMI、HOMA-IR、LH/FSH比值及血清T、LH、FBG、FINS水平低于治疗前,血清FSH水平高于治疗前,且试验组BMI、HOMA-IR、LH/FSH比值及血清T、LH、FBG、FINS水平低于对照组,血清FSH水平高于对照组,差异均有统计学意义(P<0.05)。试验组治疗的总有效率、排卵率、妊娠率高于对照组,不良反应总发生率低于对照组,差异均有统计学意义(P<0.05)。结论 温肾化痰方联合常规西药治疗肾虚痰湿型PCOS伴IR不孕症疗效优于单用常规西药,可提高排卵率及妊娠率,改善女性性激素及糖代谢指标水平,缓解IR,改善中医临床症状,且安全性良好。

脐周八穴埋线对行体外受精-胚胎移植术肥胖型多囊卵巢综合征不孕症妊娠结局、糖脂代谢及中医症候积分的影响

目的探讨脐周八穴埋线对行体外受精-胚胎移植术(IVF-ET)肥胖型多囊卵巢综合征(PCOS)不孕症病人妊娠结局、糖脂代谢及中医症候积分的影响。方法选取2020年10月至2022年3月河北省沧州中西医结合医院收治的103例行IVF-ET肥胖型PCOS不孕症病人,按随机数字表法分为对照组(n=51,常规IVF-ET治疗)和治疗组(n=52,常规IVF-ET结合脐周八穴埋线治疗)。比较两组中医症候积分、心理状况[汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)]、糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、血脂指标[三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)]、身体质量指数(BMI)、腰臀比(WHR)、炎症因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]及妊娠结局。结果治疗后,两组中医证候积分、HAMA评分、HAMD评分、FBG、FINS、HOMA-IR水平均较治疗前出现下降,治疗组治疗后上述指标水平分别为(6.02±1.68)分、(7.31±1.29)分、(6.86±1.39)分、(4.04±0.64)mmol/L、(10.04±0.64)mIU/L、(1.61±0.04)分,低于对照组(10.19±2.21)分、(10.42±2.36)分、(9.62±2.64)分、(5.32±1.02)mmol/L、(14.45±1.19)mIU/L、(2.11±0.06)分(P<0.05)。治疗组治疗后,IL-6、TNF-α、TG、LDL-C、TC、BIM、WHR水平为(6.67±1.38)ng/L、(22.18±2.23)ng/L、(1.21±0.05)mmol/L、(2.65±0.36)mmol/L、(3.12±0.45)mmol/L、(24.89±1.19)kg/m^(2)、0.87±0.06,低于对照组(P<0.05),其IL-10、HDL-C水平分别为(167.46±31.25)ng/L、(2.01±0.19)mmol/L,高于对照组(125.03±24.11)ng/L、(1.32±0.21)mmol/L(P<0.05)。治疗组与对照组的临床妊娠率比较差异无统计学意义(53.84%比41.17%)(χ^(2)=1.66,P=0.198);治疗组流产率为3.57%,低于对照组23.81%(χ^(2)=4.57,P=0.032)。两组均无不良反应发生。结论脐周八穴埋线治疗有助于降低肥胖型PCOS不孕症病人中医症候积分,改善其心理负性情绪、炎症反应,调节糖脂代谢,降低流产率,且安全可靠。

多囊卵巢综合征不孕症患者IVF-ET后妊娠压力的影响因素

目的:分析多囊卵巢综合征(PCOS)不孕症患者体外受精-胚胎移植(IVF-ET)后妊娠压力的影响因素。方法:选取2021—2023年于该院完成IVF-ET且成功妊娠的125例PCOS不孕症患者进行横断面研究,收集患者一般资料,采用妊娠压力量表(PPS)评估患者妊娠压力,并采用多元线性回归分析PCOS不孕症患者IVF-ET后妊娠压力的影响因素。结果:PCOS不孕症患者IVF-ET后PPS评分为38~69分,平均(54.71±5.62)分;单因素分析结果显示,不同孕周、文化程度、独生女、配偶独生子、居住方式、妊娠史、生育史、就业状况、居住地、家庭年收入、家庭功能的PCOS不孕症患者IVF-ET后PPS评分比较,差异均无统计学意义(P>0.05);年龄≥35岁、不孕年限>2年、IVF-ET次数>2次、皮质醇>451.06 nmol/L的PCOS不孕症患者IVF-ET后PPS评分均高于年龄<35岁、不孕年限≤2年、IVF-ET次数≤2次、皮质醇≤451.06 nmol/L的患者,差异有统计学意义(P<0.05);多元线性回归分析结果显示,年龄、不孕年限、IVF-ET次数、皮质醇水平均为PCOS不孕症患者IVF-ET后妊娠压力的影响因素(P<0.05)。结论:年龄、不孕年限、IVF-ET次数、皮质醇水平均为PCOS不孕症患者IVF-ET后妊娠压力的影响因素。

叶利群基于络脉-玄府理论辨治多囊卵巢综合征不孕症经验介绍

总结介绍叶利群教授基于络脉-玄府理论辨治多囊卵巢综合征不孕症的临床经验。络脉-玄府理论认为,胞宫及五脏周围网络着许多的络脉、玄府,协调气血津液升降出入。叶利群教授认为,多囊卵巢综合征不孕症的核心病机在于内外邪气侵袭机体,致五脏功能失调,月经周期气血阴阳消长紊乱,精气血津液升降流转障碍,产生痰瘀浊邪,影响五脏之玄府开阖、络脉通利,冲任失畅,胞络瘀阻,导致胞宫失养,血海不充,卵泡发育停滞与排出不畅。故叶利群教授在叶天士辛味药、藤类药物开玄通络用药思想的启迪下,详审病机,通补相合施治,独创效方,分别以多囊行经汤、多囊养胞汤、多囊促卵汤、多囊促经汤四方对应月经四个周期以恢复脏腑功能,以消痰瘀浊邪,使玄府通,络脉和,养胞促卵,月事以时下,方能阴阳交和,胎孕即成。

补肾化痰汤对多囊卵巢综合征不孕患者卵巢功能及性激素水平的影响

目的观察补肾化痰汤对多囊卵巢综合征(PCOS)不孕患者卵巢功能及性激素水平的影响。方法本研究为随机对照试验。选取陕西省中医医院2023年9月至2024年6月收治的PCOS不孕患者114例,按随机数字表法分研究组与对照组各57例。研究组年龄(27.91±3.15)岁;体重指数(BMI)(25.47±2.59)kg/m^(2);不孕时间(3.57±0.62)年;初潮年龄(13.86±1.15)岁。对照组年龄(28.14±3.25)岁;BMI(25.88±2.64)kg/m^(2);不孕时间(3.45±0.71)年;初潮年龄(14.03±1.06)岁。对照组口服氯米芬,50 mg/次,1次/d,月经周期第5天开始服用,连服5 d。研究组加用补肾化痰汤(200 ml药汁分早晚两次服下,每日一剂),月经结束后第1天连续服用至下次月经。两组均连续治疗3个月经周期。治疗后评估两组疗效;治疗前后,比较两组中医证候积分、卵巢功能[卵巢体积、卵泡数量、抗米勒管激素(AMH)、子宫内膜厚度]、性激素[促黄体生成素(LH)、睾酮(T)、雌二醇(E2)、促卵泡生成素(FSH)];统计两组不良反应发生情况。采用t检验、χ^(2)检验进行统计学分析。结果研究组总有效率高于对照组[91.23%(52/57)比75.44%(43/57)](P<0.05)。治疗后,两组各项中医证候积分均下降,且研究组低于对照组(均P<0.05)。治疗后,两组卵巢体积、卵泡个数、AMH均下降,且研究组[(10.53±2.46)cm^(3)、(6.71±0.95)个、(7.13±2.08)μg/L]低于对照组[(13.94±3.02)cm^(3)、(9.03±1.02)个、(9.05±4.33)μg/L];两组子宫内膜厚度均上升,且研究组[(9.83±0.64)mm]高于对照组[(9.05±0.62)mm](均P<0.05)。治疗后,两组LH、T均下降,且研究组[(6.24±1.79)mIU/ml、(1.42±0.29)nmol/L]低于对照组[(9.05±2.16)mIU/ml、(1.93±0.34)nmol/L];E2均上升,且研究组[(182.16±15.98)ng/L]高于对照组[(166.72±14.03)ng/L](均P<0.05);两组FSH无显著变化(均P>0.05)。两组不良反应总发生率差异无统计学意义(P>0.05)。结论补肾化痰汤对PCOS不孕患者疗效较佳,可有效减轻患者症状,改善卵巢功能及性激素紊乱,且安全性较高。

坤泰胶囊联合二甲双胍治疗超重或肥胖PCOS不孕症患者的临床效果

目的探究坤泰胶囊联合二甲双胍治疗超重或肥胖多囊卵巢综合征(PCOS)不孕症患者的临床疗效,进一步阐明其机制。方法选取2021年1月到2023年12月在中国人民解放军联勤保障部队第九〇一医院诊治的116例超重或肥胖PCOS不孕症患者作为研究对象,按照随机数字表法将其分为对照组(采用二甲双胍治疗,n=57)和联合组(采用二甲双胍与坤泰胶囊联合治疗,n=59)。两组均连续用药12周。对比两组疗效、血糖、血脂、胰岛素抵抗等指标,子宫内膜容受性变化,卵巢及妊娠情况,晚期糖基化终末产物(AGE)-晚期糖基化终末产物受体(RAGE)信号通路指标及不良反应发生情况。结果联合组治疗有效率(86.44%)高于对照组(70.18%)(P<0.05)。治疗后,两组空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、抗米勒管激素(AMH)、雌二醇(E_(2))、黄体生成素(LH)/卵泡刺激素(FSH)、Ⅲ型胶原α1链(COL3A1)、凋亡因子Bcl-2关联X的蛋白(Bax)mRNA指标均降低,B淋巴细胞瘤-2(Bcl-2)mRNA、子宫内膜厚度均升高,且联合组更显著,差异均具有统计学意义(P<0.05)。联合组优势卵泡数多于对照组,卵泡生成时间短于对照组,周期妊娠率高于对照组,差异均具有统计学意义(P<0.05)。结论相比单纯应用二甲双胍,联合坤泰胶囊疗效更显著,其机制可能与调节AGE-RAGE信号通路有关。