Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from th...Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that require the most attention at this time.展开更多
[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-Dec...[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-December 2016 from Chinese medicine gynecological clinic in the affiliated hospital of Hubei University of Medicine.All these patients were given one dose of Jiawei Buzhong Yiqi Decoction one time a day for three months.Body mass index(BMI) was measured before and after treatment.Sex hormone levels and ovulation were measured,and the improvement of clinical symptoms was compared before and after treatment.[Results] After treatment,the levels of BMI and serum luteinizing hormone(LH),testosterone(T) were significantly decreased,and the level of serum estradiol(E2) was significantly higher than that before treatment.Ovarian enlargement and polycystic changes,menstrual cycle,menstrual flow and menstrual period were improved in varying degrees.[Conclusions] Jiawei Buzhong Yiqi Decoction has a good clinical effect in the treatment of obese PCOS.展开更多
Objective:To evaluate the effects of Jianpi Bushen Huatan Recipe on sex hormone levels、blood lipid and blood glucose levels in the treatment of obese poly-cystic ovarian syndrome(PCOS).Methods:Data bases including th...Objective:To evaluate the effects of Jianpi Bushen Huatan Recipe on sex hormone levels、blood lipid and blood glucose levels in the treatment of obese poly-cystic ovarian syndrome(PCOS).Methods:Data bases including the CNKI、Vip、Wanfang were searched.Studies about randomized controlled trials(RCT)of the effectiveness of Jianpi Bushen Huatan Recipe Combined with Metformin in the Treatment of obese PCOS were included.Rev Man 5.3 software was used for meta analysis.Results:A total of 11 studies were enrolled.Meta-analysis showed that Jianpi Bushen Huatan Recipe Combined with Metformin significantly improved the clinical total effective rate of patien ts(RR=1.32,95%CI(1.20,1.45),P<0.00001);reduced the body mass index(BMI)(SMD=-0.92,95%CI(-1.13,-0.72),P<0.00001),luteinizing hormone(LH)(SMD=-1.00,95%CI(-1.37,-0.62),P<0.00001),LH/FSH(SMD=-1.03,95%CI(-1.34,-0.71),P<0.00001),insulin resistant index(HOMA-IR)(SMD=-0.59,95%CI(-0.79,-0.40),P<0.00001),fasting insulin(FIN)(SMD=-0.77,95%CI(-1.19,-0.35),P=0.0003),total cholesterol(TC)(SMD=-0.63,95%CI(-0.88,-0.38),P<0.00001),triglycerides(TG)(SMD=-0.60,95%CI(-0.83,-0.36),P<0.00001),highdensity lipoprotein(HDL)(SMD=-0.41,95%CI(-0.51,-0.32),P<0.00001).However,there was no statistically significant in waist-to-hip ratio(WHR),follicle stimulating hormone(FSH),fasting blood sugar(FBS)and low density lipoprotein(LDL).Conclusions:Jianpi Bushen Huatan Recipe Combined with Metformin in the treatment of obese PCOS has an advantage in improving the sex hormone level,blood lipid and blood glucose level,and is superior to metformin alone.展开更多
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women.To meet PCOS criteria,women must have a combination of hyperandrogenism,anovulation and ultrasound findings.Almost 10% of all reproduct...Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women.To meet PCOS criteria,women must have a combination of hyperandrogenism,anovulation and ultrasound findings.Almost 10% of all reproductive age women worldwide show signs of PCOS.Although women often seek care for gynecological or body image concerns,many PCOS women are at risk for metabolic syndrome (MS).Many of the metabolic consequences are overlooked and un-dertreated by physicians because these patients tend to be young,reproductive age women.MS and obesity coexist commonly with PCOS.These young women are predisposed to glucose abnormalities and ulti-mately diabetes mellitus,dyslipidemia and eventually cardiovascular disease.Bariatric surgery can be an ef-fective means of weight loss in PCOS women.Surgical techniques have become safer and less invasive over time and have been found to be effective in achieving significant weight loss.Surgical options have also in-creased,giving patients more choices.Bariatric surgery may prevent or reverse metabolic syndrome.Bariatric surgery may also have reproductive benefits in PCOS patients.Although bariatric surgery has historically been performed in older,reproductive aged women,it has recently gained favor in adolescents as well.This is of particular importance due to the prevalence of both PCOS and MS in adolescents.Treatment of PCOS and MS certainly requires a combination of medical therapy,psychological support and lifestyle modifications.These treatments are difficult and often frustrating for pa-tients and physicians.Bariatric surgery can be effective in achieving significant weight loss,restoration of the hypothalamic pituitary axis,reduction of cardiovascular risk and even in improving pregnancy outcomes.Ulti-mately,bariatric surgery should be considered part of the treatment in PCOS women,especially in those with MS.展开更多
目的探究穴位埋线对两种肥胖类型PCOS患者炎性因子及生殖指标的影响。方法将2020年1月—2021年1月于山东中医药大学附属医院妇科门诊诊断为多囊卵巢综合征(肾虚痰湿证)肥胖患者63例作为研究对象。将患者按照不同肥胖类型分为均匀性肥胖...目的探究穴位埋线对两种肥胖类型PCOS患者炎性因子及生殖指标的影响。方法将2020年1月—2021年1月于山东中医药大学附属医院妇科门诊诊断为多囊卵巢综合征(肾虚痰湿证)肥胖患者63例作为研究对象。将患者按照不同肥胖类型分为均匀性肥胖组(A组,WC<80cm,n=33)和腹型肥胖组(B组,WC≥80,n=31)。两组均给予穴位埋线配合炔雌醇环丙孕酮治疗,对比3个月后两组的性激素(E_(2)、T、FSH、LH),炎症因子(TNF-α、hs-CRP、APN、IL-6),卵巢功能(卵巢体积、AMH、INHB),子宫内膜容受性(子宫内膜厚度、PI、RI),并统计治疗后患者的体质量、BMI、治疗后2个月排卵率、妊娠率。结果治疗后,均匀性肥胖组(A组)和腹型肥胖组(B)组T(0.74±0.07 VS 1.05±0.13)ng/mL,LH(10.43±1.07 VS 14.08±0.95)mIU/mL,IL-6(17.84±0.36 VS 21.06±1.34)ng/L,TNF-α(16.19±1.61 VS 19.95±0.95)ng/L,hs-CRP(4.75±0.35 VS 6.66±0.27)ng/L,卵巢体积(10.7±0.64 VS 11.31±0.62)cm^(3),PI(2.33±0.10 VS 2.55±0.13),RI(0.62±0.04 VS 0.74±0.03),体质量(63.83±2.87 VS 69.47±3.29)kg,BMI(24.23±1.46 VS 26.35±1.31)kg/m^(2)均显著降低(P<0.05),且均匀性肥胖组(A组)降低明显(P<0.05)。均匀性肥胖组(A组)和腹型肥胖组(B)组APN(57.15±3.6 VS 48.16±1.52)pg/L,FSH(7.24±0.86 VS 6.66±0.81)mIU/mL,E_(2)(98.75±4.63 VS 70.19±23.61)pg/mL,子宫内膜厚度(8.95±0.22 VS 8.29±0.29)cm,AMH(8.60±0.54 VS 7.56±0.55)ng/dL均显著提高(P<0.05),且A组(均匀性肥胖组)提高明显(P<0.05)。A组(均匀性肥胖组)的排卵率为80%,高于B组(腹型肥胖组)的40%(χ^(2)=10.00,P=0.000)。A组(腹型肥胖)的妊娠率60%,高于B组(腹型肥胖组)的33.3%(χ^(2)=4.29,P=0.04)。结论穴位埋线联合炔雌醇环丙孕酮能够改善PCOS(肾虚痰湿证)肥胖患者的性激素、卵巢功能、子宫内膜容受性,其机制可能与改善机体炎症状态相关。均匀性肥胖组改善更明显。提示,穴位埋线治疗均匀性肥胖PCOS效果更好,临床应针对腹型肥胖PCOS患者特点,采取更精准的治疗措施。展开更多
目的探讨体重管理干预对肥胖型多囊卵巢综合征(PCOS)患者糖脂代谢的影响。方法选取肥胖型PCOS患者70例,按照患者是否愿意接受体重管理,将其分为干预组和对照组,分别测定并分析两组患者0、15、30及45 d干预糖脂代谢指标。结果 (1)干预后...目的探讨体重管理干预对肥胖型多囊卵巢综合征(PCOS)患者糖脂代谢的影响。方法选取肥胖型PCOS患者70例,按照患者是否愿意接受体重管理,将其分为干预组和对照组,分别测定并分析两组患者0、15、30及45 d干预糖脂代谢指标。结果 (1)干预后不同时间点的TG、TC、FPG、2 h PPG、FINS及PINS比较有差异(P<0.05);(2)两组患者干预后的TG、TC、2 h PPG、FINS及PINS比较有差异(P<0.05);(3)两组患者的TG、TC、2 h PPG及PINS变化趋势比较有差异(P<0.05)。结论肥胖型PCOS患者在药物治疗的基础上实施体重管理,能更有效地改善患者糖脂代谢异常,增强药物疗效。展开更多
文摘Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that require the most attention at this time.
基金Supported by Scientific Research Guidance Project of Hubei Provincial Department of Education(B2018437)Scientific Research Guiding Project of Shiyan City,Hubei Province(18Y08)
文摘[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-December 2016 from Chinese medicine gynecological clinic in the affiliated hospital of Hubei University of Medicine.All these patients were given one dose of Jiawei Buzhong Yiqi Decoction one time a day for three months.Body mass index(BMI) was measured before and after treatment.Sex hormone levels and ovulation were measured,and the improvement of clinical symptoms was compared before and after treatment.[Results] After treatment,the levels of BMI and serum luteinizing hormone(LH),testosterone(T) were significantly decreased,and the level of serum estradiol(E2) was significantly higher than that before treatment.Ovarian enlargement and polycystic changes,menstrual cycle,menstrual flow and menstrual period were improved in varying degrees.[Conclusions] Jiawei Buzhong Yiqi Decoction has a good clinical effect in the treatment of obese PCOS.
基金Science and technology planning projects from Guangdong Science and Technology Department(No.2017ZC0194)。
文摘Objective:To evaluate the effects of Jianpi Bushen Huatan Recipe on sex hormone levels、blood lipid and blood glucose levels in the treatment of obese poly-cystic ovarian syndrome(PCOS).Methods:Data bases including the CNKI、Vip、Wanfang were searched.Studies about randomized controlled trials(RCT)of the effectiveness of Jianpi Bushen Huatan Recipe Combined with Metformin in the Treatment of obese PCOS were included.Rev Man 5.3 software was used for meta analysis.Results:A total of 11 studies were enrolled.Meta-analysis showed that Jianpi Bushen Huatan Recipe Combined with Metformin significantly improved the clinical total effective rate of patien ts(RR=1.32,95%CI(1.20,1.45),P<0.00001);reduced the body mass index(BMI)(SMD=-0.92,95%CI(-1.13,-0.72),P<0.00001),luteinizing hormone(LH)(SMD=-1.00,95%CI(-1.37,-0.62),P<0.00001),LH/FSH(SMD=-1.03,95%CI(-1.34,-0.71),P<0.00001),insulin resistant index(HOMA-IR)(SMD=-0.59,95%CI(-0.79,-0.40),P<0.00001),fasting insulin(FIN)(SMD=-0.77,95%CI(-1.19,-0.35),P=0.0003),total cholesterol(TC)(SMD=-0.63,95%CI(-0.88,-0.38),P<0.00001),triglycerides(TG)(SMD=-0.60,95%CI(-0.83,-0.36),P<0.00001),highdensity lipoprotein(HDL)(SMD=-0.41,95%CI(-0.51,-0.32),P<0.00001).However,there was no statistically significant in waist-to-hip ratio(WHR),follicle stimulating hormone(FSH),fasting blood sugar(FBS)and low density lipoprotein(LDL).Conclusions:Jianpi Bushen Huatan Recipe Combined with Metformin in the treatment of obese PCOS has an advantage in improving the sex hormone level,blood lipid and blood glucose level,and is superior to metformin alone.
文摘Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women.To meet PCOS criteria,women must have a combination of hyperandrogenism,anovulation and ultrasound findings.Almost 10% of all reproductive age women worldwide show signs of PCOS.Although women often seek care for gynecological or body image concerns,many PCOS women are at risk for metabolic syndrome (MS).Many of the metabolic consequences are overlooked and un-dertreated by physicians because these patients tend to be young,reproductive age women.MS and obesity coexist commonly with PCOS.These young women are predisposed to glucose abnormalities and ulti-mately diabetes mellitus,dyslipidemia and eventually cardiovascular disease.Bariatric surgery can be an ef-fective means of weight loss in PCOS women.Surgical techniques have become safer and less invasive over time and have been found to be effective in achieving significant weight loss.Surgical options have also in-creased,giving patients more choices.Bariatric surgery may prevent or reverse metabolic syndrome.Bariatric surgery may also have reproductive benefits in PCOS patients.Although bariatric surgery has historically been performed in older,reproductive aged women,it has recently gained favor in adolescents as well.This is of particular importance due to the prevalence of both PCOS and MS in adolescents.Treatment of PCOS and MS certainly requires a combination of medical therapy,psychological support and lifestyle modifications.These treatments are difficult and often frustrating for pa-tients and physicians.Bariatric surgery can be effective in achieving significant weight loss,restoration of the hypothalamic pituitary axis,reduction of cardiovascular risk and even in improving pregnancy outcomes.Ulti-mately,bariatric surgery should be considered part of the treatment in PCOS women,especially in those with MS.
文摘目的探究穴位埋线对两种肥胖类型PCOS患者炎性因子及生殖指标的影响。方法将2020年1月—2021年1月于山东中医药大学附属医院妇科门诊诊断为多囊卵巢综合征(肾虚痰湿证)肥胖患者63例作为研究对象。将患者按照不同肥胖类型分为均匀性肥胖组(A组,WC<80cm,n=33)和腹型肥胖组(B组,WC≥80,n=31)。两组均给予穴位埋线配合炔雌醇环丙孕酮治疗,对比3个月后两组的性激素(E_(2)、T、FSH、LH),炎症因子(TNF-α、hs-CRP、APN、IL-6),卵巢功能(卵巢体积、AMH、INHB),子宫内膜容受性(子宫内膜厚度、PI、RI),并统计治疗后患者的体质量、BMI、治疗后2个月排卵率、妊娠率。结果治疗后,均匀性肥胖组(A组)和腹型肥胖组(B)组T(0.74±0.07 VS 1.05±0.13)ng/mL,LH(10.43±1.07 VS 14.08±0.95)mIU/mL,IL-6(17.84±0.36 VS 21.06±1.34)ng/L,TNF-α(16.19±1.61 VS 19.95±0.95)ng/L,hs-CRP(4.75±0.35 VS 6.66±0.27)ng/L,卵巢体积(10.7±0.64 VS 11.31±0.62)cm^(3),PI(2.33±0.10 VS 2.55±0.13),RI(0.62±0.04 VS 0.74±0.03),体质量(63.83±2.87 VS 69.47±3.29)kg,BMI(24.23±1.46 VS 26.35±1.31)kg/m^(2)均显著降低(P<0.05),且均匀性肥胖组(A组)降低明显(P<0.05)。均匀性肥胖组(A组)和腹型肥胖组(B)组APN(57.15±3.6 VS 48.16±1.52)pg/L,FSH(7.24±0.86 VS 6.66±0.81)mIU/mL,E_(2)(98.75±4.63 VS 70.19±23.61)pg/mL,子宫内膜厚度(8.95±0.22 VS 8.29±0.29)cm,AMH(8.60±0.54 VS 7.56±0.55)ng/dL均显著提高(P<0.05),且A组(均匀性肥胖组)提高明显(P<0.05)。A组(均匀性肥胖组)的排卵率为80%,高于B组(腹型肥胖组)的40%(χ^(2)=10.00,P=0.000)。A组(腹型肥胖)的妊娠率60%,高于B组(腹型肥胖组)的33.3%(χ^(2)=4.29,P=0.04)。结论穴位埋线联合炔雌醇环丙孕酮能够改善PCOS(肾虚痰湿证)肥胖患者的性激素、卵巢功能、子宫内膜容受性,其机制可能与改善机体炎症状态相关。均匀性肥胖组改善更明显。提示,穴位埋线治疗均匀性肥胖PCOS效果更好,临床应针对腹型肥胖PCOS患者特点,采取更精准的治疗措施。
文摘目的探讨体重管理干预对肥胖型多囊卵巢综合征(PCOS)患者糖脂代谢的影响。方法选取肥胖型PCOS患者70例,按照患者是否愿意接受体重管理,将其分为干预组和对照组,分别测定并分析两组患者0、15、30及45 d干预糖脂代谢指标。结果 (1)干预后不同时间点的TG、TC、FPG、2 h PPG、FINS及PINS比较有差异(P<0.05);(2)两组患者干预后的TG、TC、2 h PPG、FINS及PINS比较有差异(P<0.05);(3)两组患者的TG、TC、2 h PPG及PINS变化趋势比较有差异(P<0.05)。结论肥胖型PCOS患者在药物治疗的基础上实施体重管理,能更有效地改善患者糖脂代谢异常,增强药物疗效。
文摘目的:探讨女性多囊卵巢综合症(Polycystic Ovary Syndrome,PCOS)患者维生素D缺乏与胰岛素水平的相关性。方法:回顾性分析2014年3月至2017年3月的在我院住院并诊断为PCOS的患者45人,选取45位健康人作为对照组。分别检测维生素D水平和心血管危险因素,如胰岛素、空腹血糖、血脂,以及性腺激素等。比较病例组及对照组维生素D水平及心血管危险因素的差异,并进行相关性分析。结果:通过T检验和Pearson相关分析发现病例组较对照组维生素D的水平更低,胰岛素水平偏高(P <0.05)。相关性分析表明PCOS患者中维生素D缺乏与胰岛素及胰岛素抵抗指数HOMA-IR(Homeostatic Model of Assessment-Insulin Resistance Index)相关(r=-0.172,P <0.05)。结论:PCOS患者更容易出现维生素D缺乏,这可能与PCOS患者内分泌代谢紊乱所致胰岛素抵抗相关。
