The body of female friends has a lot of harm, and many diseases will also bother the health of our female friends. The polycystic ovary syndrome is also one of the diseases. How should we do endocrine experts to be the best?What about it?How should we effectively improve the polycystic ovary syndrome to bring very good help to our body?
1 diet intervention
The control of total energy and the rationalization of diet structure is the key. It is recommended that carbohydrates account for 45%~ 60%, and choose low -ray sugar index (GI) food, which accounts for 20%to 30%.Saturated and polyunsaturated fatty acids should be less than 10%, and protein accounts for 15%to 20%. It is mainly plant protein and milk protein. At the same time, it is necessary to consume rich vitamins, minerals and dietary fiber.
2 exercise intervention
For patients with obesity or overweight, the main goal of exercise is to improve body fat distribution and weight loss. A decrease of 5%to 10%of the weight can significantly improve the reproductive and metabolic abnormalities of patients.It is recommended to perform the motion effects of at least 150 min and medium intensity (to a maximum heart rate of 50%to 70%) per week, mainly aerobic exercise, each time 20 ~ 60 min, depends on the strength of the motion.For patients with normal weight but insulin resistance and hypertrophy, exercise can also increase insulin sensitivity, which is conducive to its clinical return.
3 behavioral intervention
Quit smoking limit wine and psychological adjustment (removing bad emotions such as anxiety and depression) can correct bad living habits, which plays an important role in consolidating the effects of diet and exercise therapy and preventing weight rebound.
Metabolic abnormal intervention
1
puberty
Patients with non -obesity or obesity PCOS with sugar regulating damage (IGR) or diabetes, if the simple lifestyle intervention effect is not good, it is recommended to use dual -double buns, the maximum dose is recommended for 500 mg/d, and the course of treatment is at least 3 months.For PCOS patients with overweight or obesity, after the treatment of lifestyle intervention, the weight decrease is less than 5%of the basic weight. It is recommended to use or switched to lipase inhibitors (Oli Si) based on the two metamical.Inhibit the effects of lipase in the pancreas and gastrointestinal tract, inhibit the decomposition and absorption of fat in intestinal food, and reduce weight. The research of small samples indicates that it can also reduce the level ofrogens.It should be noted that patients with adolescent PCOS should not be too fast to reduce their weight, and they should be gradual, which is based on the principle of not affecting the normal development of adolescence.
2 childbirth period
(1) Merge IGR:
Non -pregnancy: Regardless of whether obesity or non -obese PCOS patients are recommended to be diagnosed, the two -septic treatment can be started. This drug mainly improves insulin resistance of liver and peripheral tissue, inhibit liver glycogen and glycogen decomposition, increases peripheral tissue to glucose on glucose glucoseUse to improve high insulinmia.It is recommended to start in small doses and gradually increase. Non -obesity patients recommend 1 000 ~ 1 500 mg/d, obese patients recommend 2 000 ~ 2500 mg/d, take it immediately or after meals, for at least 3 to 6 months.If insulin resistance or abnormal sugar regulation is significantly improved, patients with preparation patients are recommended to be used to diagnose pregnancy, and patients with no pregnancy plan can be used until sugar regulation abnormal recovery; if there is no effect for 3 to 6 months, it is recommended to adjust the treatment plan. Considering the basics of the two metamicals, the foundation of the two -two dual -胍 胍 foundation can be considered.Used or modified: ① 噻azolerine dione drug (pylmitetone), which can improve the sensitivity of target tissue on insulin, reduce insulin resistance of peripheral tissue and liver, reduce liver glycogen output, improve sugar -lipid metabolism, And have the effects of reducing inflammation, small sample research suggests that it can improve thermotropymia and ovulation, combined with two metformin has a synergistic treatment effect, and contraceptives need to be used during the medication.-The glycosinase to reduce the absorption of sugar in the small intestine. At the same time, it can also regulate the intestinal flora, increase the patient’s post-meal GLP-1 level, and improve blood lipids. Evidence of small samples suggests that Akaba sugar is reduced to reduce the level of LH and improves Agenth.Hemplication; contraception during the medication.
During pregnancy: For patients with pregnancy, the first choice of lifestyle intervention. If blood sugar cannot meet the blood glucose control standards during pregnancy, insulin is used in a timely manner; when the two -taboo taboos are taboos, the patient can also use the two -meta and duality after obtaining the consent of the patient’s knowledge.
(2) Obesity and fatty liver: When the lifestyle intervention cannot effectively control weight and improve fatty liver, drug treatment should be assisted as soon as possible.
Non -pregnancy period: Recommended two -meta dual -cymbal treatment. The course of treatment is at least 3 to 6 months, and the weight declines reaches at least 5%of the original weight. Patients for pregnancy are recommended to be used for diagnosis.If the weight decreases is less than 5%of the original weight, it is recommended to use or switched to Olis. If lifestyle intervention and drugs can not effectively control weight and improve fatty liver can consider metabolic surgery. Applicable people include: BMI> 35KG/M2 or BMI> 30 kg/m2 has at least one or more complications. For details, see the 2017 AACE guide.If the patient’s combination of fatty liver with liver enzymes does not exceed 3 times the normal upper limit, it is recommended to use drugs that improve insulin sensitivity. If the liver enzyme exceeds 3 times the normal upper limit, it is recommended to protect the liver and improve the liver function. See 2017 for details. See 2017 2017.Guidelines for diagnosis and treatment of non -alcoholic fatty liver disease in the Asia -Pacific working group.
During pregnancy: If the weight during pregnancy still exceeds the standard range, it is not recommended to continue to lose weight during pregnancy, but the rate of weight gain should be controlled.
(3) Last metabolic abnormalities: Patients with abnormal blood lipids, if the lifestyle intervention is invalid, the first choice of Biting drugs can be preferred. This drug is selectively inhibited.It can improve blood lipid disorders, and the research of small samples suggest that it can also reduce the level ofrogen. For specific drugs and treatment, see the Guide to Chinese adult blood lipid abnormal prevention in 2016, and the treatment of blood lipid abnormalities has an unclear impact on PCOS patients.If PCOS patients have no blood lipid disorders and high -risk factors of cardiovascular disease, Catiner’s drugs do not treat conventional recommendations for treatment.
(4) Risk of cardiovascular disease: Reducing cardiovascular disease risk of patients with PCOS is the long -term target of PCOS treatment.Comprehensive management to reduce risk factors of cardiovascular disease, such as smoking abstaining, weight loss or improving abdominal obesity, correcting sugar -lipid metabolic disorders, reducing blood pressure, treating obstructive sleep and respiratory syndrome (OSAS).
Reproductive abnormal intervention
1 Anti -Hepatoma hemotidation treatment
Applicable people with PCOS patients with high androgen hemiamark phenotypes.
(1) Short -active oral contraceptive pill (OCP): For patients with PCOS in adolescence and childbearing age, Hakukenexia and clinical manifestations (hairy disease, acne, etc.) are recommended as the preferred treatment.
For patients with menstrual tide in the future, as long as they have entered the late youth development (such as levels of breast development ≥tanner ⅳ), those with demand can also be treated with OCP.OCP generally takes about 3 to 6 months for acne; it can only be effective after at least 6 months for treatment.For patients with ineffective acne and hair loss with OCP, they need to go to the dermatologist to cooperate with related local treatment or physical therapy.
It should be noted: In the absence of other metabolic risk factors, OCP can be used separately; if there are other metabolic risk factors, it is recommended to use OCP to use drugs that improve metabolic risks.
(2) Slacks: Patients with Kenrocosmia who are not good for OCP treatment, have not good treatment effects, OCP taboos or tolerance of OCP.The daily dose is 60 ~ 100 mg. It is recommended that in the case of effective contraception, small doses began to be used gradually, and at least 6 months are used to take effect.
In large doses of use, breast pain, menstrual disorders, headaches, or urine will occur. Pay attention to hypotension and hypertrophytic potassium. It is recommended to regularly review blood potassium and renal function.
2 Adjust the menstrual cycle
It is suitable for PCOS patients with no fertility requirements for puberty and age, and menstrual disorders caused by ovulation disorders.
(1) Periodic use of progesterone: For patients with non -chlorproxia and clinical androgen, and patients with non -insulin resistance periodic use of periodic progesterone.
Drugs include splitterone 10 ~ 20 mg/d or progesterone 100 ~ 200 mg/d or acetic hydroxyl acetone 10 mg/d, 10 ~ 14 d per cycle.This method does not affect metabolism and does not suppress the hypothalamus-pituitary-gland axis.
(2) Short -acting oral contraceptives (OCP): PCOS patients who have high menstrual flow or extended menstrual periods and high -male androgens and (or) high -asshior manifestations can be given OCP.OCP is preferred to reach Ying 35, starting from 3 to 5 days from menstruation, and taking 21 d continuously (continuous use of no more than 6 months).Patients with severe obesity and metabolic disorders of metabolism are recommended to combine two metformin or insulin sensitizants.
(3) Estrogen hormone sequencing therapy: For patients with PCOS patients with low fertility requirements or estrogen are low and have symptoms of menstrual periods, they can give estrogen sequential sequencing methods to regulate menstrual abnormalities. The specific schemes refer to the peerous period and postmenopausal periods.Clinical application guidelines for hormone therapy.
3 ovation
It is suitable for PCOS patients with fertility disorders as the main phenotype.Women without ovulation are available in fertility. It is recommended to consult before pregnancy. The effects of obesity, hhogotroboi, age, age, ovarian volume, and menstrual abnormalities should be considered on the end of pregnancy ending.The specific plan refers to the consensus on the treatment of infertility of polycystic ovary syndrome.Patients with metabolic abnormal PCOS recommended to correct metabolic abnormalities before ovulation promotes ovulation.
Prevention and management of long -term complications
Regular management is extremely important for PCOS itself and its long -term complications.If PCOS patients have early risk factors such as family history of cardiovascular disease, family history of cardiovascular disease, history of smoking, IGR/2 diabetes, hypertension, abnormal blood lipids, sleep and respiratory syndrome (OSAS), obesity (especially central obesity), etc., it should be regularlyMonitor.
PCOS merges IGR, it is recommended to perform OGTT examinations every year, and type 2 diabetes has been diagnosed, and appropriate hypoglycemic treatment should be given; if it is abnormal with blood lipids, it is recommended to review every 3 to 6 months.The frequency should increase.
For patients with obesity, high insulin ledmia, diabetes, and PCOS patients who have not ovulated for a long time, the endometrium hyperplasia or endometrial cancer increases significantly, and the endometrium should be performed regularly in gynecological ultrasonic monitoring.
Traditional Chinese Medicine and Traditional Chinese and Western Medicine Treatment
Traditional Chinese medicine believes that PCOS is closely related to the dysfunction of liver, spleen, and kidney dirt. It is also a variety of pathological factors such as miscellaneous qi, phlegm dampness, blood stasis, and internal heat.Dialectical dialectics are applied to various methods such as qi, phlegm, dampness, stasis, and heat clearing heat. If it can be combined with menstrual cycle for installments, it will be more helpful to restore ovulation or successful conception of PCOS patients.Traditional Chinese medicine, acupuncture, moxibustion, acupoint buried lines, etc. also have certain effects.
If there are some diseases in our body, this disease will also seriously endanger our lives and healthy growth, and bring great trouble to our lives, so we should follow us in normal times.The correct way brings very good help to our bodies, and the body of our female friends is healthy.
