Comprehensive treatment method for polycystic ovarian syndrome in obstetrics and gynecology department

Abstract

The invention relates to the technical field of gynaecology and obstetrics, in particular to a comprehensive treatment method for polycystic ovarian syndrome in gynaecology and obstetrics. Step 2, comprehensive treatment; step 3, performing subsequent feedback; according to the system, close cooperation of various modes such as lifestyle adjustment, drug treatment and surgical treatment is achieved, a patient can learn about specific conditions such as the weight, the menstrual cycle and the blood sugar level of the patient through professional self-management guidance, and the patient can timely and accurately feed back various conditions in the treatment process to a doctor; problems possibly existing in the treatment process can be found in time, the treatment scheme is adjusted in a targeted mode, and better and more effective treatment experience is provided for patients with the polycystic ovarian syndrome.

Description

Technical Field

[0001] The present invention relates to the technical field of obstetrics and gynecology, and specifically relates to a comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology. Background Technique

[0002] Polycystic ovary syndrome (PCOS), as a common and complex gynecological endocrine disease, its pathogenesis involves the interaction of multiple factors such as genetics, environment, and lifestyle. It is mainly characterized by hyperandrogenism, ovulation disorder, polycystic ovarian changes, and insulin resistance, which bring many adverse effects to the reproductive health and overall quality of life of patients;

[0003] However, in actual treatment, each treatment method is often carried out relatively independently, lacking close cooperation. The popularization of knowledge about polycystic ovary syndrome among patients is insufficient. Many patients are not clear about the causes, impacts, and treatment principles of the disease. And after treatment, there is a lack of a convenient and clear feedback channel between patients and doctors. It is difficult for doctors to accurately judge the treatment effect and timely adjust the treatment plan based on this. Therefore, a comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology is proposed. Summary of the Invention

[0004] In view of this, the present invention provides a comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology to solve or alleviate the technical problems existing in the prior art and at least provide a beneficial option.

[0005] The technical solution of the present invention is realized as follows: A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology, comprising the following steps:

[0006] Step 1, symptom assessment;

[0007] Step 2, comprehensive treatment;

[0008] Step 3, subsequent feedback.

[0009] Further preferably, in the said Step 1, inquired in detail about the patient's menstrual condition, understood the patient's hirsutism symptoms, inquired whether the patient had obesity problems, paid attention to the patient's infertility condition, conducted a comprehensive physical examination, focused on examining the patient's height and weight, calculated the body mass index to evaluate the degree of obesity, BMI≥24kg / m 2 is regarded as overweight, BMI≥28kg / m 2Considered obese, check the patient's hair distribution, observe whether the hair is abnormally thick and coarser, check the patient's skin condition, and examine the patient's sex hormones through laboratory tests, including follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, and prolactin. In patients with polycystic ovary syndrome, the LH / FSH ratio is ≥2, and the testosterone level is elevated. Blood glucose and insulin tests: Detect fasting blood glucose, 2-hour postprandial blood glucose, fasting insulin, and 2-hour postprandial insulin levels. Blood lipid tests: Examine triglycerides, cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Some patients with polycystic ovary syndrome have abnormal blood lipid conditions. Use imaging examinations, such as transabdominal or transvaginal ultrasound to examine the ovarian morphology. In patients with polycystic ovary syndrome, the ovaries show polycystic changes, and more than 12 follicles with a diameter of 2-6 mm can be seen in one or both ovaries, and the ovarian volume increases.

[0010] Further preferably, in the second step, according to the diagnosis result in the first step, treat patients with polycystic ovary syndrome. The treatment methods in the second step include general treatment, drug treatment, surgical treatment, and psychological treatment. The general treatment includes diet adjustment: It is recommended that patients control calorie intake and formulate a personalized calorie intake plan according to the patient's weight and activity level. For overweight or obese patients with polycystic ovary syndrome, appropriately reduce calorie intake, increase dietary fiber intake, control carbohydrate intake, and ensure an adequate intake of high-quality protein. Exercise intervention: Develop an exercise plan for the patient. For most patients with polycystic ovary syndrome, perform moderate-intensity aerobic exercise, and appropriately increase high-intensity interval training to improve the metabolic rate. Combine strength training to increase muscle mass and improve the basal metabolic rate.

[0011] Further preferably, for drug treatment, patients with polycystic ovary syndrome often have high androgen levels. According to the specific situation of the patient, select drugs to reduce androgen levels. For example, if there is hypertension, choose appropriate drugs. If the patient does not have hypertension, choose to use spironolactone in combination with short-acting oral contraceptives. Patients with polycystic ovary syndrome often have insulin resistance. Use metformin to improve insulin resistance through multiple mechanisms.

[0012] Further preferably, for surgical treatment, for patients with poor drug treatment effects and fertility requirements, laparoscopic ovarian drilling can be considered. Conduct a comprehensive evaluation of the patient, including physical condition, fertility requirements, and ovarian function. Determine the size, morphology, and polycystic changes of the ovaries through ultrasound examination to evaluate the necessity and feasibility of the surgery.

[0013] Further preferably, for the psychotherapy, by talking with the patient and using psychological assessment tools, it is evaluated whether the patient has adverse psychological states such as anxiety and depression. For mild adverse psychological states, the patient is advised to conduct self-regulation to relax the body and mind. For moderate to severe adverse psychological states, further treatment is carried out by professional psychological counselors or psychiatrists.

[0014] Further preferably, in step three, the treated patients are regularly reexamined. In terms of lifestyle adjustment: the patient has a weight and BMI reexamination every 1 - 2 months to evaluate the effects of diet and exercise interventions;

[0015] For the psychological adjustment situation, the psychological state of the patient is reevaluated again by means of conversation during each follow-up visit to see if there is any improvement;

[0016] In terms of drug treatment, for patients taking drugs to regulate the menstrual cycle, the menstrual situation is observed after the end of each menstrual cycle to evaluate the effects of the drugs on sex hormone levels;

[0017] For patients taking drugs to reduce androgen levels, it is observed whether the androgen level decreases and whether there are other adverse reactions;

[0018] For patients taking drugs to improve insulin resistance, the improvement of the drugs on insulin resistance is evaluated;

[0019] Surgical treatment: For patients undergoing laparoscopic ovarian drilling, ultrasound is reexamined 1 - 2 months after the operation to observe the shape, size and follicle development of the ovaries to see if normal ovulation is restored. At the same time, the menstrual situation of the patient is observed to see if a regular menstrual cycle appears.

[0020] Further preferably, according to the results of the regular reexamination, the treatment effect is evaluated. If the patient's menstrual cycle becomes regular, the menstrual volume is normal, the androgen level decreases, the insulin resistance improves, the weight drops and reaches the healthy range, and the psychological state is good, it indicates that the comprehensive treatment plan is effective, and the current treatment plan can be continued or fine-tuned according to the specific situation. Otherwise, the treatment plan needs to be adjusted.

[0021] Due to the adoption of the above technical solutions in the embodiments of the present invention, it has the following advantages:

[0022] The present invention realizes the close cooperation of multiple methods such as lifestyle adjustment, drug treatment and surgical treatment. Through professional self-management guidance, the patient can learn to feedback various situations in the treatment process to the doctor in a timely and accurate manner according to specific situations such as their own weight, menstrual cycle, blood sugar level, etc., and timely discover possible problems in the treatment process and adjust the treatment plan accordingly, providing a better quality and more effective treatment experience for patients with polycystic ovary syndrome.

[0023] The above summary is only for the purpose of the specification and is not intended to be limiting in any way. In addition to the illustrative aspects, embodiments, and features described above, further aspects, embodiments, and features of the present invention will be readily apparent by reference to the accompanying drawings and the following detailed description. BRIEF DESCRIPTION OF THE DRAWINGS

[0024] In order to more clearly illustrate the technical solutions in the embodiments of the present application or the prior art, the following will briefly introduce the drawings required for use in the description of the embodiments or the prior art. Obviously, the drawings in the following description are only some embodiments of the present application. For those of ordinary skill in the art, without creative efforts, other drawings can be obtained based on these drawings.

[0025] Figure 1 It is a flowchart of the method of the present invention. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0026] In the following, only some exemplary embodiments are simply described. As those skilled in the art can recognize, the described embodiments can be modified in various different ways without departing from the spirit or scope of the present invention. Therefore, the drawings and the description are considered to be exemplary in nature rather than restrictive.

[0027] The embodiments of the present invention will be described in detail below with reference to the accompanying drawings.

[0028] As Figure 1 shown, the embodiments of the present invention provide a comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology, including the following steps:

[0029] Step 1, symptom assessment;

[0030] Step 2, comprehensive treatment;

[0031] Step 3, follow-up feedback.

[0032] In one embodiment, in Step 1, the patient's menstrual situation is inquired in detail, the hirsutism symptoms of the patient are understood, whether the patient has obesity problems is inquired, the infertility situation of the patient is concerned, a comprehensive physical examination is carried out, focusing on checking the patient's height and weight, calculating the body mass index to evaluate the degree of obesity, BMI≥24 kg / m 2 is regarded as overweight, BMI≥28 kg / m 2Considered obese, check the hair distribution of the patient, observe whether the hair is abnormally thick and coarser, check the patient's skin condition, and examine the patient's sex hormones through laboratory tests, including follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, prolactin. In patients with polycystic ovary syndrome, the LH / FSH ratio is ≥2, and the testosterone level is elevated. Blood glucose and insulin tests: Detect fasting blood glucose, 2-hour postprandial blood glucose, fasting insulin, and 2-hour postprandial insulin levels. Blood lipid tests: Examine triglycerides, cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Some patients with polycystic ovary syndrome have abnormal blood lipid conditions. Use imaging examinations, transabdominal or transvaginal ultrasound to examine the ovarian morphology. In patients with polycystic ovary syndrome, the ovaries show polycystic changes. More than 12 follicles with a diameter of 2-6 mm can be seen in one or both ovaries, and the ovarian volume increases.

[0033] In one embodiment, in step two, according to the diagnosis result in step one, treat the patients with polycystic ovary syndrome. The treatment methods in step two include general treatment, drug treatment, surgical treatment, and psychological treatment. General treatment, diet adjustment: It is recommended that the patient control calorie intake and formulate a personalized calorie intake plan according to the patient's weight and activity level. For overweight or obese patients with polycystic ovary syndrome, appropriately reduce calorie intake, increase dietary fiber intake, control carbohydrate intake, and ensure the intake of high-quality protein. Exercise intervention: Develop an exercise plan for the patient. For most patients with polycystic ovary syndrome, perform moderate-intensity aerobic exercise, and appropriately increase high-intensity interval training to improve the metabolic rate. Combine strength training to increase muscle mass and improve the basal metabolic rate.

[0034] In one embodiment, for drug treatment, patients with polycystic ovary syndrome often have a situation of excessive androgen levels. According to the specific situation of the patient, select drugs to reduce androgen levels. If there is hypertension, choose appropriate drugs. If the patient does not have hypertension, choose to use spironolactone in combination with short-acting oral contraceptives. Patients with polycystic ovary syndrome often have insulin resistance. Use metformin to improve insulin resistance through multiple mechanisms.

[0035] In one embodiment, for surgical treatment, for patients with poor drug treatment effect and fertility requirements, laparoscopic ovarian drilling can be considered. Conduct a comprehensive evaluation of the patient, including physical condition, fertility requirements, and ovarian function. Determine the size, morphology, and polycystic changes of the ovaries through ultrasound examination means, and evaluate the necessity and feasibility of the surgery.

[0036] In one embodiment, for psychotherapy, by talking with the patient and using psychological assessment tools, it is evaluated whether the patient has adverse psychological states such as anxiety and depression. For mild adverse psychological states, the patient is advised to adjust themselves, relax the body and mind. For moderate to severe adverse psychological states, further treatment is carried out by professional psychological counselors or psychiatrists.

[0037] In one embodiment, in step three, the treated patients are regularly reexamined. In terms of lifestyle adjustment: the patient's weight and BMI are reexamined every 1 - 2 months to evaluate the effects of diet and exercise interventions.

[0038] For the situation of psychological adjustment, the patient's psychological state is reevaluated by means of conversation at each follow-up visit to see if there is any improvement.

[0039] In terms of drug treatment, for patients taking drugs to regulate the menstrual cycle, the menstrual situation is observed after the end of each menstrual cycle to evaluate the effect of the drug on sex hormone levels.

[0040] For patients taking drugs to reduce androgen levels, it is observed whether the androgen level decreases and whether there are any other adverse reactions.

[0041] For patients taking drugs to improve insulin resistance, the improvement of the drug on insulin resistance is evaluated.

[0042] Surgical treatment: For patients who have undergone laparoscopic ovarian drilling, ultrasound is reexamined 1 - 2 months after the operation to observe the shape, size and follicle development of the ovaries to see if normal ovulation is restored. At the same time, the patient's menstrual situation is observed to see if a regular menstrual cycle appears.

[0043] In one embodiment, according to the results of regular reexamination, the treatment effect is evaluated. If the patient's menstrual cycle becomes regular, the menstrual volume is normal, the androgen level decreases, insulin resistance improves, the weight drops and reaches a healthy range, and the psychological state is good, it indicates that the comprehensive treatment plan is effective, and the current treatment plan can be continued or fine-tuned according to the specific situation. Otherwise, the treatment plan needs to be adjusted.

[0044] The above is only the specific implementation manner of the present invention, but the protection scope of the present invention is not limited thereto. Any person skilled in the art within the technical scope disclosed by the present invention can easily think of various changes or substitutions, and these should all be covered within the protection scope of the present invention. Therefore, the protection scope of the present invention should be subject to the protection scope of the claimed rights.

Claims

1. A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology, characterized by: The following steps are involved: Step 1: Symptom assessment; Step 2: Comprehensive treatment; Step 3: Follow-up feedback.

2. A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology according to claim 1, characterized in that: In step 1, the patient is asked in detail about the menstrual status, the hirsutism symptoms, whether the patient has obesity problems, and the infertility of the patient. A comprehensive physical examination is performed, focusing on the height and weight of the patient, and the body mass index is calculated to assess the degree of obesity. BMI ≥ 24 kg / m 2 Considered overweight, BMI ≥ 28 kg / m 2 The patient is considered obese. The patient's hair distribution is checked to see if the hair is abnormally dense or thick. The patient's skin condition is checked. The patient's sex hormones are tested in the laboratory, including follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, and prolactin. Patients with polycystic ovary syndrome show an LH / FSH ratio ≥ 2 and elevated testosterone levels. Blood glucose and insulin tests: fasting blood glucose, 2-hour postprandial blood glucose, fasting insulin, and 2-hour postprandial insulin levels are tested. Blood lipid tests: triglycerides, cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Some patients with polycystic ovary syndrome have dyslipidemia. Imaging examinations are used to examine the ovarian morphology through the abdomen or transvaginal ultrasound. The ovaries of patients with polycystic ovary syndrome show polycystic changes, with more than 12 follicles with a diameter of 2-6 mm in one or both ovaries, and the ovaries are enlarged.

3. A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology according to claim 1, characterized in that: In the step 2, the PCOS patient is treated according to the diagnosis result in the step 1. The treatment method of the step 2 includes general treatment, drug treatment, surgical treatment and psychotherapy. The general treatment includes: dietary adjustment: patients are advised to control calorie intake, and a personalized calorie intake plan is formulated according to the patient's weight and activity level. For overweight or obese PCOS patients, calorie intake is appropriately reduced, dietary fiber intake is increased, carbohydrate intake is controlled, and high-quality protein intake is ensured. Exercise intervention: an exercise plan is formulated for the patient. For most PCOS patients, moderate-intensity aerobic exercise is performed, and high-intensity interval training can be appropriately added to increase the metabolic rate. Strength training is combined to increase muscle mass and increase the basal metabolic rate.

4. A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology according to claim 1, characterized in that: Regarding the drug treatment, patients with polycystic ovary syndrome often have excessively high androgen levels. Depending on the patient's specific situation, drugs that lower androgen levels are selected. For example, if hypertension exists, appropriate drugs are selected. If the patient does not have hypertension, spironolactone is selected in combination with short-acting oral contraceptives. Patients with polycystic ovary syndrome often have insulin resistance, and metformin is used to improve insulin resistance through multiple mechanisms.

5. A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology according to claim 1, characterized in that: For patients who have poor response to drug treatment and who want to have children, laparoscopic ovarian drilling can be considered for surgical treatment. A comprehensive assessment of the patient, including physical condition, fertility requirements, and ovarian function, is conducted. Ultrasound examination is used to determine the size and shape of the ovaries and the presence of polycystic changes, and the necessity and feasibility of the surgery is evaluated.

6. A comprehensive treatment method for gynecological polycystic ovary syndrome according to claim 1, characterized in that: The psychotherapy described above assesses whether the patient has anxiety, depression or other negative psychological states by talking with the patient and using psychological assessment tools. For mild negative psychological states, the patient is advised to self-regulate and relax. For moderate to severe negative psychological states, further treatment is provided by a professional psychological counselor or psychologist.

7. A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology according to claim 1, characterized in that: In step 3, the patients after treatment are reviewed regularly. In terms of lifestyle adjustment: the patients' weight and BMI are reviewed every 1-2 months to evaluate the effects of diet and exercise interventions; Regarding psychological adjustment, the patient's psychological state is reassessed through conversation at each follow-up visit to see if there is any improvement; In terms of drug treatment, for patients taking drugs to regulate the menstrual cycle, the menstrual situation is observed after the end of each menstrual cycle to evaluate the effect of the drugs on sex hormone levels; For patients taking drugs to lower androgen levels, to observe whether androgen levels are reduced and whether other adverse reactions occur; For patients taking medications to improve insulin resistance, to assess the medication's improvement in insulin resistance; Surgical treatment: For patients who undergo laparoscopic ovarian drilling, ultrasound examination should be performed 1-2 months after the operation to observe the morphology, size and follicle development of the ovaries to see whether normal ovulation has resumed. At the same time, the patient's menstrual condition should be observed to see whether regular menstrual cycles occur.

8. A comprehensive treatment method for polycystic ovary syndrome in obstetrics and gynecology according to claim 7, characterized in that: The therapeutic effect is evaluated based on the results of regular follow-up examinations. If the patient's menstrual cycle becomes regular, menstrual volume is normal, androgen levels decrease, insulin resistance improves, weight decreases and reaches a healthy range, and the mental state is good, it means that the comprehensive treatment plan is effective. The current treatment plan can be maintained or fine-tuned according to the specific situation. In any case, the treatment plan needs to be adjusted.

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