医学营养治疗对肥胖型多囊卵巢综合征不孕症影响临床研究

摘要

Objective To research the effect of medical nutrition therapy (MNT) on obese and infertile patients with polycystic ovary syndrome in body composition,endocrinology and metabolism and reproductive function,and to provide clinical basis and management experience of MNT for obese and infertile patients with PCOS.Methods Totally 110 cases of obese and infertile patients with PCOS were treated with MNT by a group practice pattern,which lasted for 12 weeks.Indicators of human body composition,endocrinology and metabolism and reproductive function before and after MNT were compared by pared-samples T test.Results After 12 weeks,index of obesity,such as body weight,waist circumference,BMI and body fat percentage,were significantly decreased (P＜0.001).Endocrine and metabolism indexes,such as FPG,FIN,HOMA-IR,TG,TC and LDL-C and other indexes,were significantly decreased (P＜ 0.001).Reproductive function indexes,such as T,LH,LH/FSH,were also significantly decreased (P＜ 0.001).About 79.5％ of the patients had improvement in menstrual cycle.Conclusion Twelve weeks of MNT can effectively reduce body weight and body fat percentage of obese and infertile patients with PCOS,and significantly improve endocrine and metabolism and reproductive function.MNT is an effective method for obese and infertile patients with PCOS.%目的 研究医学营养治疗对肥胖型多囊卵巢综合征(PCOS)不孕症患者体成分、内分泌代谢和生殖功能的影响,为肥胖型PCOS的医学营养治疗提供临床依据及管理经验.方法 通过PCOS联合门诊的模式,对2015年10月至2016年4月在北京大学第一医院的110例肥胖型PCOS不孕症患者进行为期12周的医学营养治疗,对治疗前后患者的人体成分、内分泌代谢指标及生殖学指标进行配对样本t检验.结果 医学营养治疗12周后,衡量肥胖的指标如体重、腰围、体重指数(BMI)及体脂百分比均显著下降(P＜0.001),内分泌代谢指标如空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)等指标均显著下降(P＜0.001),生殖功能指标游离睾酮(T)、黄体生成素(LH)及LH/卵泡刺激素(FSH)显著下降(P＜0.001),79.5％的患者月经周期改善及恢复正常.结论 12周医学营养治疗可有效降低PCOS患者体重和体脂百分比,并显著改善内分泌代谢和生殖功能,是治疗肥胖型PCOS的有效方法.