针药结合治疗多囊卵巢综合征并胰岛素抵抗的临床研究
|
摘要
研究背景
PCOS是育龄期妇女常见内分泌性综合征,发病率高达5%-10%,其中肥胖型比率高达50%,胰岛素抵抗发生率为50-70%,占发病患者的绝大部分,过量的胰岛素作用于卵巢内相应受体,引起卵泡发育和成熟障碍,无优势卵泡形成,从而导致不排卵及不孕,故患者出现月经稀发、闭经、痤疮、多毛、肥胖、不孕等症状。目前认为胰岛素抵抗和高胰岛素血症在多囊卵巢综合征发病中起到关键的作用,而胰岛素抵抗为临床多种疾病的高危因素,可导致糖尿病、心血管疾病和子宫内膜癌的发病率升高,远期危害性高,积极探索寻找PCOS合并IR有效的、副作用少并且对远期并发症起到良好预防作用的治疗方法具有重要意义。
我院省名老中医李丽芸教授根据前人论述,结合自己多年的临证经验,提出多囊卵巢综合征的病机以肾虚为本,血瘀及痰阻为标,属虚实夹杂之证,故以补肾导痰活血为法治疗多囊卵巢综合征,并创立了经验方且已制成院内制剂灵术颗粒和参芪胶囊。前期研究表明,经验方灵术颗粒和参芪胶囊对治疗PCOS确有疗效。穴位埋线是近年兴起的针灸绿色疗法,以其简便廉验为特色,在肥胖病的治疗研究上取得一定成效。
检索文献,目前对中药联合穴位埋线治疗多囊卵巢综合征临床疗效、作用机理以及对PCOS远期并发症方面相关危险因素IR、肥胖、血脂等的干预作用报道非常少,并且疗效评定标准各不相同,尚缺乏系统性和规范性的研究。因此针对目前中医对PCOS研究现状,以及西药应用方面缺陷,我们设想创立一种中药联合穴位埋线治疗PCOS的新方法,借助穴位埋线对肥胖方面良好的治疗作用及李丽芸教授治疗PCOS经验方灵术颗粒,评估联合两种治疗方式在干预及治疗PCOS及其远期并发症的部分高危因素方面能否发挥重要作用。
研究目的
本研究旨在通过比较李丽芸教授经验方灵术颗粒与目前西医治疗PCOS合并IR的最常用药物二甲双胍以及灵术颗粒联合穴位埋线治疗多囊卵巢综合征的临床疗效差异,通过观察月经、排卵、体质量、生殖内分泌、胰岛素抵抗、血脂等的改善情况,对灵术颗粒以及灵术颗粒联合穴位埋线治疗多囊卵巢综合征的临床疗效作出客观评价、探讨其可能的作用机制。为临床提供PCOS有效的、副作用少并且对远期并发症起到良好预防作用的治疗方法奠定理论基础。
研究方法
本研究采用前瞻性临床对照试验研究,选择2008年2月至2009年2月广东省中医院妇科门诊就诊的符合诊断和纳入标准的PCOS合并IR的患者77例,设立中药治疗组、西药组、针药结合组。其中中药组28例,采用经验方灵术颗粒(广东省院内制剂,批号:08102305)治疗,西药组21例,采用二甲双胍(格华止,上海施贵宝药业公司)治疗,针药结合组28例,采用经验方灵术颗粒联合穴位埋线治疗。治疗3个月为一疗程。评价治疗前后主要临床症状、体征改善情况;以及治疗前后体重、BMI、腰围、臀围、WHR,多毛、痤疮评分、BBT、治疗前后性激素、GLU、INS、HOMA—IR、TG、Tc、HDL—C、LDL—C、ApoA、ApoB等疗效判定指标的改善情况。以及治疗前后检测一般安全性项目,及记录不良反应的发生。
研究结论
1.三组治疗均可以改善PCOS患者体内内分泌状况、在降低T水平上三组疗效无显著差异,西药组和针药结合组还可降低LH/FSH。
2.三组治疗均可改善PCOS患者体重指数、腰围、臀围,针药结合组治疗后体重、腰围、臀围下降最为明显,西药组和中药组组间疗效相当。
3.三组治疗均可改善PCOS患者IR,针药结合组与西药组在改善HOMA-IR方面的疗效优于单纯中药组,而西药组与针药结合组在改善HOMA—IR方面的疗效无统计学意义。
4.针药结合组可改善PCOS患者的血脂情况,在疗效上优于中药组和西药组。
5.三组治疗均可改善PCOS患者中医症状量化评分,中药组和针药结合组在改善中医症状方面疗效优于西药组。
6.根据本研究结果,我们推测补肾健脾、化痰祛瘀法灵术颗粒以及灵术颗粒联合穴位埋线治疗PCOS的机理可能是通过降低T水平,改善胰岛素抵抗,降低患者体重,而起到调节内分泌的作用,具有多靶点、多方面整体调节下丘脑-垂体-卵巢轴的功能,从而达到促进卵泡发育和排卵的作用,其中降低体质量可能起到关键作用。
7.根据上述客观研究结果,我们认为灵术颗粒,灵术颗粒联合穴位埋线是治疗PCOS合并IR患者的有效治疗方法。它可以明显降低体重、腰围、臀围,可以降低患者T水平,使患者月经规则、恢复排卵,且使部分不孕患者受孕,可通过降低T治疗高雄激素血症,改善座疮:可以降低FINS、HOMA-IR而改善胰岛素抵抗及因胰岛素抵抗引起的代偿性高胰岛素血症;针药结合组还可以改善血脂代谢情况。根据组间疗效差异比较,我们认为灵术颗粒联合穴位埋线在治疗PCOS并IR患者中起协同作用,疗效优于单纯中药治疗或单纯西药治疗。
8.根据上述客观研究结果,我们认为灵术颗粒联合穴位埋线可以通过降低体质量,改善胰岛素抵抗,改善血脂代谢情况,在某种程度上可降低PCOS的远期并发症如糖尿病、高血脂和心血管等疾病的风险。
Background
Polycystic ovary syndrome(PCOS) is a common endocrine syndrome of childbearing age women.Its incidence rate is as high as 5%to 10%,50%of which is caused by fatness,and 50%to 70%of them is caused by insulin resistance,which is a majority part in patients.Too much insulin acting on the corresponding receptor in the ovary will cause obstacles in follicular development and maturity and there won't any advanced follicles.This will thus lead to anovulation and infertility.In that case,the symptoms,such as rare menstruation,amenorrhea,acne,hirsutism,obesity,infertility and so on will emerge.At present,it is considered that insulin resistance and hyperinsulinemia play a key role in the pathogenesis of polycystic ovary syndrome.Insulin resistance is also a high risk factor for many clinical diseases.It may increase the incidence ratio of diabetes,cardiovascular disease and endometrial cancer and has long future harm.Hence,it is very important to explore and find an effective treatment method for PCOS and IR with fewer side effects,which is also effectively preventive to future complications.
Based on the existing treatises from former researchers and the long time clinical experiences accumulated by herself,TCM professor of our hospital Li Liyun,who is a provincial veteran,put forward the conclusion that the pathogenesis of polycystic ovary syndrome is basically in kidney deficiency and apparently in blood stasis and sputum obstacle.It is a deficiency-excess complication.So the method is tonifying the kidney,smoothing the sputum and invigorating the blood circulation to cure PCOS.She has established an experienced prescription and made the preparations,Necromancy Particle and Shenshi Capsule.Previous research has proved that these medicines do have healing effect onto the treatment of PCOS.Acupoint catgut embedding is a green acupuncture treatment rising in recent years,which is characterized by simplicity and cheapness.This treatment has a certain achievement on the treatment and research for obese patients.
It is rare to find some reports on the clinical healing effect,action principle of TCM combined with acupoint catgut embedding therapy for curing PCOS,and the intervening effect of this treatment to the risk factor IR, obesity and blood fat related to PCOS long future complication.The evaluation standard o the healing effect is also different with each other.There is an obvious lack of systematic and normative research.So according to the present TCM research status of PCOS and the limitation of Western Medicine,we are planning to establish a TCM and acupoint catgut embedding combined method to see whether this combined treatment method can play an important role on intervening and curing PCOS and the high risk factors of its long future complication with the benefit of the good treatment effect of acupoint catgut embedding for obesity and the experienced prescription of Necromancy Particle from professor Li Liyun for curing PCOS.
Objectives
Through comparing the clinical healing effect difference for PCOS between the Necromancy Particle from Professor Li Liyun,the most common medicine metformin for curing PCOS and IR in Western Medicine and the Necromancy Particle and acupoint catgut embedding combined treatment as well as observing improvement of menstruation,ovulation,body mass,reproductive endocrinology, insulin resistance,lipids,etc,this study is aiming at making objective evaluation to the clinical healing effects of Necromancy Particle and Necromancy Particle and acupoint catgut embedding combined treatment for PCOS and exploring the possible action mechanism in order to lay the foundation for the treatment method which has high efficiency and less side for curing PCOS and can also excellently prevent its long future complication.
Method
This study adopts forward looking clinical experiment research,chooses 77 PCOS and IR patients who went to Guangdong TCM Hospital to see gynecologic doctors during the time from February 2008 to February 2009 and are conforming to the diagnosis and adopting standard and divides them into three groups, TCM treatment group,Western Medicine treatment group and injection and medicine combined group.TCM treatment group has 28 patients and they are treated with the experienced prescription Necromancy Particle(domestic preparation,batch number:08102305).Western Medicine treatment group has 21 patients and they are treated with metformin(made in Shanghai).Injection and Medicine combined group has 28 patients and they are treated with Necromancy Particle and acupoint catgut embedding therapy,three months for each treatment period.This study evaluates the improvement situation of clinical symptoms and signs before and after the treatment,as well as the improvement situation of weight,BMI,waistline,hipline,WHR,hirsutism,acne scores,BBT,sex hormones before and after treatment,GLU,INS,HOMA-IR,TG, Tc,HDL-C,LDL-C,ApoA,ApoB and other indicators to determine efficacy, examines the general safety items before and after the treatment and records the occurrence of adverse reactions.
Conclusion
1.The treatment of all of the three groups can improve the endocrine status of PCOS patients.There is no significant difference with T level lowering between the three groups.The Western Medicine treatment group and injection and medicine combined group can also lower LH/FSH.
2.The treatment of all of the three groups can improve the weight index, waistline and hipline of PCOS patients.The weight,waistline and hipline loss is the most significant in injection and medicine combined group after the treatment.That of the Western Medicine treatment group and TCM treatment group is almost the same.
3.The treatment of all of the three groups can improve the IR of PCOS patients. The treatment of injection and medicine combined group and Western Medicine group has a better effect on HOMA-IR improvement than that of the TCM treatment group.There is no statistic importance to compare the HOMA-IR improvement effect of the Western Medicine group with that of the injection and medicine combined group.
4.Blood fat status can be improved in injection and medicine combined group. Its effect is better than that of the TCM group and Western Medicine group.
5.The treatment of all of the three groups can improve the quantitative scores of TCM symptoms of PCOS patients.The TCM group and injection and medicine combined group have a better effect than the Western Medicine group.
6.According to the results of this study,we suppose that the action principle of Necromancy Particle which is used to tonify the kidney,strengthen the spleen,smooth the sputum and remove obstacle,and Necromancy Particle and acupoint catgut embedding combined therapy for PCOS is to regulate the endocrine by lowering T level,improving insulin resistance and lowering the weight of patients.It has the function of regulating hypothalamus-pituitary -ovarian axis with multiple targets and overall aspect so as to achieve the promotion of follicular development and ovulation,Lowering the body mass may play a key role for that.
7.Based on above objective results,we think the Necromancy Particle and acupoint catgut embedding combined treatment is an effective treatment method for curing PCOS and IR.It can significantly lower weight,waistline,hipline, and T level,regulate menstruation,restore ovulation,make some patients with infertility become pregnant,cure hyperprolanemia by lowering T,improve acne, and improve insulin resistance and vicarious hyperinsulinemia caused by insulin resistance by lowering FINS and HOMA-IR.injection and medicine combined treatment can also improve the blood fat metabolism status.According to the curative effect differences between the groups,we think the Necromancy Particle and acupoint catgut embedding combined treatment has a synergy effect in the treatment of PCOS and IR patients.It is better than single TCM treatment or Western Medicine treatment.
8.According to the objective findings,we believe that the Necromancy Particle and acupoint catgut embedding combined treatment,through lowering the body mass,improving the insulin resistance and improving the blood fat metabolism status,can lower in a way the risk of PCOS long future complications,such as diabetes,high blood cholesterol,angiocardiopathy and so on.
PCOS是育龄期妇女常见内分泌性综合征,发病率高达5%-10%,其中肥胖型比率高达50%,胰岛素抵抗发生率为50-70%,占发病患者的绝大部分,过量的胰岛素作用于卵巢内相应受体,引起卵泡发育和成熟障碍,无优势卵泡形成,从而导致不排卵及不孕,故患者出现月经稀发、闭经、痤疮、多毛、肥胖、不孕等症状。目前认为胰岛素抵抗和高胰岛素血症在多囊卵巢综合征发病中起到关键的作用,而胰岛素抵抗为临床多种疾病的高危因素,可导致糖尿病、心血管疾病和子宫内膜癌的发病率升高,远期危害性高,积极探索寻找PCOS合并IR有效的、副作用少并且对远期并发症起到良好预防作用的治疗方法具有重要意义。
我院省名老中医李丽芸教授根据前人论述,结合自己多年的临证经验,提出多囊卵巢综合征的病机以肾虚为本,血瘀及痰阻为标,属虚实夹杂之证,故以补肾导痰活血为法治疗多囊卵巢综合征,并创立了经验方且已制成院内制剂灵术颗粒和参芪胶囊。前期研究表明,经验方灵术颗粒和参芪胶囊对治疗PCOS确有疗效。穴位埋线是近年兴起的针灸绿色疗法,以其简便廉验为特色,在肥胖病的治疗研究上取得一定成效。
检索文献,目前对中药联合穴位埋线治疗多囊卵巢综合征临床疗效、作用机理以及对PCOS远期并发症方面相关危险因素IR、肥胖、血脂等的干预作用报道非常少,并且疗效评定标准各不相同,尚缺乏系统性和规范性的研究。因此针对目前中医对PCOS研究现状,以及西药应用方面缺陷,我们设想创立一种中药联合穴位埋线治疗PCOS的新方法,借助穴位埋线对肥胖方面良好的治疗作用及李丽芸教授治疗PCOS经验方灵术颗粒,评估联合两种治疗方式在干预及治疗PCOS及其远期并发症的部分高危因素方面能否发挥重要作用。
研究目的
本研究旨在通过比较李丽芸教授经验方灵术颗粒与目前西医治疗PCOS合并IR的最常用药物二甲双胍以及灵术颗粒联合穴位埋线治疗多囊卵巢综合征的临床疗效差异,通过观察月经、排卵、体质量、生殖内分泌、胰岛素抵抗、血脂等的改善情况,对灵术颗粒以及灵术颗粒联合穴位埋线治疗多囊卵巢综合征的临床疗效作出客观评价、探讨其可能的作用机制。为临床提供PCOS有效的、副作用少并且对远期并发症起到良好预防作用的治疗方法奠定理论基础。
研究方法
本研究采用前瞻性临床对照试验研究,选择2008年2月至2009年2月广东省中医院妇科门诊就诊的符合诊断和纳入标准的PCOS合并IR的患者77例,设立中药治疗组、西药组、针药结合组。其中中药组28例,采用经验方灵术颗粒(广东省院内制剂,批号:08102305)治疗,西药组21例,采用二甲双胍(格华止,上海施贵宝药业公司)治疗,针药结合组28例,采用经验方灵术颗粒联合穴位埋线治疗。治疗3个月为一疗程。评价治疗前后主要临床症状、体征改善情况;以及治疗前后体重、BMI、腰围、臀围、WHR,多毛、痤疮评分、BBT、治疗前后性激素、GLU、INS、HOMA—IR、TG、Tc、HDL—C、LDL—C、ApoA、ApoB等疗效判定指标的改善情况。以及治疗前后检测一般安全性项目,及记录不良反应的发生。
研究结论
1.三组治疗均可以改善PCOS患者体内内分泌状况、在降低T水平上三组疗效无显著差异,西药组和针药结合组还可降低LH/FSH。
2.三组治疗均可改善PCOS患者体重指数、腰围、臀围,针药结合组治疗后体重、腰围、臀围下降最为明显,西药组和中药组组间疗效相当。
3.三组治疗均可改善PCOS患者IR,针药结合组与西药组在改善HOMA-IR方面的疗效优于单纯中药组,而西药组与针药结合组在改善HOMA—IR方面的疗效无统计学意义。
4.针药结合组可改善PCOS患者的血脂情况,在疗效上优于中药组和西药组。
5.三组治疗均可改善PCOS患者中医症状量化评分,中药组和针药结合组在改善中医症状方面疗效优于西药组。
6.根据本研究结果,我们推测补肾健脾、化痰祛瘀法灵术颗粒以及灵术颗粒联合穴位埋线治疗PCOS的机理可能是通过降低T水平,改善胰岛素抵抗,降低患者体重,而起到调节内分泌的作用,具有多靶点、多方面整体调节下丘脑-垂体-卵巢轴的功能,从而达到促进卵泡发育和排卵的作用,其中降低体质量可能起到关键作用。
7.根据上述客观研究结果,我们认为灵术颗粒,灵术颗粒联合穴位埋线是治疗PCOS合并IR患者的有效治疗方法。它可以明显降低体重、腰围、臀围,可以降低患者T水平,使患者月经规则、恢复排卵,且使部分不孕患者受孕,可通过降低T治疗高雄激素血症,改善座疮:可以降低FINS、HOMA-IR而改善胰岛素抵抗及因胰岛素抵抗引起的代偿性高胰岛素血症;针药结合组还可以改善血脂代谢情况。根据组间疗效差异比较,我们认为灵术颗粒联合穴位埋线在治疗PCOS并IR患者中起协同作用,疗效优于单纯中药治疗或单纯西药治疗。
8.根据上述客观研究结果,我们认为灵术颗粒联合穴位埋线可以通过降低体质量,改善胰岛素抵抗,改善血脂代谢情况,在某种程度上可降低PCOS的远期并发症如糖尿病、高血脂和心血管等疾病的风险。
Background
Polycystic ovary syndrome(PCOS) is a common endocrine syndrome of childbearing age women.Its incidence rate is as high as 5%to 10%,50%of which is caused by fatness,and 50%to 70%of them is caused by insulin resistance,which is a majority part in patients.Too much insulin acting on the corresponding receptor in the ovary will cause obstacles in follicular development and maturity and there won't any advanced follicles.This will thus lead to anovulation and infertility.In that case,the symptoms,such as rare menstruation,amenorrhea,acne,hirsutism,obesity,infertility and so on will emerge.At present,it is considered that insulin resistance and hyperinsulinemia play a key role in the pathogenesis of polycystic ovary syndrome.Insulin resistance is also a high risk factor for many clinical diseases.It may increase the incidence ratio of diabetes,cardiovascular disease and endometrial cancer and has long future harm.Hence,it is very important to explore and find an effective treatment method for PCOS and IR with fewer side effects,which is also effectively preventive to future complications.
Based on the existing treatises from former researchers and the long time clinical experiences accumulated by herself,TCM professor of our hospital Li Liyun,who is a provincial veteran,put forward the conclusion that the pathogenesis of polycystic ovary syndrome is basically in kidney deficiency and apparently in blood stasis and sputum obstacle.It is a deficiency-excess complication.So the method is tonifying the kidney,smoothing the sputum and invigorating the blood circulation to cure PCOS.She has established an experienced prescription and made the preparations,Necromancy Particle and Shenshi Capsule.Previous research has proved that these medicines do have healing effect onto the treatment of PCOS.Acupoint catgut embedding is a green acupuncture treatment rising in recent years,which is characterized by simplicity and cheapness.This treatment has a certain achievement on the treatment and research for obese patients.
It is rare to find some reports on the clinical healing effect,action principle of TCM combined with acupoint catgut embedding therapy for curing PCOS,and the intervening effect of this treatment to the risk factor IR, obesity and blood fat related to PCOS long future complication.The evaluation standard o the healing effect is also different with each other.There is an obvious lack of systematic and normative research.So according to the present TCM research status of PCOS and the limitation of Western Medicine,we are planning to establish a TCM and acupoint catgut embedding combined method to see whether this combined treatment method can play an important role on intervening and curing PCOS and the high risk factors of its long future complication with the benefit of the good treatment effect of acupoint catgut embedding for obesity and the experienced prescription of Necromancy Particle from professor Li Liyun for curing PCOS.
Objectives
Through comparing the clinical healing effect difference for PCOS between the Necromancy Particle from Professor Li Liyun,the most common medicine metformin for curing PCOS and IR in Western Medicine and the Necromancy Particle and acupoint catgut embedding combined treatment as well as observing improvement of menstruation,ovulation,body mass,reproductive endocrinology, insulin resistance,lipids,etc,this study is aiming at making objective evaluation to the clinical healing effects of Necromancy Particle and Necromancy Particle and acupoint catgut embedding combined treatment for PCOS and exploring the possible action mechanism in order to lay the foundation for the treatment method which has high efficiency and less side for curing PCOS and can also excellently prevent its long future complication.
Method
This study adopts forward looking clinical experiment research,chooses 77 PCOS and IR patients who went to Guangdong TCM Hospital to see gynecologic doctors during the time from February 2008 to February 2009 and are conforming to the diagnosis and adopting standard and divides them into three groups, TCM treatment group,Western Medicine treatment group and injection and medicine combined group.TCM treatment group has 28 patients and they are treated with the experienced prescription Necromancy Particle(domestic preparation,batch number:08102305).Western Medicine treatment group has 21 patients and they are treated with metformin(made in Shanghai).Injection and Medicine combined group has 28 patients and they are treated with Necromancy Particle and acupoint catgut embedding therapy,three months for each treatment period.This study evaluates the improvement situation of clinical symptoms and signs before and after the treatment,as well as the improvement situation of weight,BMI,waistline,hipline,WHR,hirsutism,acne scores,BBT,sex hormones before and after treatment,GLU,INS,HOMA-IR,TG, Tc,HDL-C,LDL-C,ApoA,ApoB and other indicators to determine efficacy, examines the general safety items before and after the treatment and records the occurrence of adverse reactions.
Conclusion
1.The treatment of all of the three groups can improve the endocrine status of PCOS patients.There is no significant difference with T level lowering between the three groups.The Western Medicine treatment group and injection and medicine combined group can also lower LH/FSH.
2.The treatment of all of the three groups can improve the weight index, waistline and hipline of PCOS patients.The weight,waistline and hipline loss is the most significant in injection and medicine combined group after the treatment.That of the Western Medicine treatment group and TCM treatment group is almost the same.
3.The treatment of all of the three groups can improve the IR of PCOS patients. The treatment of injection and medicine combined group and Western Medicine group has a better effect on HOMA-IR improvement than that of the TCM treatment group.There is no statistic importance to compare the HOMA-IR improvement effect of the Western Medicine group with that of the injection and medicine combined group.
4.Blood fat status can be improved in injection and medicine combined group. Its effect is better than that of the TCM group and Western Medicine group.
5.The treatment of all of the three groups can improve the quantitative scores of TCM symptoms of PCOS patients.The TCM group and injection and medicine combined group have a better effect than the Western Medicine group.
6.According to the results of this study,we suppose that the action principle of Necromancy Particle which is used to tonify the kidney,strengthen the spleen,smooth the sputum and remove obstacle,and Necromancy Particle and acupoint catgut embedding combined therapy for PCOS is to regulate the endocrine by lowering T level,improving insulin resistance and lowering the weight of patients.It has the function of regulating hypothalamus-pituitary -ovarian axis with multiple targets and overall aspect so as to achieve the promotion of follicular development and ovulation,Lowering the body mass may play a key role for that.
7.Based on above objective results,we think the Necromancy Particle and acupoint catgut embedding combined treatment is an effective treatment method for curing PCOS and IR.It can significantly lower weight,waistline,hipline, and T level,regulate menstruation,restore ovulation,make some patients with infertility become pregnant,cure hyperprolanemia by lowering T,improve acne, and improve insulin resistance and vicarious hyperinsulinemia caused by insulin resistance by lowering FINS and HOMA-IR.injection and medicine combined treatment can also improve the blood fat metabolism status.According to the curative effect differences between the groups,we think the Necromancy Particle and acupoint catgut embedding combined treatment has a synergy effect in the treatment of PCOS and IR patients.It is better than single TCM treatment or Western Medicine treatment.
8.According to the objective findings,we believe that the Necromancy Particle and acupoint catgut embedding combined treatment,through lowering the body mass,improving the insulin resistance and improving the blood fat metabolism status,can lower in a way the risk of PCOS long future complications,such as diabetes,high blood cholesterol,angiocardiopathy and so on.
引文
[1]Ehrmann DA.Polycystic ovary syndrome[J].N Engl J Med,2005;352(12):1223-1236.
[2]杨丹.多囊卵巢综合征促排卵治疗的新方案[J].国外医学计划生育分册.1998;17(3):153.
[3]苏华延.多囊卵巢综合征的治疗[J].生殖医学杂志,2000;9(5):304-309.
[4]Dianmnti KE,Piperi C,Spina J,Pt at Polyc) stic ovaiy syndrome:the influence of environmental and genetic factors[J].Hormones,2006;5(1):17-34
[5]Mullis PE,Yoshimura N,Kuhlmann B,et al.Aromatase deficiency in a female who is compound hererozygote for two new point mutations in the P450arom gene:impact of estrogens on hypergonadotropic hypogonadism,muhicystic ovaries,and bone densitometry in childhood.J Clin Endocrinol Metab,1997;82:1739-1745.
[6]Tong Y,Liao W X,Roy AC,et al.Association of ACCI polymorphism in the follicle-stimulating hormone bet a gene with polycystic ovarysyndrome.Fertil Steril,2000;74:1233-1236.
[7]Zhao SP,Tan g XM,Shao DH,et al.Association study between a polymorphism of aldosterone synthetase gene and the pathogenesis of polycystic ovary syndrome.Chin J Obstet Gyneol,2003;38:94-97.
[8]Tucci S,Eutterweit W,Concepcion ES,et al.Evidence for association of polycystic ovary syndrome in caucasian women with a marker at the insulin receptor gene locus.J Clin Endocrinol Metab,2001;86:446-449.
[9]Siegel S,Futterweit W,Davies TF,et al.A C/T single nucleotide polymorphism at the tyrosine kinase domain of the insulin receptor gene is associated with polycystic ovary syndrome.Fertl Steril,2002;78:1240-1243.
[10]Moran C,Huerta R,Conway-Myers BA,et al.Altered autophosphorylation of the insulin receptor in the ovary of a womarl with polycystic ovary syndrome.Fertil Stefil,2001;75:625-628.
[11]El Mkadem SA,Lautier C,Macari F,et al.Role of allelic variants gly972arg of irs-Ⅰ and gly1057asp of irs-2 in moderate-to-severe insulin resistance of women with polycystic ovary syndrome.Diabetes,2001;50:2164-2168.
[12]Barreca A,Del Monte P,Ponzani P,et al.IntrafOllicular insulin-like growth factor-Ⅱ levels in normally ovulating women and in patients with polycystic ovary syndrome.Fertil Steril,1996;65:739-745.
[13]Peral B,San Milan JL,CasteloR,et al.Comment:themethionine 196 arglnine polymorphism in exon 6 of the TNF receptor 2 gene(TNFRSFI B) is associated with the polycystic ovary syndrome and hyperandrogenism.J Clin Endocrinol Metab,2002;87:3977-3983.
[14]Dravecka I,Lazurova I,Kraus V.Obesity is maior factor determinning an insulin sensitivity and androgen production in women with anovulary cycles[J].Bretisl Lek Listy,2003;104(12):393-399.
[15]Endola KA,Zhou J,Adesanya oo,et al.Androgen stimulate early stages of follicular growth in the primate ovary[J].J Clin Invest,1998;101(12):2622-2629.
[16]Balen AH,Conway GS,Dieguez C.The role of leptinin reproduction:experimental and clinical aspects[J].Ann Med,2002;340:5.
[17]Shelling AM,Buon KA,Chand AL.Inhibin:A candidaegene for premate ovarian failure[J].Hum Reprod,2006;15:2644.
[18]Ovalle F and Azziz R.Insulin resistance,polycystic ovary synrome,and type 2 diabetes mellitus.Fertil Steril,2002;77:1095-1105.
[19]Ovalle F,Azziz R.Insulin resistance,polysystic ovary syndrome,and type 2 diabetes mellitus[J].Fertil steril,2002;77(6):1095-1105.
[20]Weiss JM,Polack S,Diedrich K,et aL.Effects of insulin on luteinizing hormone and prolactin secretion and calcium signaling in female rat pituitary cells[J].Arch Gynecol Obstet,2003;269(1):45-50.
[21]Kuscu NK,Koyuncu F,Ozbilgin K,et al.Insulin:does it induce folliclar arrest in the rat ovary[J].Gynecol Endocrinol,2002;16(5):361-364.
[22]Dunaif A,W u X,Lee A,et al.Defects in insulin receptor signaling in vivo in the polycystic ovary syndrome(PCOS).Am J Physiol Endocrinol Metab,2001;281:392-399.
[23]王竹晨,顾熊飞,杨冬梓,等.脂肪组织中胰岛素受体底物1蛋白的表达及酪氨酸磷酸化在多囊卵巢综合征发病中的作用[J].中华妇产科杂志,2005;40:20-123.
[24]邱红玉,初永丽,李曼,等.多囊卵巢综合征合并胰岛素抵抗患者脂肪组织胰岛素受体底物2蛋白的表达及酪氨酸磷酸化的研究[J].中华妇产科杂志,2005;,40:116-119.
[25]Corbould A,Kim YB,Youngren JF,et al.Insulin resistance in the skeletal muscle of women with PCOS involves intrinsic and acquired defects in insulin signaling.Am J Physiol EndocrinolM etab,2005,288:1047-1054.
[26]Chenniappan M.Insulin resistance and coronary artery disease[J].J Indian Med Assoc,2007;105(1):29 32,36.
[27]Deedwania PC.Clinical significance of cardiovascular dysmeta bolic syndrome[J].Curt Control Trials Cardiovasc Med,2002;3(1):2.
[28]Leroith D.Dyslipidemia and glucose dysregulation in over weight and obese patients[J].Clin Cornerstone,2007;8(3):38-52.
[29]Benson S,Janssen OE,Hahn S,et al.Obesity,depression,and chronic low grade inflammation in women with polycystic ovary syndrome.Brain Behav Imm un,2008;22:177-184
[30]Kravariti M,Naka KK,Kalantaridou SN,et al.Predictors of endothelial dysfunction in young women with polycystic ovary syndrome.[J]Clin Endocrinol Metab,2005;90:5088-5095.
[31]Escobar M HF,VIlluendasG,BotellaC JI,et al.Adiponectinand resisfin in PCOS:A clinical,biochemical and molecular genetic study[J].Hum Reprod,2006;21:2257-2265.
[32]Fedorcsa k P,Dale PO,Storeng R,Tan bo T,Abyholm T.Theimpact of obesity and insun resistance on the outcome of 1VF or 1CS1 in women with polycystic ovarian syndrome.Hum Reprod,2001;16:1086-1091.
[33]de Leo V,la Marca A,Petraglia F.insulin-lowering agents in the management of polycystic ovary syndrome[J].Endocr Rev,2003;24(5):633-637.
[34]Filicori M,Flamigni C,Dellai P.Treatment of an ovulation with pulsatile gonadotropin-releasing horm one:prognostic factors and clinical results in 600 cycles.J Clin Endocrinol Metab,1994;79:1215-1220.
[35]Morin-papunen L,Rautio K,Raokonen A.Meformin reduces serum crecctive protein levels in women with polycystic ovary syndrome[J].Clin Emdocrinol Medab,2003;88:4546.
[36]袁慧娟,自悦心,孙良阁.罗格列酮对多囊卵巢综合征的疗效观察[J].中华内分泌代谢杂志,2005;21:21.
[37]Strowitzki T,Halser B,Demant T.Bodyfatdistribution,insulin entitivity.Ovarian dysfunction and senlm lipe proteins in patients with polyeystieovary syndrome.Gynecol Endocrinol,2002;16(1):45-51
[38]Smoth U,Gogg S,Johansson A.Thiazolidinediones(PPARgamma agohists),but not PPA Rgamma agohists increase IRS-2 gene expression in 3T3-L1 and human a dipocytes[J].FASEB,2006;15(4):215.
[39]刘义,吕立群.罗格列酮治疗多囊卵巢综合征对改善内分泌、代谢及排卵功能 的疗效[J]．生殖医学杂志,2004；13(3)：143．
[40]Giusti V,Verdumo C,Suter M.Expression of peroxisome prolifrator aetiveted receptor r-1 and peroxisome prolifrator aetirated receptor-r-2 in risceral an d subcutan eous adipose tissue of obese women[J].Diabetes,2003;52(7):1673.
[41]Mohlig M,Spranger,OsterhofM.The polyeystie ovary syndrome peme is not associated with increased chronic intlammatlon[J].Ear J ndocrinol,2006;150(4):525.
[42]贾伟平．代谢综合征与胰岛素抵抗[J]．中华妇产科杂志,2004；39(9)：643-645
[43]Sam S,DunaifA.Polycystic ovary syndrome:syndrome XX?Trends Endocrinol Metab,2003;14:365-370.
[44]Glueck CJ,PapannaR,Wang P,etal.Incidence an d treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome.Metabolism,2003;52:908-915.
[45]Apridonidze T,Essab P,Luorno M,et al.Prevalence and charactefistics of the metabolic syndrome in women with polycystic ovarysyn drome.J Clin Endocrinol Metab,2005;90:1929-1935
[46]Legro RS,Kunselman AR,Dodson WC.Prevalence and predictors ofrisk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome:a prospective controlled study in 254 afected women.J Clin Endocrinol Metab,1999;84 (2):165-169
[47]Cuchel M,Rader DJ.The role of high density lipopmteins in thrombosis.Scientitic World Journal,2002;2:89-95
[48]Wild S.PierpointT,McKeigue P.etal.Cardiovascular disease in wolmen with polycystic ovary syndrome at long-term follow-up:respec—tive colaoll study.Clin Endocrinol,2000;52:595-600.
[49]Birdsall MA,Farquhar CM,White HD.Association between polycystic ovaries and extent of coronary artery disease in wonlen having cardiac catheterisatlon.Ann Intern Med,1997;126:32-35
[50]Wild RA,Aplebaum-Bowden D,Demers LM.Lipoprotein lipids in women with androgen exe~88:independent associations th increased insulin and androgen.Gin Chem,1990;36:283-289
[51]Birdsall MA,Farquhar CM,White HD.Association between polycystic ovaries and extent of coronary artery disease in wonlen having cardiac catheterisatlon.Ann Intern Med,1997;126:32-35
[52]Guziek DS,Talbott EO,Sutton—Tyrrell K et aL Carotid atherosclerosis in women with polyeystic ovary syndrome:initial results from a case—control study.Am J Obstet Gocol,1996;174:1224
[53]Carmina E.Dignosis of polycystic ovary syndrome:from NIH criteria to ESHRE-ASRM guidelines.Minerva Ginecol,2004;56(1):1-6.
[54]Saleh A M,Khalil H S.Review of nonsurgical and surgical treatment and the role of insulin-sensitizing agents in them anagement of infertile women with polycystic ovary syndrome[J]Acta Obstet Gynecol Scand,2004;83(7):614-621.
[55]Nestle J E.Should patients with polycystic ovarian syndrome betreated with metformin?:an enthusiastic endorsement[J].HumReprod,2002,17(8):1950—1953.
[56]Essah PA,Apridonidze T,luomo MJ,et al.Efects of short-term and long-term meformin treatment on menstrual cyclicity in women with olycystic ovary syndrome.Fertil Steril,2006;86(1):230-232
[57]Watts J.Understanding the causes and management of hirsutism.Nuts Tirues,2006;102(8):26-28
[58]HarborneL,FlemingR,LyallH,etal.Meformin or antiandrogen in the treatment of hirsutism in polycystic ovary syndrome.J Clin Endocrinol Metab,2003;88(4):4116-4123
[59]Harbome LR,Sattar N,Norman JE,et al.Meform in and weight losse in obese women with polycystic ovary syndrome:comparison of doses.J Clin Endecrinol Metab,2005;90(8):4593-4598
[60]Tang T,Glanville J,Hayden CJ,et al.Combined lifestyle modification and meform in in obese patients with polyeystie ovary syndrome.Arandomized,placebo-controlled,double-blind muhieentre study.HumReprod,2006;21(1):80-89
[61]Homburg R.Should patients with polycystic ovarian syndrome be treated with meformin?A note of cautious optimism[J].Hum Reprod,2002;17(4):853-856.
[62]HemingR.Hopkinson ZE,Wallace AM,et al.Ovarian function and metaolic formin in a randomized double blind placebo—controlled trial[J].J Clin Endocrinol Metab,2002;87(2):569-574.
[63]Costello MF,Eden JA.A systematic review of the reproductive system efects of metformin in patients with polycystic ovary syndrome[J].Fertil Steril,2003;79(1):1-13.
[64]Kashyap S,Wells GA,Rosenwaks Z.Insulin-sensitizing agents as primary therapy for patients with polycystic ovarian syndrome.Hum Reprod,2004;19(6):2474-2483
[65]Glueck CJ0 Salehi M,Sieve L,etal.Growth,motor,and social development n breast and form ulafed infants of mefon' nin treated women with polycystic ovary syndrome.J Pediatr,2006;148(5):628-632
[66]PalombaS,FalboA,OrioFJr,etal.Meform in hydrochloride and recurrent miscarriage in a womall with polyeystie ovary syndrome.Fertil Steril,2006;85(5):1511
[67]Vanky E,Salvesen KA,Heimstad R,et al.Meforrnin reduces pregnancy complications without effectsDand drogen levels inpregnant polyeystie ovary syndrome women:results of a ran domized study.Hum Repred,2004;19(6):1734-174
[68]Banaszewska B,DulebaAJ,Spaczynski RZ,etal.Lipids in polycystic ovary syndrome:role of hyperinsulinemia and Qffects of metformin.Am J Obstet Gynecol,2006;194(5):1266-1272
[69]Tankova T.Current indieations for meforrnin therapy.Rom J Intern Med,2003;41(3):215-225
[70]Palomba S.Russo T.erie F Jr,et 81.Uterine Qffects of meform in administration in anovulatory women with polyeystie ovary syndrome.Hum Reprod,2006;21(2):457-465
[71]Iuorno M J,Nestler J E.Insulin-lowering drugs in polycystic ovary syndrome[J].Obstet Gynecol Clin North Am,2001;28:153-164.
[72]Franks S,Adamas J,Mason H,et al.Ovulatory disorders in women with polycystic ovary syndrome.Clin Obestet Gynecol,1985;12:605-632.
[73]Wu CH,Winkel CA.The efect of therapy initiation day on clomiphene cit-rate therapy.Fertil Steftl.1989;52:564-568.
[74]Practice Committee of the American Society for Reproductive Medicine.Use of clomiphene citrate in women.Fertil Stefil,2003;80(5):130-1308.
[75]Costello M F,Eden I A.A systematic review of the reproductive systeme effects of metform in in patients with polycystic ovary syndrome[J].Fertil Steril,2003;79(1):1-13.
[76]Saleh A M,Khalil H S.Review of nonsurgical and surgical treatment and the role of insulin-sensitizing agents in them anagement of infertile women with polycystic ovary syndrome[J]Acta Obstet Gynecol Scand,2004;83(7): 614-621.
[77]Fauser BC,Van Heusden AM.Manipulation of human ovarian fucntiom physiological concepts and clinical consequences.Endo Rev,1997;18:71-106.
[78]Brown JB,Adey FD,Taft HP,et al.Factom involved in the induction of fertile ovulation with human gonadotopins.J Obstet Gynecol Br Commonw,1969;76:289-306.
[79]Balash J.Inducing follicular development in anovulatory patients and normally ovulating women:current concepts and the role of recombinant gonadotropins.In Assisted reproductive techniques,2001;W.A.Gardner DK,Howies CM,Shoham Z,ed.
[80]Hedon B,H.J,Emperaire JC,Chabaud JJ,et al.A comparative prospective study of a chronic low dose versus a conventional ovulation stiroulation regimen using recombinant human follicle stimdating hormone in anovulatory infertile women.Hum Reprod,1998;13:2688-2692.
[81]Fernandez-Moris.J,Vinuela,C.Pizarro,V,et al.Recombinant human folicle stimulating hormone(r-hFSH)in patients referred to ovulation induction(01):low dose step up verstls step down protocols.Fertil Stefil,2001;76(3),Suppl,S176.
[82]Van Santbrink EJ,0.P,van Dessel TJ,Fauser BC.Gonadotrophin induection of ovulation using a step-down dose regina:single-centre clinical experience in 82 patients.Hum Reprod.1995;10:1048-1053.
[83]Christin-Maitre S.Hugues JN,Recombinant FSH Study Group.A comparative randomized multicentric study comping the step-up versus stepdown protocol in polycystic ovary syndrome.Hum.Reprod.2003;18(8):1626-1631.
[84]Hugues JN,C.-D.I,Avril C,et al.Sequential step-up and step-down dose regime n:an alternative method for ovulation induction with follicle stimulating hormone in polycystic ovarian syndrome.Hum Reprod,1996;11:2581-2584.
[85]Dhaliwal-L-K,Sialy-R-K,Gopalan-S.Minimal stimulation protocol for use with intrauterine insemination in the treatment of Infertility.J-Obstet-Gynaecol.Res,2002;28(6):295-299
[86]Yildirim M,Noyan V Bulent TM,et al.Ovarian wedge resection by Minilaparatomy in inferlie patients with polycystic ovarian syndrome:A new technique[J].Eur J Obstet Gynecol Reprod Biol,2003;107(1):85-87.
[87]Ramzy AM,AllnanyH,Aboulfoutouh 1,et al.Uitrasonograpic guided ovarian Stroma ovary syndrome[J].Acta Obstet Gynecol Scand,2001;80(11):1046-1050.
[88]Clemann L,Lauszus FF,Trolle B.Laparoscopic ovary drilling as first line of treatment with polycystic ovary syndrome[J].Gynecol Endocrinol,2004;18(3):138-143.
[89]Pelosi MA,Pelosi MA.Laparosoopic eleetrosurglcal furrowing technique for the treatment of polycysticovaries[J].J Am Assoc Gynecol La paroscop,1996;4:57.
[90]章巧萍.补肾活血为主治疗多囊卵巢综合征21例[J].浙江中医学院学报,2002;26(3):25-26
[91]林至君.中药人 Ⅰ 周期疗法治疗 PCOS 的临床探讨[J].中医杂志,1984;1(6):2
[92]张帆.补肾化痰祛瘀法治疗多囊卵巢综合征35例[J].中医药学刊,2004;22(2):366-367
[93]孟宪斌,陈布,黄玉萍,等.多囊卵巢综合征的中医药治疗[J].肿瘤防治杂志,2000;7(5):543-544
[94]陈玲,王丽英,王昆.健脾益肾化痰汤治疗多囊卵巢综合征30例[J].江苏中医,1999;20(7):31
[95]史莲花,韩宁.褚玉霞教授治疗多囊卵巢综合征经验[J].四川中医,2004;22(1):1-2
[96]徐宏生,万瑞雄.浅谈中医诊治多囊卵巢综合征[J].湖北中医杂志,1998;20(5):33-34
[97]杨正望.尤昭玲教授诊治多囊卵巢综合征之经验总结[J].湖南中医学院学报,2003:23(4):23-25
[98]陆眉亚,汤昆.辨证治疗多囊卵巢综合征经验撷要[J].福建中医药,2003;34(6):18-19
[99]王兴娟.乘师心语-滋阴降火法治疗多囊卵巢综合征[J].上海中医药杂志,1999:1(12):22-23
[100]冯光荣.补肾活血法治疗多囊卵巢综合征[J].陕西中医学院学报,2004;27(2):63-64
[101]庞保珍.祛痰补肾法治疗无排卵不孕67例疗效观察[J].浙江中医杂志,1996;(11):496
[102]张风蝉,薛耀.中医药治疗多囊卵巢综合征方法初探[J].新中医,1991;(1):14-16
[103]王大增.龙胆泻肝汤清泻肝法治疗多囊卵巢综合征诱发排卵的体会[J].中西医结合杂志,1985;5(4):199-120
[104]闵静红.多囊卵巢综合征的辨治体[J].四川中医,2004;22(5):14-16
[105]刘丽清,蔡平平.戴德英治疗多囊卵巢综合征经验[J].中医杂志,2002;43(4):261-262
[106]候景玟,俞瑾,魏美娟.中药天癸方治疗多卵巢综合征中高雄激素、高胰岛素血症的研究.中国中西医结合杂志,2000;20(8):589-590.
[107]倪彦燕.温肾化瘀中药治疗多囊卵巢综合征疗效观察.江苏医学院学报,1999;99(1):108.
[108]郑恺.胆泻肝汤治疗多囊卵巢综合征40例.中国民间疗法,2000;8(7):35.
[109]胡章如.温肾涤痰汤治疗多卵巢综合征64例疗效观察[J].浙江中医学院学报,1999:23(1):40-41.
[110]陈珍治.涤痰汤加减治疗多卵巢综合征35例[J].浙江中医学院学报,1998;22(1):55.
[111]华苓,张巨明,柴松岩等.益肾健脾养血通利法治疗多囊卵巢综合征-附32例临床资料分析[J].北京中医杂志,2002;21(6):323-325.
[112]田萍,朱三,李力.启宫丸加减治疗多囊卵巢综合征30例[J].河南中医,1999;19(3):44.
[113]袁雄芳.中医周期疗法治疗多囊卵巢综合征38例[J].福建中医药,2003;34(2):22.
[114]陈秀芳.补肾疏肝化痰法治疗多卵巢综合征25例[J].新中医,1999;31(8):43-44.
[115]李亚平,张颖等.补肾化痰软坚法治疗多卵巢综合征30例[J].中医杂志,2001;42(6):376-377.
[116]桑海莉.补肾加针刺治疗多囊卵巢综合征35例临床观察[J].中医杂志,2000;7;4(7):412-413.
[117]费义娟,王晓滨,丛惠芳.电针治疗多囊卵巢综合征排卵障碍的临床观察30例[J].2001;17(12):18.
[118]杨越红,洪建云,魏达友.腹丛刺为主针刺治疗多囊卵巢综合征所致不孕的临床观察[J].中国医药论坛,2005;5(3):4-6.
[119]侣雪平,丛惠芳,王晓滨.针药并用治疗多囊卵巢综合征排卵障碍的疗效观察[J].针灸临床杂志,2007;23(8):35-36
[120]陈栋,陈恕仁,石晓兰,等.针挑治疗多囊卵巢综合征临床观察[J].中国针灸,2007;27(2):99-102
[121]黎小斌,李丽芸.导痰种子方联合克罗米芬治疗多囊卵巢综合征[J].实用医学杂志,2000;16(4):330-332
[122]黎小斌,李丽芸.腹腔镜手术辅以补肾化痰中药治疗多囊卵巢综合征[J].中药新药与临床药理,2002;13(2)
[123]陈虹,黎小斌.中西医治疗多囊卵巢综合征[J].国际医药卫生导报,2001;11:104-105
[124]胡向丹,黄旭晖.灵术冲剂联合参芪胶囊治疗多囊卵巢综合征34例[J].实用医学杂志,2007;23(18):2950-2951
[125]袁慧娟,汪艳芳,马书平,等.多囊卵巢综合征胰岛素抵抗特征及相关因素分析[J].临床心身疾病杂志,2006;12:4-6
[126]包玉倩,贾伟平,朱敏,等.快速相胰岛素分泌功能的评价[J].中华内分泌代谢杂志,2004;20:129-131
[127]史轶蘩主编.肥胖症临床诊治手册[M].上海:上海科技出版社,2001,2-5
[128]王浴生主编.中药药理与应用[M].人民卫生出版社,1983,1102
[129]丁按伟.现代中药临床手册[M].南京:江苏科学技术出版社,2000,337-338
[130]崔凤起.仙茅合剂对大鼠生殖系统老化的影响[J].佳木斯医学院学报,1994;17(3):4
[131]夏泉,张平,李绍平.当归的药理作用研究进展[J].时珍国医国药,2004;15(3):164
[132]张志萍,刘屏,丁飞.鸡血藤对高脂血症大鼠血浆超氧化物歧化酶和脂质过氧化物的影响[J].中国药理学会通讯,2000;17(3):15
[133]王巍.鸡血藤、鬼箭羽和土鳖虫调脂作用的比较[J].中国中药杂志,1991;16(5):299-302
[134]Huang QF,Wang ZM,Qi LZ.A survey of the treatment of obesity with acupuncture and moxibustion after the foundation of P.R.China.Shanghai Zhen Jiu Za Zhi.2006;25(2):40-41.Chinese with abstract in Egnlish.
[135]黄琴峰,赵善祥,黄颖.针灸治疗肥胖病的用穴统计分析[J].中西医结合学报,2007:5(6):695-696
[136]Vink J.Heritability of polycystic ovary syndrome in a Dutch twin family study.J Clin Endocrinol Metab,2005;91:2100-2104.
[137]Kent Sarah C.Gnatuk Carol I,Kunselm an Alien R,et al.Hy erandrogenism and hyperinsulinism in children of women with polycystic ovary syndrome:a controlled study.J Clin Endocrinol M etab,2008;93:1662-1669.
[138]Escobar M orreale HF.The moleculargenetic basis of functional hyperandrogenism and the polycystic ovary syndrome.Endoer Rev.2005;26:251-282.
[139]Benitez IR,Sir-Petermann T,Palomino A,1.Prevalence of metabolic disorders a long family members of patients with polycystic ovary syndrome[J].Rev ivied Chil,2001;129(7):707-712
[140]王王蓉,曹云霞,周平,等.多囊卵巢综合征患者家族疾病情况调查分析[J].疾病控制杂志,2008;12(1):11-13
[141]胡燕宁.青少年多囊卵巢综合征与其父母代谢综合征的相关性研究[J].现代中西医结合杂志,2008;173):335-337
[142]陈竺.医学遗传学[M].北京:人民卫生出版社,2001,91.
[143]罗丽兰.不孕与不育[M].北京:人民卫生出版社,2000,387-388
[144]张树成,沈明秀,蔡连香,等.补肾调经和养血补肾方药调经促排卵作用的实验研究[J].中医杂志,1999;40(6):369.
[145]文炯.补肾化瘀法治疗多囊卵巢综合征的研究进展[J].中医药导报,2001;14(3):84-86
[146]李翠萍,黄霞,郭丽华.补肾调周法对多囊卵巢大鼠血清胰岛素和抵抗素的影响[J].辽宁中医杂志,2008;35(11):1769-1771
[147]姚巧玲,李岷雯,帕而哈提·阿不都热依木,等.针刺对肥胖大鼠肥胖指标及脂肪组织形态学影响[J].新疆医科大学学报,2005;28(7):608-610
[148]赵玫,袁锦虹,李嘉,等.针刺对实验性肥胖大鼠下丘脑摄食中枢的影响[J].中国针灸,2001;21(5):305-306
[149]Christian RC,Dumesic DA,Behrenbeck T,et al.Prevalence and predlctom of coronary artery calcification in women with polycystic ovary syndrome[J].J Clin Endocrinol Metab,2003;88(6):2562-256
[150]李翠萍,黄霞,牛丽丽,等.补肾调周法对 PCO 大鼠排卵障碍干预的实验研究[J].山西中医,2008;24(5):46-48
[151]李喜莲,王针织,俞超芹.补肾活血化瘀方上调雄激素致不孕大鼠脂肪组织中胰岛素受体底物1及其酪氨酸磷酰化[J].中西医结合学报,2008;6(6):621-624
[152]车志英,季聚良.益气养阴活血化痰法对2型糖尿病胰岛素抵抗患者白介素-6及肿瘤坏死因子-a 的影响[J].时珍国医国药,2007;18(6):1402-14035.
[153]郝贤.益气养阴活血方对2型糖尿病胰岛素抵抗及血脂的影响[J].中国中医药科技,2006;13(3):274.
[154]姜艳华,李晓辉,李美芝.多囊卵巢综合征胰岛素抵抗患者的临床特征[J].实用妇产杂志,2001;17(5):2932.
[155]许金榜,林莺.健脾益肾活血法改善多囊卵巢综合征胰岛素抵抗理论探讨[J].福建中医学院学报,2005;15(2):50.
[156]何丽,郭盛,刘昌玉.健脾益气法对营养性肥胖大鼠胰岛素敏感指数及脂肪组织中肿瘤坏死因子-a 的影响[J].中国中医药信息杂志,2003;10(2):32-33.
[157]陈峰,吴凡,张艳.针刺对单纯性肥胖患者 TNF-β和 Resistin 水平的影响[J].针刺研究,2005;30(4):243
[158]刘志诚,孙凤岷,赵东红,等.针刺对肥胖大鼠瘦素水平和瘦素受体基因表达的作用[J].中国针灸,2003;23(7):412-416.
[159]刘志诚,孙凤岷,赵东红,等.针刺刺对肥胖大鼠脂肪组织 β-肾上腺素能受体的基因表达的影响[J].中医杂志,2003;44(7):503-505.
[160]Cuchel M,Rader DJ.The role of high density lipopmteins in thrombosis.Scientitic World Journal,2002;2:89-95
[161]杨卉,曹缵孙,安宁,等.二甲双胍对多囊卵巢综合征患者血脂水平的影响[J].西安交通大学学报(医学版),2002;23(4):363
[162]霍新慧,尹改珍,马琪.穴位埋线疗法对单纯性肥胖大鼠的影响[J].新疆医科大学学报,2008;31(1):31-33
[163]许倩,陈云慧,杨岚,等.穴位埋线治疗单纯性肥胖症78例[J].河北中医,2006:28(3):196.
[164]丛莘,金庆文,李莉芳,等.穴位埋线治疗肥胖型高血脂症及对血脂水平的影响[J].中国社区医生,2006;22(21):45-46.
[164]张静,许良智.多囊卵巢综合征的诊断[J].中华妇幼临床医学杂志,2006;2(5).296-298
[165]Carmina E.Dignosis of polycystic ovary syndrome:from NIH criteria to ESHRE-ASRM guidelines.Minerva Ginecol,2004;56(1):1-6.
[2]杨丹.多囊卵巢综合征促排卵治疗的新方案[J].国外医学计划生育分册.1998;17(3):153.
[3]苏华延.多囊卵巢综合征的治疗[J].生殖医学杂志,2000;9(5):304-309.
[4]Dianmnti KE,Piperi C,Spina J,Pt at Polyc) stic ovaiy syndrome:the influence of environmental and genetic factors[J].Hormones,2006;5(1):17-34
[5]Mullis PE,Yoshimura N,Kuhlmann B,et al.Aromatase deficiency in a female who is compound hererozygote for two new point mutations in the P450arom gene:impact of estrogens on hypergonadotropic hypogonadism,muhicystic ovaries,and bone densitometry in childhood.J Clin Endocrinol Metab,1997;82:1739-1745.
[6]Tong Y,Liao W X,Roy AC,et al.Association of ACCI polymorphism in the follicle-stimulating hormone bet a gene with polycystic ovarysyndrome.Fertil Steril,2000;74:1233-1236.
[7]Zhao SP,Tan g XM,Shao DH,et al.Association study between a polymorphism of aldosterone synthetase gene and the pathogenesis of polycystic ovary syndrome.Chin J Obstet Gyneol,2003;38:94-97.
[8]Tucci S,Eutterweit W,Concepcion ES,et al.Evidence for association of polycystic ovary syndrome in caucasian women with a marker at the insulin receptor gene locus.J Clin Endocrinol Metab,2001;86:446-449.
[9]Siegel S,Futterweit W,Davies TF,et al.A C/T single nucleotide polymorphism at the tyrosine kinase domain of the insulin receptor gene is associated with polycystic ovary syndrome.Fertl Steril,2002;78:1240-1243.
[10]Moran C,Huerta R,Conway-Myers BA,et al.Altered autophosphorylation of the insulin receptor in the ovary of a womarl with polycystic ovary syndrome.Fertil Stefil,2001;75:625-628.
[11]El Mkadem SA,Lautier C,Macari F,et al.Role of allelic variants gly972arg of irs-Ⅰ and gly1057asp of irs-2 in moderate-to-severe insulin resistance of women with polycystic ovary syndrome.Diabetes,2001;50:2164-2168.
[12]Barreca A,Del Monte P,Ponzani P,et al.IntrafOllicular insulin-like growth factor-Ⅱ levels in normally ovulating women and in patients with polycystic ovary syndrome.Fertil Steril,1996;65:739-745.
[13]Peral B,San Milan JL,CasteloR,et al.Comment:themethionine 196 arglnine polymorphism in exon 6 of the TNF receptor 2 gene(TNFRSFI B) is associated with the polycystic ovary syndrome and hyperandrogenism.J Clin Endocrinol Metab,2002;87:3977-3983.
[14]Dravecka I,Lazurova I,Kraus V.Obesity is maior factor determinning an insulin sensitivity and androgen production in women with anovulary cycles[J].Bretisl Lek Listy,2003;104(12):393-399.
[15]Endola KA,Zhou J,Adesanya oo,et al.Androgen stimulate early stages of follicular growth in the primate ovary[J].J Clin Invest,1998;101(12):2622-2629.
[16]Balen AH,Conway GS,Dieguez C.The role of leptinin reproduction:experimental and clinical aspects[J].Ann Med,2002;340:5.
[17]Shelling AM,Buon KA,Chand AL.Inhibin:A candidaegene for premate ovarian failure[J].Hum Reprod,2006;15:2644.
[18]Ovalle F and Azziz R.Insulin resistance,polycystic ovary synrome,and type 2 diabetes mellitus.Fertil Steril,2002;77:1095-1105.
[19]Ovalle F,Azziz R.Insulin resistance,polysystic ovary syndrome,and type 2 diabetes mellitus[J].Fertil steril,2002;77(6):1095-1105.
[20]Weiss JM,Polack S,Diedrich K,et aL.Effects of insulin on luteinizing hormone and prolactin secretion and calcium signaling in female rat pituitary cells[J].Arch Gynecol Obstet,2003;269(1):45-50.
[21]Kuscu NK,Koyuncu F,Ozbilgin K,et al.Insulin:does it induce folliclar arrest in the rat ovary[J].Gynecol Endocrinol,2002;16(5):361-364.
[22]Dunaif A,W u X,Lee A,et al.Defects in insulin receptor signaling in vivo in the polycystic ovary syndrome(PCOS).Am J Physiol Endocrinol Metab,2001;281:392-399.
[23]王竹晨,顾熊飞,杨冬梓,等.脂肪组织中胰岛素受体底物1蛋白的表达及酪氨酸磷酸化在多囊卵巢综合征发病中的作用[J].中华妇产科杂志,2005;40:20-123.
[24]邱红玉,初永丽,李曼,等.多囊卵巢综合征合并胰岛素抵抗患者脂肪组织胰岛素受体底物2蛋白的表达及酪氨酸磷酸化的研究[J].中华妇产科杂志,2005;,40:116-119.
[25]Corbould A,Kim YB,Youngren JF,et al.Insulin resistance in the skeletal muscle of women with PCOS involves intrinsic and acquired defects in insulin signaling.Am J Physiol EndocrinolM etab,2005,288:1047-1054.
[26]Chenniappan M.Insulin resistance and coronary artery disease[J].J Indian Med Assoc,2007;105(1):29 32,36.
[27]Deedwania PC.Clinical significance of cardiovascular dysmeta bolic syndrome[J].Curt Control Trials Cardiovasc Med,2002;3(1):2.
[28]Leroith D.Dyslipidemia and glucose dysregulation in over weight and obese patients[J].Clin Cornerstone,2007;8(3):38-52.
[29]Benson S,Janssen OE,Hahn S,et al.Obesity,depression,and chronic low grade inflammation in women with polycystic ovary syndrome.Brain Behav Imm un,2008;22:177-184
[30]Kravariti M,Naka KK,Kalantaridou SN,et al.Predictors of endothelial dysfunction in young women with polycystic ovary syndrome.[J]Clin Endocrinol Metab,2005;90:5088-5095.
[31]Escobar M HF,VIlluendasG,BotellaC JI,et al.Adiponectinand resisfin in PCOS:A clinical,biochemical and molecular genetic study[J].Hum Reprod,2006;21:2257-2265.
[32]Fedorcsa k P,Dale PO,Storeng R,Tan bo T,Abyholm T.Theimpact of obesity and insun resistance on the outcome of 1VF or 1CS1 in women with polycystic ovarian syndrome.Hum Reprod,2001;16:1086-1091.
[33]de Leo V,la Marca A,Petraglia F.insulin-lowering agents in the management of polycystic ovary syndrome[J].Endocr Rev,2003;24(5):633-637.
[34]Filicori M,Flamigni C,Dellai P.Treatment of an ovulation with pulsatile gonadotropin-releasing horm one:prognostic factors and clinical results in 600 cycles.J Clin Endocrinol Metab,1994;79:1215-1220.
[35]Morin-papunen L,Rautio K,Raokonen A.Meformin reduces serum crecctive protein levels in women with polycystic ovary syndrome[J].Clin Emdocrinol Medab,2003;88:4546.
[36]袁慧娟,自悦心,孙良阁.罗格列酮对多囊卵巢综合征的疗效观察[J].中华内分泌代谢杂志,2005;21:21.
[37]Strowitzki T,Halser B,Demant T.Bodyfatdistribution,insulin entitivity.Ovarian dysfunction and senlm lipe proteins in patients with polyeystieovary syndrome.Gynecol Endocrinol,2002;16(1):45-51
[38]Smoth U,Gogg S,Johansson A.Thiazolidinediones(PPARgamma agohists),but not PPA Rgamma agohists increase IRS-2 gene expression in 3T3-L1 and human a dipocytes[J].FASEB,2006;15(4):215.
[39]刘义,吕立群.罗格列酮治疗多囊卵巢综合征对改善内分泌、代谢及排卵功能 的疗效[J]．生殖医学杂志,2004；13(3)：143．
[40]Giusti V,Verdumo C,Suter M.Expression of peroxisome prolifrator aetiveted receptor r-1 and peroxisome prolifrator aetirated receptor-r-2 in risceral an d subcutan eous adipose tissue of obese women[J].Diabetes,2003;52(7):1673.
[41]Mohlig M,Spranger,OsterhofM.The polyeystie ovary syndrome peme is not associated with increased chronic intlammatlon[J].Ear J ndocrinol,2006;150(4):525.
[42]贾伟平．代谢综合征与胰岛素抵抗[J]．中华妇产科杂志,2004；39(9)：643-645
[43]Sam S,DunaifA.Polycystic ovary syndrome:syndrome XX?Trends Endocrinol Metab,2003;14:365-370.
[44]Glueck CJ,PapannaR,Wang P,etal.Incidence an d treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome.Metabolism,2003;52:908-915.
[45]Apridonidze T,Essab P,Luorno M,et al.Prevalence and charactefistics of the metabolic syndrome in women with polycystic ovarysyn drome.J Clin Endocrinol Metab,2005;90:1929-1935
[46]Legro RS,Kunselman AR,Dodson WC.Prevalence and predictors ofrisk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome:a prospective controlled study in 254 afected women.J Clin Endocrinol Metab,1999;84 (2):165-169
[47]Cuchel M,Rader DJ.The role of high density lipopmteins in thrombosis.Scientitic World Journal,2002;2:89-95
[48]Wild S.PierpointT,McKeigue P.etal.Cardiovascular disease in wolmen with polycystic ovary syndrome at long-term follow-up:respec—tive colaoll study.Clin Endocrinol,2000;52:595-600.
[49]Birdsall MA,Farquhar CM,White HD.Association between polycystic ovaries and extent of coronary artery disease in wonlen having cardiac catheterisatlon.Ann Intern Med,1997;126:32-35
[50]Wild RA,Aplebaum-Bowden D,Demers LM.Lipoprotein lipids in women with androgen exe~88:independent associations th increased insulin and androgen.Gin Chem,1990;36:283-289
[51]Birdsall MA,Farquhar CM,White HD.Association between polycystic ovaries and extent of coronary artery disease in wonlen having cardiac catheterisatlon.Ann Intern Med,1997;126:32-35
[52]Guziek DS,Talbott EO,Sutton—Tyrrell K et aL Carotid atherosclerosis in women with polyeystic ovary syndrome:initial results from a case—control study.Am J Obstet Gocol,1996;174:1224
[53]Carmina E.Dignosis of polycystic ovary syndrome:from NIH criteria to ESHRE-ASRM guidelines.Minerva Ginecol,2004;56(1):1-6.
[54]Saleh A M,Khalil H S.Review of nonsurgical and surgical treatment and the role of insulin-sensitizing agents in them anagement of infertile women with polycystic ovary syndrome[J]Acta Obstet Gynecol Scand,2004;83(7):614-621.
[55]Nestle J E.Should patients with polycystic ovarian syndrome betreated with metformin?:an enthusiastic endorsement[J].HumReprod,2002,17(8):1950—1953.
[56]Essah PA,Apridonidze T,luomo MJ,et al.Efects of short-term and long-term meformin treatment on menstrual cyclicity in women with olycystic ovary syndrome.Fertil Steril,2006;86(1):230-232
[57]Watts J.Understanding the causes and management of hirsutism.Nuts Tirues,2006;102(8):26-28
[58]HarborneL,FlemingR,LyallH,etal.Meformin or antiandrogen in the treatment of hirsutism in polycystic ovary syndrome.J Clin Endocrinol Metab,2003;88(4):4116-4123
[59]Harbome LR,Sattar N,Norman JE,et al.Meform in and weight losse in obese women with polycystic ovary syndrome:comparison of doses.J Clin Endecrinol Metab,2005;90(8):4593-4598
[60]Tang T,Glanville J,Hayden CJ,et al.Combined lifestyle modification and meform in in obese patients with polyeystie ovary syndrome.Arandomized,placebo-controlled,double-blind muhieentre study.HumReprod,2006;21(1):80-89
[61]Homburg R.Should patients with polycystic ovarian syndrome be treated with meformin?A note of cautious optimism[J].Hum Reprod,2002;17(4):853-856.
[62]HemingR.Hopkinson ZE,Wallace AM,et al.Ovarian function and metaolic formin in a randomized double blind placebo—controlled trial[J].J Clin Endocrinol Metab,2002;87(2):569-574.
[63]Costello MF,Eden JA.A systematic review of the reproductive system efects of metformin in patients with polycystic ovary syndrome[J].Fertil Steril,2003;79(1):1-13.
[64]Kashyap S,Wells GA,Rosenwaks Z.Insulin-sensitizing agents as primary therapy for patients with polycystic ovarian syndrome.Hum Reprod,2004;19(6):2474-2483
[65]Glueck CJ0 Salehi M,Sieve L,etal.Growth,motor,and social development n breast and form ulafed infants of mefon' nin treated women with polycystic ovary syndrome.J Pediatr,2006;148(5):628-632
[66]PalombaS,FalboA,OrioFJr,etal.Meform in hydrochloride and recurrent miscarriage in a womall with polyeystie ovary syndrome.Fertil Steril,2006;85(5):1511
[67]Vanky E,Salvesen KA,Heimstad R,et al.Meforrnin reduces pregnancy complications without effectsDand drogen levels inpregnant polyeystie ovary syndrome women:results of a ran domized study.Hum Repred,2004;19(6):1734-174
[68]Banaszewska B,DulebaAJ,Spaczynski RZ,etal.Lipids in polycystic ovary syndrome:role of hyperinsulinemia and Qffects of metformin.Am J Obstet Gynecol,2006;194(5):1266-1272
[69]Tankova T.Current indieations for meforrnin therapy.Rom J Intern Med,2003;41(3):215-225
[70]Palomba S.Russo T.erie F Jr,et 81.Uterine Qffects of meform in administration in anovulatory women with polyeystie ovary syndrome.Hum Reprod,2006;21(2):457-465
[71]Iuorno M J,Nestler J E.Insulin-lowering drugs in polycystic ovary syndrome[J].Obstet Gynecol Clin North Am,2001;28:153-164.
[72]Franks S,Adamas J,Mason H,et al.Ovulatory disorders in women with polycystic ovary syndrome.Clin Obestet Gynecol,1985;12:605-632.
[73]Wu CH,Winkel CA.The efect of therapy initiation day on clomiphene cit-rate therapy.Fertil Steftl.1989;52:564-568.
[74]Practice Committee of the American Society for Reproductive Medicine.Use of clomiphene citrate in women.Fertil Stefil,2003;80(5):130-1308.
[75]Costello M F,Eden I A.A systematic review of the reproductive systeme effects of metform in in patients with polycystic ovary syndrome[J].Fertil Steril,2003;79(1):1-13.
[76]Saleh A M,Khalil H S.Review of nonsurgical and surgical treatment and the role of insulin-sensitizing agents in them anagement of infertile women with polycystic ovary syndrome[J]Acta Obstet Gynecol Scand,2004;83(7): 614-621.
[77]Fauser BC,Van Heusden AM.Manipulation of human ovarian fucntiom physiological concepts and clinical consequences.Endo Rev,1997;18:71-106.
[78]Brown JB,Adey FD,Taft HP,et al.Factom involved in the induction of fertile ovulation with human gonadotopins.J Obstet Gynecol Br Commonw,1969;76:289-306.
[79]Balash J.Inducing follicular development in anovulatory patients and normally ovulating women:current concepts and the role of recombinant gonadotropins.In Assisted reproductive techniques,2001;W.A.Gardner DK,Howies CM,Shoham Z,ed.
[80]Hedon B,H.J,Emperaire JC,Chabaud JJ,et al.A comparative prospective study of a chronic low dose versus a conventional ovulation stiroulation regimen using recombinant human follicle stimdating hormone in anovulatory infertile women.Hum Reprod,1998;13:2688-2692.
[81]Fernandez-Moris.J,Vinuela,C.Pizarro,V,et al.Recombinant human folicle stimulating hormone(r-hFSH)in patients referred to ovulation induction(01):low dose step up verstls step down protocols.Fertil Stefil,2001;76(3),Suppl,S176.
[82]Van Santbrink EJ,0.P,van Dessel TJ,Fauser BC.Gonadotrophin induection of ovulation using a step-down dose regina:single-centre clinical experience in 82 patients.Hum Reprod.1995;10:1048-1053.
[83]Christin-Maitre S.Hugues JN,Recombinant FSH Study Group.A comparative randomized multicentric study comping the step-up versus stepdown protocol in polycystic ovary syndrome.Hum.Reprod.2003;18(8):1626-1631.
[84]Hugues JN,C.-D.I,Avril C,et al.Sequential step-up and step-down dose regime n:an alternative method for ovulation induction with follicle stimulating hormone in polycystic ovarian syndrome.Hum Reprod,1996;11:2581-2584.
[85]Dhaliwal-L-K,Sialy-R-K,Gopalan-S.Minimal stimulation protocol for use with intrauterine insemination in the treatment of Infertility.J-Obstet-Gynaecol.Res,2002;28(6):295-299
[86]Yildirim M,Noyan V Bulent TM,et al.Ovarian wedge resection by Minilaparatomy in inferlie patients with polycystic ovarian syndrome:A new technique[J].Eur J Obstet Gynecol Reprod Biol,2003;107(1):85-87.
[87]Ramzy AM,AllnanyH,Aboulfoutouh 1,et al.Uitrasonograpic guided ovarian Stroma ovary syndrome[J].Acta Obstet Gynecol Scand,2001;80(11):1046-1050.
[88]Clemann L,Lauszus FF,Trolle B.Laparoscopic ovary drilling as first line of treatment with polycystic ovary syndrome[J].Gynecol Endocrinol,2004;18(3):138-143.
[89]Pelosi MA,Pelosi MA.Laparosoopic eleetrosurglcal furrowing technique for the treatment of polycysticovaries[J].J Am Assoc Gynecol La paroscop,1996;4:57.
[90]章巧萍.补肾活血为主治疗多囊卵巢综合征21例[J].浙江中医学院学报,2002;26(3):25-26
[91]林至君.中药人 Ⅰ 周期疗法治疗 PCOS 的临床探讨[J].中医杂志,1984;1(6):2
[92]张帆.补肾化痰祛瘀法治疗多囊卵巢综合征35例[J].中医药学刊,2004;22(2):366-367
[93]孟宪斌,陈布,黄玉萍,等.多囊卵巢综合征的中医药治疗[J].肿瘤防治杂志,2000;7(5):543-544
[94]陈玲,王丽英,王昆.健脾益肾化痰汤治疗多囊卵巢综合征30例[J].江苏中医,1999;20(7):31
[95]史莲花,韩宁.褚玉霞教授治疗多囊卵巢综合征经验[J].四川中医,2004;22(1):1-2
[96]徐宏生,万瑞雄.浅谈中医诊治多囊卵巢综合征[J].湖北中医杂志,1998;20(5):33-34
[97]杨正望.尤昭玲教授诊治多囊卵巢综合征之经验总结[J].湖南中医学院学报,2003:23(4):23-25
[98]陆眉亚,汤昆.辨证治疗多囊卵巢综合征经验撷要[J].福建中医药,2003;34(6):18-19
[99]王兴娟.乘师心语-滋阴降火法治疗多囊卵巢综合征[J].上海中医药杂志,1999:1(12):22-23
[100]冯光荣.补肾活血法治疗多囊卵巢综合征[J].陕西中医学院学报,2004;27(2):63-64
[101]庞保珍.祛痰补肾法治疗无排卵不孕67例疗效观察[J].浙江中医杂志,1996;(11):496
[102]张风蝉,薛耀.中医药治疗多囊卵巢综合征方法初探[J].新中医,1991;(1):14-16
[103]王大增.龙胆泻肝汤清泻肝法治疗多囊卵巢综合征诱发排卵的体会[J].中西医结合杂志,1985;5(4):199-120
[104]闵静红.多囊卵巢综合征的辨治体[J].四川中医,2004;22(5):14-16
[105]刘丽清,蔡平平.戴德英治疗多囊卵巢综合征经验[J].中医杂志,2002;43(4):261-262
[106]候景玟,俞瑾,魏美娟.中药天癸方治疗多卵巢综合征中高雄激素、高胰岛素血症的研究.中国中西医结合杂志,2000;20(8):589-590.
[107]倪彦燕.温肾化瘀中药治疗多囊卵巢综合征疗效观察.江苏医学院学报,1999;99(1):108.
[108]郑恺.胆泻肝汤治疗多囊卵巢综合征40例.中国民间疗法,2000;8(7):35.
[109]胡章如.温肾涤痰汤治疗多卵巢综合征64例疗效观察[J].浙江中医学院学报,1999:23(1):40-41.
[110]陈珍治.涤痰汤加减治疗多卵巢综合征35例[J].浙江中医学院学报,1998;22(1):55.
[111]华苓,张巨明,柴松岩等.益肾健脾养血通利法治疗多囊卵巢综合征-附32例临床资料分析[J].北京中医杂志,2002;21(6):323-325.
[112]田萍,朱三,李力.启宫丸加减治疗多囊卵巢综合征30例[J].河南中医,1999;19(3):44.
[113]袁雄芳.中医周期疗法治疗多囊卵巢综合征38例[J].福建中医药,2003;34(2):22.
[114]陈秀芳.补肾疏肝化痰法治疗多卵巢综合征25例[J].新中医,1999;31(8):43-44.
[115]李亚平,张颖等.补肾化痰软坚法治疗多卵巢综合征30例[J].中医杂志,2001;42(6):376-377.
[116]桑海莉.补肾加针刺治疗多囊卵巢综合征35例临床观察[J].中医杂志,2000;7;4(7):412-413.
[117]费义娟,王晓滨,丛惠芳.电针治疗多囊卵巢综合征排卵障碍的临床观察30例[J].2001;17(12):18.
[118]杨越红,洪建云,魏达友.腹丛刺为主针刺治疗多囊卵巢综合征所致不孕的临床观察[J].中国医药论坛,2005;5(3):4-6.
[119]侣雪平,丛惠芳,王晓滨.针药并用治疗多囊卵巢综合征排卵障碍的疗效观察[J].针灸临床杂志,2007;23(8):35-36
[120]陈栋,陈恕仁,石晓兰,等.针挑治疗多囊卵巢综合征临床观察[J].中国针灸,2007;27(2):99-102
[121]黎小斌,李丽芸.导痰种子方联合克罗米芬治疗多囊卵巢综合征[J].实用医学杂志,2000;16(4):330-332
[122]黎小斌,李丽芸.腹腔镜手术辅以补肾化痰中药治疗多囊卵巢综合征[J].中药新药与临床药理,2002;13(2)
[123]陈虹,黎小斌.中西医治疗多囊卵巢综合征[J].国际医药卫生导报,2001;11:104-105
[124]胡向丹,黄旭晖.灵术冲剂联合参芪胶囊治疗多囊卵巢综合征34例[J].实用医学杂志,2007;23(18):2950-2951
[125]袁慧娟,汪艳芳,马书平,等.多囊卵巢综合征胰岛素抵抗特征及相关因素分析[J].临床心身疾病杂志,2006;12:4-6
[126]包玉倩,贾伟平,朱敏,等.快速相胰岛素分泌功能的评价[J].中华内分泌代谢杂志,2004;20:129-131
[127]史轶蘩主编.肥胖症临床诊治手册[M].上海:上海科技出版社,2001,2-5
[128]王浴生主编.中药药理与应用[M].人民卫生出版社,1983,1102
[129]丁按伟.现代中药临床手册[M].南京:江苏科学技术出版社,2000,337-338
[130]崔凤起.仙茅合剂对大鼠生殖系统老化的影响[J].佳木斯医学院学报,1994;17(3):4
[131]夏泉,张平,李绍平.当归的药理作用研究进展[J].时珍国医国药,2004;15(3):164
[132]张志萍,刘屏,丁飞.鸡血藤对高脂血症大鼠血浆超氧化物歧化酶和脂质过氧化物的影响[J].中国药理学会通讯,2000;17(3):15
[133]王巍.鸡血藤、鬼箭羽和土鳖虫调脂作用的比较[J].中国中药杂志,1991;16(5):299-302
[134]Huang QF,Wang ZM,Qi LZ.A survey of the treatment of obesity with acupuncture and moxibustion after the foundation of P.R.China.Shanghai Zhen Jiu Za Zhi.2006;25(2):40-41.Chinese with abstract in Egnlish.
[135]黄琴峰,赵善祥,黄颖.针灸治疗肥胖病的用穴统计分析[J].中西医结合学报,2007:5(6):695-696
[136]Vink J.Heritability of polycystic ovary syndrome in a Dutch twin family study.J Clin Endocrinol Metab,2005;91:2100-2104.
[137]Kent Sarah C.Gnatuk Carol I,Kunselm an Alien R,et al.Hy erandrogenism and hyperinsulinism in children of women with polycystic ovary syndrome:a controlled study.J Clin Endocrinol M etab,2008;93:1662-1669.
[138]Escobar M orreale HF.The moleculargenetic basis of functional hyperandrogenism and the polycystic ovary syndrome.Endoer Rev.2005;26:251-282.
[139]Benitez IR,Sir-Petermann T,Palomino A,1.Prevalence of metabolic disorders a long family members of patients with polycystic ovary syndrome[J].Rev ivied Chil,2001;129(7):707-712
[140]王王蓉,曹云霞,周平,等.多囊卵巢综合征患者家族疾病情况调查分析[J].疾病控制杂志,2008;12(1):11-13
[141]胡燕宁.青少年多囊卵巢综合征与其父母代谢综合征的相关性研究[J].现代中西医结合杂志,2008;173):335-337
[142]陈竺.医学遗传学[M].北京:人民卫生出版社,2001,91.
[143]罗丽兰.不孕与不育[M].北京:人民卫生出版社,2000,387-388
[144]张树成,沈明秀,蔡连香,等.补肾调经和养血补肾方药调经促排卵作用的实验研究[J].中医杂志,1999;40(6):369.
[145]文炯.补肾化瘀法治疗多囊卵巢综合征的研究进展[J].中医药导报,2001;14(3):84-86
[146]李翠萍,黄霞,郭丽华.补肾调周法对多囊卵巢大鼠血清胰岛素和抵抗素的影响[J].辽宁中医杂志,2008;35(11):1769-1771
[147]姚巧玲,李岷雯,帕而哈提·阿不都热依木,等.针刺对肥胖大鼠肥胖指标及脂肪组织形态学影响[J].新疆医科大学学报,2005;28(7):608-610
[148]赵玫,袁锦虹,李嘉,等.针刺对实验性肥胖大鼠下丘脑摄食中枢的影响[J].中国针灸,2001;21(5):305-306
[149]Christian RC,Dumesic DA,Behrenbeck T,et al.Prevalence and predlctom of coronary artery calcification in women with polycystic ovary syndrome[J].J Clin Endocrinol Metab,2003;88(6):2562-256
[150]李翠萍,黄霞,牛丽丽,等.补肾调周法对 PCO 大鼠排卵障碍干预的实验研究[J].山西中医,2008;24(5):46-48
[151]李喜莲,王针织,俞超芹.补肾活血化瘀方上调雄激素致不孕大鼠脂肪组织中胰岛素受体底物1及其酪氨酸磷酰化[J].中西医结合学报,2008;6(6):621-624
[152]车志英,季聚良.益气养阴活血化痰法对2型糖尿病胰岛素抵抗患者白介素-6及肿瘤坏死因子-a 的影响[J].时珍国医国药,2007;18(6):1402-14035.
[153]郝贤.益气养阴活血方对2型糖尿病胰岛素抵抗及血脂的影响[J].中国中医药科技,2006;13(3):274.
[154]姜艳华,李晓辉,李美芝.多囊卵巢综合征胰岛素抵抗患者的临床特征[J].实用妇产杂志,2001;17(5):2932.
[155]许金榜,林莺.健脾益肾活血法改善多囊卵巢综合征胰岛素抵抗理论探讨[J].福建中医学院学报,2005;15(2):50.
[156]何丽,郭盛,刘昌玉.健脾益气法对营养性肥胖大鼠胰岛素敏感指数及脂肪组织中肿瘤坏死因子-a 的影响[J].中国中医药信息杂志,2003;10(2):32-33.
[157]陈峰,吴凡,张艳.针刺对单纯性肥胖患者 TNF-β和 Resistin 水平的影响[J].针刺研究,2005;30(4):243
[158]刘志诚,孙凤岷,赵东红,等.针刺对肥胖大鼠瘦素水平和瘦素受体基因表达的作用[J].中国针灸,2003;23(7):412-416.
[159]刘志诚,孙凤岷,赵东红,等.针刺刺对肥胖大鼠脂肪组织 β-肾上腺素能受体的基因表达的影响[J].中医杂志,2003;44(7):503-505.
[160]Cuchel M,Rader DJ.The role of high density lipopmteins in thrombosis.Scientitic World Journal,2002;2:89-95
[161]杨卉,曹缵孙,安宁,等.二甲双胍对多囊卵巢综合征患者血脂水平的影响[J].西安交通大学学报(医学版),2002;23(4):363
[162]霍新慧,尹改珍,马琪.穴位埋线疗法对单纯性肥胖大鼠的影响[J].新疆医科大学学报,2008;31(1):31-33
[163]许倩,陈云慧,杨岚,等.穴位埋线治疗单纯性肥胖症78例[J].河北中医,2006:28(3):196.
[164]丛莘,金庆文,李莉芳,等.穴位埋线治疗肥胖型高血脂症及对血脂水平的影响[J].中国社区医生,2006;22(21):45-46.
[164]张静,许良智.多囊卵巢综合征的诊断[J].中华妇幼临床医学杂志,2006;2(5).296-298
[165]Carmina E.Dignosis of polycystic ovary syndrome:from NIH criteria to ESHRE-ASRM guidelines.Minerva Ginecol,2004;56(1):1-6.