青春期多囊卵巢综合征诊断及治疗策略研究进展

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摘要多囊卵巢综合征（PCOS）是育龄期女性最常见的内分泌疾病，多始于青春期。青春期PCOS是目前备受妇科及儿科内分泌学家关注的疾病，因其临床特征与青春期生理性表现重叠，诊断标准目前尚存在争议。目前对青春期PCOS诊断，《多囊卵巢综合征中国诊疗指南》推荐必须同时符合2003年鹿特丹诊断标准中的3个指标，同时应排除其他导致雄激素水平升高的病因及其他引起排卵障碍的疾病。青春期PCOS的治疗应根据其临床症状及体征的不同，采用多种治疗方法联合的策略，调整月经周期，纠正性激素及糖脂代谢异常，改善其他临床症状并预防远期并发症的发生。近年来，除生活方式调整、口服避孕药和胰岛素增敏剂等治疗方案外，补充替代医学疗法如自然疗法、瑜伽、穴位埋线和耳穴压籽也逐步应用于青春期PCOS的干预，且获得了良好的疗效。本文就青春期PCOS国内外诊治进展进行综述。

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	李妍1 侯丽辉2 张美微3

关键词 ：青春期, 多囊卵巢综合征, 诊断标准, 治疗策略

Abstract：Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, and the onset of PCOS is in puberty. Adolescent PCOS is a disease concerned by gynecologists and pediatric endocrinologists because of overlapping clinical features and physiological manifestations of puberty, the diagnostic criterion for adolescent PCOS is still controversial. At present, guidelines for the diagnosis and treatment of polycystic ovarian syndrome in China suggests that diagnostic criterion for adolescent PCOS should fulfill all the three indexes of 2003 Rotterdam PCOS diagnostic criterion and exclusion of other causes of elevated androgen levels and other diseases that cause ovulation disorders. Treatment strategy of adolescent PCOS should be focused on using multiple treatments to adjust menstrual cycle, correct abnormal sex hormones and glucolipid metabolism, improve other clinical symptoms and prevent long-term complications, according to different clinical symptoms and signs. In addition to lifestyle intervention, oral contraceptives, insulin sensitizer and so on, complementary and alternative medicine managements such as natural therapies, yoga asana practice, acupoint catgut embedding and auricular acupressure are also used in treating adolescent PCOS and have obtained good curative effects. The present study reviewed the progress of diagnosis and treatment on adolescent PCOS at home and abroad.

Key words： Adolescent Polycystic ovary syndrome Diagnosis criterion Treatment strategy

基金资助:国家自然科学基金资助项目（81804139）；
国家中医药管理局国家中医临床研究基地业务建设科研专项课题（JDZX2015058）。

通讯作者: 侯丽辉（1951.12-）女，教授，博士研究生导师；研究方向：妇科内分泌疾病。

作者简介: 李妍（1981.1-），女，博士，副主任医师；研究方向：妇科内分泌疾病。

引用本文:

李妍1 侯丽辉2 张美微3. 青春期多囊卵巢综合征诊断及治疗策略研究进展[J]. 中国医药导报, 2018, 15(34): 41-44.
LI Yan1 HOU Lihui2 ZHANG Meiwei3. Research progress on the diagnosis criteria and treatment strategy of adolescent polycystic ovary syndrome. 中国医药导报, 2018, 15(34): 41-44.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I34/41

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