多囊卵巢综合症课件.ppt

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PolycysticOvarySyndrome9/2/2021 IntroductionPCOSistheabbreviationpolycysticovarysyndromePCOSisamultifactorialpathogenisisandclinicalmanifestationinwomenPCOSisanendocrinedysfunction,specificallyabnormalandrogenandmetabolism.9/2/2021 Etiology&Pathopysiology1.Abnormalgonadotropinsecretion2.HypersecretionofandrogensDisruptsfolliclematuration3.Insulinresistance,Elevatedinsulinlevels9/2/2021 PathologyOvaries:enlargedand/orpolycysticovariesendometrium:Lackofovulationforanextendedperiodoftimemaycauseexcessivethickeningoftheendometrium9/2/2021 Pathology9/2/2021 SymptomsIrregularorLackofMenses9/2/2021 SymptomsHirsutismExcessivebodyhair.Coarsehairappearontheface,neck,chest,arms,andinbetweenthelegs.9/2/2021 Symptomsmorbidobesity.9/2/2021 SymptomsAcneMoreandrogencausedskinoilsandblockedporesandmoreacnearoundthejawline,armsandchest.9/2/2021 SymptomsAlopeciaThinningorlossofhairisusuallycontainedtotopofthescalp,butotherslossofhairinfrontoronthehairlinehasbeendocumented.9/2/2021 OtherSymptomsAcanthosisNigricansThisconditioncauseslightbrowntoblackroughpatchesaroundtheneckandunderarms.9/2/2021 OtherSymptomsMigrainesSevereheadachesthatcauselightsensitivity,nauseaanddizziness.9/2/2021 DiagnosisBBT(basalbodytemperature)Bultrasound:multiplesmallovariancystsenlargedovaryEndometriumbiopsybeforemensesrevealtoproliferativeglandsDeterminationofLH,FSH,E2,P,T,PRL，Ins，(LH:FSH≧3:1)Laparoscopy9/2/2021 TreatmentIfpregnancyisdesired----causeovulationanti-estrogens(CC)Gonadotropins(Gn)insulin-loweringagents(MET)anti-androgensgonadotropinreleasinghormoneagonists(GnRHa)9/2/2021 IfpregnancyisnotdesiredToreducetheriskofendometrialcancercyclicalprogesterone(MPA)insulin-loweringagents(MET)anti-androgens.Treatment9/2/2021 LongTermEffects:InfertilityManywomenexperienceinfertilitywhilehavingPCOS.Manywillhavetogotoanfertilitydoctortoconceive.ToconceivewomenwithPCOShavetolearntomonitorovulationbytakingtheirBasalBodyTemperature(BBT)andexaminingcervicalmucus.9/2/2021 LongTermEffects:HeartDiseaseThereisnewevidencethatfindswomenwithPCOSareatahigherriskformetaboliccardiovasculardisease.Bothdiseasesarecharacterizedbyinsulinresistance,highbloodpressure,andobesity.9/2/2021 TCMforPCOSawareness肾虚Kidneydeficiency气滞血瘀Qistagnationandbloodstasis痰湿Phlegm肝经郁火Liverheat9/2/2021 TCMdiagnosisOligomenorrheawaistacheObesityAndsoon9/2/2021 TCMtreatmentKidneydeficiency-YouguidecotionQistagnationandbloodstasis-GexiazhuyudecoctionPhlegm-CangfudaotandecoctionLiverheat-Danzhixiaoyaodecoction9/2/2021 ThanksforYourAttention9/2/2021