The Clinical Efficacy Analysis On Ovarian Function Of Polycystic Ovary Syndrome Patients By Bioelectric Stimulation Conbined With Diane-35

Polycystic Ovary Syndrome?PCOS?is a group of common gynecological endocrine diseases characterized by sparse ovulation or persistent anovulation caused by ovarian dysfunction.The incidence rate is about 5%to 10%.PCOS occurs in women of childbearing age,which etiology and pathogenesis are not yet clear.It may be related to heredity,environment,serum luteinizing hormone,high androgen levels,high insulin levels,obesity,and low inflammatory response.The study found that the clinical manifestations of PCOS are characterized by diversity and complexity,mainly reflected in the increase of androgen levels and/or insulin levels.The clinical manifestations of the disease in women with recent harm are menstrual disorders,infertility,hirsutism,acne,intimal hyperplasia,and abnormal uterine bleeding,The long-term hazards of PCOS refer to high blood pressure,dyslipidemia and the increase of several diseases such as cardiovascular disease,type 2 diabetes,osteoporosis and endometrial cancer.At present,there are no cures method for eradicating PCOS all over the world.Symptomatic treatment and delaying the progression of PCOS are currently hot topics in the field of obstetrics and gynecology.In 2018,the guideline for the treatment of PCOS by the Obstetrics and Gynecology of the Chinese Medical Association was specially pointed out that the treatment of PCOS should be based on individual age,fertility requirements,and metabolic changes.Nowadays,the treat methods for PCOS mainly fall into the following four categories:?1?Lifestyle interventions:exercise,diet control,stress reduction and regular life;?2?Drug therapy:oral administration of Diane-35,progesterone,anti-insulin resistance such as metformin,and ovulation induction therapy with clomiphene and letrozole;?3?Surgical treatment:laparoscopic ovarian drilling and assisted reproductive technology;?4?Traditional medical treatment:traditionalChinesemedicine,acupuncturepoints,Acupunctureand electro-acupuncture treatment.To some extent,the above treatment methods can alleviate the clinical manifestations of PCOS,but there are still some limitations,?1?For moderate and severe PCOS patients,lifestyle intervention treatment effect is not obvious or ineffective;?2?The efficacy of drug treatment sometimes is slowly with a Longer treatment cycle.Besides,relapse coming after drug withdrawal.What's more,the ovulation stimulation drug can lead to ovarian hyperstimulation syndrome and poor patient compliance.?3?Surgical treatment has disadvantages such as greater trauma,postoperative complications,short-term recurrence and economic burden;?4?Traditions medical treatment has almost no standards and specifications,which the curative effect is yet not exact.PCOS is a life-long disease that affects patients'living quality and fertility requirements.Therefore,the research of PCOS therapy with effective and less invasive has become a hot spot.Biomimetic electrostimulation is a kind of electrostimulation therapy based on low-frequency electrical stimulation technology.By imitating the human bioelectric model,it can improve local target organs by means of stimulating local target organs or performing whole-body adjustment using low-frequency electric pulses that are harmless to the human body,improving the local environment of target organs.A number of studies have reported that the technology has been widely used in women's gynecological fields such as female pelvic floor dysfunction?prolapse?,postpartum pelvic floor muscle rehabilitation,premature ovarian failure,intrauterine adhesions and thin endometrium regulation.Its mechanism mainly includes?1?A neuroendocrine regulation of the HPO axis?hypothalamus-pituitary-ovarian axis?;?2?Promoting muscle contraction of target organs,improving effective blood circulation and metabolism of target organs.Therefore,the subject is at the breakthrough point what aims to applying electrical stimulation treatment on the ovarian function of patients with PCOS?ovulation and endocrine functions?,trying to?1?Using META to analyze the published clinical data on the efficacy of electrostimulation therapy for PCOS patients.and understand the current clinical efficacy of electrostimulation techniques for ovarian function in patients with PCOS;?2?Adopting the prospective clinical randomized controlled trial to further explore the role of biomimetic electrostimulation combined with Diane-35 on ovarian function,and also find the relationship of the ovarian related metabolism.It is expected to classify the effect of bioelectric stimulation therapy on the ovarian function of PCOS patients from different perspectives and attempt to seek a new method which can improve the main symptom of PCOS with less side effects.Therefore,the research is divided into two parts:Part One:The efficacy of electrostimulation therapy on the ovarian function of PCOS patients:a META-analysis of clinical randomized controlled trials.Objective:To analyze the clinical effect of electrostimulation therapy on ovulation rate and serum LH,LH/FSH,T and E₂ level in patients with PCOS.Methods:Using the Meta analysis method and searching the relative the relevant clinical randomized controlled trials which published in Pubmed,Embase,Web of science,the Cochrane Library,The science and technology of China citation database?sino-Med?,CNKI,VIP,WANGFANG DATA and the Library of Fujian Medical university retrieval on 31^stt December,2017.Setting the inclusion and exclusion criteria according to the relevant procedures of Cochrane Handbook 5.1.0,and then complete the data extraction and literature quality evaluation.Lastly,using RevMan 5.3 software to make the Meta analysis towards to the ovulation rate,LH,LH/FSH,T and E₂ included in the literature.Results:A total of 171 articles were retrieved,and finally 15 articles were included after screening.The results of meta-analysis showed that the use of electrical stimulation alone or in combination with other non-electrical stimulation methods can improve the ovulation rate RD=0.28?95%CI:0.15,0.40?,P?0.01,the difference was statistically significant;the serum LH concentration has been lower[WMD=-0.89,95%CI:?-1.37,-0.42?],as well as the LH/FSH[WMD=-0.24,95%CI:?-0.29,-0.18?],and T[WMD=-0.55,95%CI:?-0.67,-0.42?].The serum E₂ concentration content in the electric stimulation group was lower than that in the control group[WMD=-4.30,95%CI:?-8.25,-0.35?]were more effective than the control group,P?0.01 the difference has statistically significant.Conclusion:Electrical stimulation therapy can increase the ovarian oviposit rate of PCOS patients and improve the ovarian endocrine functions,which infer that this approach can be used as a effective method on PCOS therapy no matter alone or as a combination therapy.Electrical stimulation therapy on PCOS worth the further clinical researchPart Two:The clinical study on the ovarian function of PCOS patients by bioelectric stimulation combined with Daine-35Objective:To explore the clinical effect of bioelectric stimulation on ovarian function of PCOS patients.Methods:Collecting 100 patients with PCOS who visit Fuzhou general hospital of the Chinese people's liberation army?PLA?in June 2016 to September2017.According the medical visiting order,the patients were randomly divided into trial group and control group,every group has 50 objects.In the control group,the objects accept the daine-35 treatment only.And,the experimental group accept another approach-bioelectric stimulation?4 stimulus points located in the front and back of the bilateral ovary on the pelvis skin?base on the daine-35 therapy.Each of the method stared on the 5th day of the menstrual cycle.The specific method of daine-35 is 1 pill per day and the bioelectric therapy is almost 30 minutes at a time.The treatment continue 3 menstrual cycle.And then,observing ovarian deposit,endometrial thickness,number of mature follicle,relative sex hormone levels and metabolism situation?Fasting Blood Glucose,insulin resistance index,cholesterol and triglycerides?.Results:Compared with the control group,the ovulation rate of the experimental group increased,the difference was statistically significant?P<0.05?;serum AMH,T,LH,LH/FSH and E₂ were reduced,the difference was statistically significant?P<0.05?.The ovarian volume became smaller and the number of follicles decreased.,the difference was statistically significant.The glucose metabolism index,such as FINS increasing,the FBG decreasing,and the HOMA-IR improving,the difference was statistically significant?P<0.05?.The lipid metabolism index like TC and TG both decreased slightly.However,compared with the control group,the difference was not statistically significant?P>0.05?.Conclusion:Biomimetic electrostimulation combined with Daine-35 can better improve ovarian function,increase ovulation rate,and improve ovarian endocrine function in patients with PCOS.It can be used as a new effective treatment for PCOS.