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Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine and metabolic disorder among women of childbearing age, with insulin resistance (IR) and abnormal glucose and lipid metabolism acting as the core driving factors in obese PCOS. Currently, Western medical therapies represented by metformin combined with glucagon-like peptide-1 receptor agonists (GLP-1RA) (such as semaglutide) have demonstrated definite efficacy in weight loss and IR improvement. However, they are limited by adverse gastrointestinal reactions and a high risk of weight rebound after drug withdrawal. Traditional Chinese Medicine (TCM) posits that the pathogenesis of this disease is characterized by "kidney deficiency as the root, spleen deficiency as the pivot, and phlegm-dampness and blood stasis as the branch." TCM possesses multi-target advantages in regulating body metabolism and reproductive endocrinology. Studies have shown that the synergistic application of TCM formulas combined with appropriate techniques, such as acupuncture and acupoint catgut embedding, alongside the aforementioned Western medicines, can not only further enhance weight loss and metabolic improvement by synergistically regulating key signaling pathways like adenosine 5′-monophosphate-activated protein kinase (AMPK) and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), but also effectively optimize the ovarian microenvironment, improve endometrial receptivity, and significantly antagonize the gastrointestinal adverse reactions induced by Western medicines. This article systematically reviews the core mechanisms, evidence-based data, and safety profile of the combined treatment of metformin, semaglutide, and TCM for obese PCOS. It aims to provide a scientific theoretical basis for formulating standardized integrated Traditional Chinese and Western Medicine treatment protocols and offer new insights to break through the bottlenecks in the long-term clinical management of this disease.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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