二甲双胍联合环丙孕酮/炔雌醇治疗多囊卵巢综合征的临床研究  

The effect of combination therapy with Metformin and combined Cyproterone Acetate/Ethinyloestradiol on PCOS patients

作　　者：刘锦霞[1] 党洁明[1] 吴元赭[1] 郑宁[1] 吴效科[1] 

机构地区：[1]南京军区南京总医院妇产科,江苏南京210002

出　　处：《医学研究生学报》2006年第6期530-533,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金资助项目(批准号:30572404)

摘　　要：目的:针对多囊卵巢综合征(PCOS)患者的胰岛素抵抗、高雄激素血症,用胰岛素增敏剂二甲双胍联合避孕药环丙孕酮/炔雌醇(达因-35)对治疗效果进行评估。方法:选择临床诊断为PCOS患者60例,随机分为二甲双胍组(单药组)、二甲双胍联合达因-35治疗6个月组(联合用药Ⅰ组)和联合达因-35治疗3个月组(联合用药Ⅱ组)。每组20例,测定治疗前、后(2次)黄体生成素(LH)、睾酮(T)、硫酸脱氢表雄酮(DHEAS)、空腹胰岛素(FINS)、性激素结合蛋白(SHBG)、空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)。计算游离睾酮指数(AFI)及胰岛素敏感指数(ISI)。结果:单药组T、FINS下降,治疗6个月后AFI下降,SHBG升高。联合用药组血中T、AFI、SHBG的变化较单药组明显,临床症状改善显著,联合用药Ⅰ组和Ⅱ组比较各项指标无显著差异。结论:二甲双胍联合达因-35治疗PCOS疗效优于单用二甲双胍,对有生育要求的患者选择二甲双胍联合达因-35治疗3个月的方案更为合适。Objective： Insulin resistance and hyperandrogenism are the characteristics of patients with polycystic ovary syndrome （PCOS）. The paper evaluated the therapeutic effects of mefformin and Cyproterone Acetate/Ethinyloestradiol （ Diane35 ） in PCOS patients Methods：This clinical study lasted 6 months and included 60 women with PCOS, which divided into three groups of 20 women each. metformin Group received metformin alone , combined therapy group Ⅰtreated with metformin and Diane35, combined therapy group Group Ⅱ in which Diane35 was added to the same treatment only during the first 3 months of the investigation. Serum levels of Luteinizing hormone （ LH ）, testosterone （ T）, fasting insulin （ FINS）, sex hormone binding globulin （ SHBG ）, dehydroepiandrosterone sulfate （ DHEAS ） , fasting glucose and lipid metabolism parameters were measured before androgen index and insulin sensitivity index were calculated. assessed before and after the therapy. Results：Patients in in T , FINS and AFI, and a significant increase in SHBG. combined use of metformin and Diane35 had more significant the treat, on the third and sixth month. Free Body mass index and waist to hip ratio were the metformin group had significant decrease Compared to metformin group , groups with changes in these parameters. There were no difference between 6 months and 3 months of Diane35 treatment. Conclusion ： The PCOS patients treated with mefformin and Diane35 might be more effective compared with mefformin alone. The combination of mefformin with intermittent application of Diane35 is an appropriate alternative for PCOS patients intented for conception .

关 键 词：二甲双胍 环丙孕酮/炔雌醇 多囊卵巢综合征 

分 类 号：R711.75[医药卫生—妇产科学]