生活方式调整及药物治疗多囊卵巢综合征的临床研究  

Effect of lifestyle adjustment,metformin and rosiglitazone in polycystic ovary syndrome

作　　者：马良坤[1] 金利娜[1] 郁琦[1] 徐苓[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院妇产科,100730

出　　处：《中华妇产科杂志》2007年第5期294-297,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨生活方式调整、二甲双胍及罗格列酮治疗多囊卵巢综合征(PCOS)的临床疗效。方法将106例 PCOS 患者随机分为单纯生活方式调整(锻炼及饮食控制)、生活方式调整+二甲双胍与生活方式调整+罗格列酮治疗3组,分别为43、36、27例,共有60例(分别为22、21、17例)患者完成治疗,观察3组患者治疗前、后排卵情况,比较体重指数(BMI)、腰围、腰围与臀围比值(WHR)、血清睾酮、空腹真胰岛素水平、血脂、稳态模型法测定的胰岛素抵抗指数(HOMA-IR)、空腹血糖与胰岛素比值(GIR)、定量胰岛素敏感检测指数(QUICKI)的变化。结果治疗前3组患者年龄、BMI、腰围、WHR、睾酮水平、空腹真胰岛素水平、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)比较,差异均无统计学意义(P>0.05)。单纯生活方式调整组的43例患者中22例完成治疗,23%(5/22)恢复排卵;生活方式调整+二甲双胍组的36例患者中21例完成治疗,43%(9/21)恢复排卵;生活方式调整+罗格列酮组的27例患者中17例完成治疗,59%(10/17)恢复排卵。3组患者的恢复排卵率比较,差异无统计学意义(P>0.05);但生活方式调整+罗格列酮组较单纯生活方式调整组恢复排卵率高,且差异有统计学意义(P<0.05)。治疗后3组患者的 BMI、腰围、WHR、睾酮、TC、TG、LDL-C、HDL-C 比较,差异均无统计学意义(P>0.05)。结论生活方式调整、二甲双胍、罗格列酮对 PCOS 患者均有恢复排卵作用。Objective To compare the efficacy of weight loss, metformin and rosightazone in women with polycystic ovary syndrome （PCOS）. Methods A randomized controlled trial （RCT） was carried out in Peking Union Medical College Hospital （PUMCH） , one hundred and six women with PCOS were assigned to three intervention groups： weight loss, weight loss and metformin, weight loss and rosightazone group. Patients were treated with weight loss （ diet and exercise ）, weight loss and metformin （500 mg three times daily）, weight loss and rosightazone （4 mg once daily） for three months. Sixty patients completed treatments. Basal body temperature （ BBT）, total testosterone as well as fasting serum insulin levels and lipid were measured and compared in all patients before and after weight loss. Results No significant differences were found in the baseline characteristics among three groups. In weight loss group 51% （22/43） patients completed treatment, and 23% （5/22） patients resumed ovulation. In weight loss and mefformin group 58% （21/36） patients completed treatment, and 43% （9/21） patients resumed ovulation. In weight loss and rosiglitazone group 63% （ 17/27 ） patients completed treatment, and 59% （10/17） patients resumed ovulation. Ovulation rate was significantly higher in weight loss and rosiglitazone group than in weight loss group. There was no significant difference among three groups in body mass index （BMI）, waist circumference, waist-hip ratio （WHR）, sex hormone, serum fasting insulin and lipid level after treatmenL Conclusion Weight loss, mefformin and rosiglitazone all can improve ovulation each.

关 键 词：多囊卵巢综合征 生活方式 二甲双胍 噻唑烷二酮类 排卵 

分 类 号：R711.75[医药卫生—妇产科学]