二甲双胍和噻唑烷二酮类分别与达因-35联用治疗多囊卵巢综合征的疗效比较  

The therapeutic effect of metformin and thiazolidinediones combined with Diane-35 in polycystic ovary syndrome

作　　者：邢海燕[1] 李鹏飞[1] 廖琳[1] 董建军[2] 

机构地区：[1]山东大学附属省立医院内分泌科,济南250021 [2]山东大学齐鲁医院内分泌科

出　　处：《现代妇产科进展》2009年第5期340-342,346,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:比较二甲双胍和噻唑烷二酮类(TZDs)分别与达因-35联用治疗多囊卵巢综合征(PCOS)的临床疗效。方法:随机将53例患者分成两组,A组予以二甲双胍治疗3个月后与达因-35共用3个月,B组予以TZDs治疗3个月后和达因-35共用3个月,总治疗期6个月,比较治疗前后内分泌激素、体重指数、血糖、排卵率等的改变。结果:两组治疗后胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、睾酮(T)及黄体生成素(LH)均明显降低(P<0.05,P<0.01)。A组降低体重优于B组,B组改善胰岛素抵抗优于A组。两组在排卵率和妊娠率方面无显著差异(P>0.05),双胍组4例自发性妊娠,TZDs组也有4例自发性妊娠。随访1年,8例婴儿发育均无异常。结论:二甲双胍和TZDs分别与达因-35联用,均能改善PCOS患者的胰岛素抵抗及内分泌紊乱,肥胖的PCOS患者推荐首选二甲双胍+达因-35,体重正常者或胰岛素抵抗严重者选用TZDs+达因-35。Objective： To compare the therapeutic effect of metformin and thiazolidinediones （TZDs） combined with Diane-35 in polycystic ovary syndrome （PCOS）. Methods ：53 cases of PCOS were randomly divided into two groups （ group A was given metformin for 3 months and then plus Diane-35 for another 3 months;group B given TZDs for 3 months and then plus Diane-35 for another 3 months）. The changes of endocrine hormone, body mass index, blood glucose and ovulation rate were compared before and after treatment. Results：After treatment, there were obvious decreases in insulin （ INS）, insulin resistance index （ HOMA-IR）, triglyceride（TG）,low density lipoprotein （LDL-C）, testosterone（T） and luteinizing hormone （LH） in both groups（P 〈0. 05 or P 〈0. 01 ）. Cases in group A losed more weight than that in group B. Cases in group B had a better improvement in insulin resistance than that in group A. There were no significant differences in the rate of ovulation and the result of pregnancy between two groups（P 〉0.05 ）. There were four spontaneous pregnancies in metformin combined with Diane-35 and four in TZDs combined with Diane-35 group. All eight babies developed normally at one year＇s follow-up. Conclusion：Both metformin plus Diane-35 and TZDs plus Diane-35 can improve the insulin resistance and imbalance of other endocrine hormones of PCOS cases. The first choice of PCOS cases with obese is metformin and Diane-35. While for the PCOS cases with normal weight or with severe insulin resistance, TZDs and Diane-35 is a better choice.

关 键 词：多囊卵巢综合征 二甲双胍 噻唑烷二酮类 文迪雅 达因-35 治疗结果 对比研究 

分 类 号：R588.6[医药卫生—内分泌]