控制体重对肥胖型多囊卵巢综合征患者的疗效观察  

Effect of weight controlon obesity patients with polycystic ovary syndrome

作　　者：彭真 张全 王丽娥 邹淑花 

机构地区：[1]青岛市妇女儿童医院生殖中心,青岛266000

出　　处：《生殖医学杂志》2016年第11期992-997,共6页Journal of Reproductive Medicine

摘　　要：目的探讨肥胖型多囊卵巢综合征(PCOS)患者控制体重的疗效。方法选择BMI≥25的多囊卵巢综合征患者122例,随机分成二甲双胍联合达英-35对照组与体重控制实验组,治疗6个月后观察两组体重指数、内分泌代谢指标及妊娠结局。结果 (1)对照组与实验组治疗后代谢指标LH、TT、CHO、TG、LDL及FPG、1hPG、GAUC、FINS、HOMA-IR均较治疗前显著下降,具有统计学意义(P<0.05)。(2)实验组患者BMI[(24.39±2.13)kg/m2]、FINS[(7.94±2.41)mU/L]、1hINS[(93.32±40.32)mU/L]、2hINS[(65.27±32.34)mU/L]、IAUC[(129.69±35.37)mU/L·h]较药物对照组[分别为(26.02±2.05)kg/m2、(15.02±2.11)mU/L、(136.32±62.31)mU/L、(99.27±70.34)mU/L、(193.98±98.75)mU/L·h]下降明显(P<0.05),差异有统计学意义。(3)实验组月经恢复率(75.00%vs.54.72%,P<0.05)及排卵率(64.58%vs.43.40%,P<0.05)优于对照组。结论控制体重能有效改善患者糖脂代谢异常,尤其是胰岛素敏感性增加,总疗效优于复合药物治疗。Objective： To study the clinical effect of weight control on obesity patients with polycystic ovary syndrome（PCOS）. Methods： A total of 122 PCOS patients with BMI≥25 were randomly divided into control group and experimental group. The patients in control group were treated with metformin combined with Diane-35, and the patients in experimental group were treated with weight control. The body mass index（BMI）, endocrine ＆ metabolism index and pregnancy outcome after 6 months treatment were observed and compared between the two groups. Results： 1） The endocrinology index and metabolism index including LH, total testosterone （TT）, cholesterol（CHO） ,triglyceride（TG）, Low-density lipoprotein（LDL）,fasting plasma glucose（FPG）, 1 hour postprandial blood glucose （ lhPBG）, glucose area under curve （ GAUC）, fasting insulin （ FINS）, and homeostasis model of assessment for insulin resistence index（ HOMA-IR） were significantly decreased after treatment both in the two groups （P〈0. 05）. 2） BMI[（24.39±2.13）vs. 26. 02±2. 05 ） kg/m^2 ] , FINS [（7.94±2.41） vs. （15.02±2. 11） mU/L], lhINS[（93. 32±40.32） vs. （136.32±62.31） mU/L], 2hINS [（65.27±32.34）vs. （99.27±70.34）mU/L],IAUC[（129.69±35.37）vs. （193.98±98.75）mU/L·h] in the experiment group were significant lower than those in the control group （P〈0.05）. 3）Menstrual recovery rate（75.00% vs. 54.72%）and the ovulation rate（64.58% vs. 43.40%）in experimental group were significantly higher than the control group（P〈0.05）. Conclusions： Glucose-lipid metabolic abnormality, especially the increase in insulin sensitivity, is effectively improved by weight control. The effect of weight control is better than combination medicine therapy.

关 键 词：多囊卵巢综合征 胰岛素释放试验 二甲双胍 

分 类 号：R[医药卫生]