炔雌醇环丙孕酮分别联合二甲双胍、吡格列酮治疗多囊卵巢综合征的疗效和安全性比较  

Comparison of the Efficacy and Safety of Ethinyl Estradiol Cyproterone Respectively Combined with Metformin and Pioglitazone in the Treatment of Polycystic Ovary Syndrome

作　　者：李晓燕[1] 张蓓[2] 林莉[2] 

机构地区：[1]厦门市第二医院体检部,福建厦门361021 [2]厦门市第二医院妇科,福建厦门361021

出　　处：《中国药房》2016年第36期5073-5075,共3页China Pharmacy

摘　　要：目的:比较炔雌醇环丙孕酮分别联合二甲双胍、吡格列酮治疗多囊卵巢综合征的疗效和安全性。方法:80例多囊卵巢综合征患者随机分为A组(40例)和B组(40例)。两组患者均给予炔雌醇环丙孕酮片,于月经来潮第5天起每日服用1片,连用21 d为1个周期,于下次月经来潮第5天开始下个周期。在此基础上,A组患者给予二甲双胍片0.5 g,口服,每日3次;B组患者给予吡格列酮片15 mg,口服,每日1次。两组疗程均为3个月。观察两组患者治疗前后体质量指数(BMI)、黄体生成素(LH)、睾酮(T)、空腹胰岛素(FINS)、稳态胰岛素评价指数(HOMA-IR)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,随访6个月记录两组患者自发排卵率、妊娠率及不良反应发生情况。结果:两组患者自发排卵率、妊娠率、不良反应发生率比较差异均无统计学意义(P>0.05)。治疗前,两组患者BMI、LH、T、FINS、HOMA-IR、TG、TC、LDL-C、HDL-C水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者BMI水平均显著低于同组治疗前,且A组低于B组,HDL-C水平均显著高于同组治疗前,且B组高于A组,差异均有统计学意义(P<0.05);两组患者LH、T、FINS、HOMA-IR水平均显著低于同组治疗前,差异均有统计学意义(P<0.05),但两组间比较差异均无统计学意义(P>0.05)。两组患者治疗前后TG、TC、LDL-C水平比较差异均无统计学意义(P>0.05)。结论:炔雌醇环丙孕酮联合二甲双胍与炔雌醇环丙孕酮联合吡格列酮治疗多囊卵巢综合征的疗效和安全性均相当,但二甲双胍在降低患者BMI水平方面效果显著,吡格列酮在提高HDL-C水平方面效果显著。OBJECTIVE： To compare the efficacy and safety of ethinyl estradiol cyproterone respectively combined with metformin and pioglitazone in the treatment of polycystic ovary syndrome. METHODS： 80 patients with polycystic ovary syndrome were randomly divided into group A （40 cases） and group B （40 cases）. All patients received 1 Ethinyl estradiol cyproterone tablet from the 5 d of menstruation, once a day, 21-d was a treatment course, then began the next course from the 5 d of the next menstruation. Based on it, group A received Metformin tablet 0.5 g, orally, 3 times a day; group B received Pioglitazone tablet 15 mg, orally, once a day. All patients were treated for 3 mouths. Body mass index （BMI） level, luteinizing hormone （LH）, testosterone （T）, fasting insulin （FINS）, steady state insulin evaluation index （HOMA-IR） , triglyceride （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C） and high-density lipoprotein cholesterol （HDL-C） in 2 groups before and after treat- ment were observed, spontaneous ovulation rate, pregnancy rate and the incidence of adverse reactions in 2 groups were recorded after 6-month follow-up. RESULTS： There were no significant differences in the spontaneous ovulation rate, pregnancy rate and the incidence of adverse reactions in 2 groups （P〉0.05）. Before treatment, there were no significant differences in the BMI, LH, T, FINS, HOMA-IR, TG, TC, LDL-C and HDL-C levels in 2 groups （P〉0.05）. After treatment, BMI level in 2 groups was signifi- cantly lower than before, and group A was lower than group B, HDL-C level was significantly higher than before, and group B was higher than group A, with statistical significances （P〈0.05）, LH, T, FINS and HOMA-IR levels in 2 groups were significant- ly lower than before, with statistical significances （P〈0.05）, while there were no significant differences between 2 groups （P〉 0.05）. And there was no significant difference in the TG, TC and LDL-C in 2 groups

关 键 词：炔雌醇环丙孕酮 二甲双胍 吡格列酮 多囊卵巢综合征 疗效 安全性 

分 类 号：R711.75[医药卫生—妇产科学]