120例高原地区多囊卵巢综合征合并胰岛素抵抗患者不同治疗方案临床疗效研究  

The Clinical Efficacy of Different Treatment Options Treating 120 Patients with Polycystic Ovary Syndrome Complicated with Insulin Resistance at High Altitude Area

作　　者：向玉[1] 

机构地区：[1]青海红十字医院生殖中心,810000

出　　处：《青海医药杂志》2016年第8期6-9,共4页Qinghai Medical Journal

摘　　要：目的:分析高原地区不同治疗方案治疗合并胰岛素抵抗(IR)、多囊卵巢综合征(PCOS)患者后对排卵率和月经恢复规律的疗效,以及对腰围与臀围比(WHR)、体重指数(BMI)、空腹胰岛素(INS)和睾酮(T)等指标的影响。方法:将我院2013年5月—2015年5月期间确诊的120例高原地区合并胰岛素抵抗多囊卵巢综合征患者随机分为三组,治疗方法分别为:A组:行为治疗+达因-35方案;B组:行为治疗+达因-35+盐酸二甲双胍片方案;C组:行为治疗+达因-35+罗格列酮方案。疗程为3个月经周期,记录排卵率及月经恢复情况,检测治疗前后空腹胰岛素(INS)、血清睾酮(T)、血脂、空腹血糖(GLU)水平,对比治疗前后WHR及BMI变化。结果:三组患者经治疗,排卵率和月经规律均明显提高,WHR、BMI、INS、T各指标与治疗前相比均明显下降,P<0.05,治疗前后三组患者的血脂指标对比差异无统计学意义,P>0.05,三组患者的临床疗效对比差异无统计学意义;对比排卵率和月经率两指标,A组和C组之间对比有统计学意义,P<0.05。结论:对于治疗合并胰岛素抵抗PCOS患者,应当遵循个体化治疗原则,在积极引导患者行为治疗基础上需要慎重考虑利弊,适当选择二甲双胍、达因-35、罗格列酮等药物治疗,应用胰岛素增敏剂联合其他药物治疗前景广阔,有望获得更高疗效。Objective：To analyze the different treatment onrecovery of ovulation and menstruation in patients with polycystic ovary syndrome（PCOS）complicated with insulin resistance（IR）and the influence on the waist to hip ratio（WHR）,body mass index（BMI）,fasting insulin（INS）and testosterone（T）and other indexes.Methods：Randomly divided 120 cases ofpatients with polycystic ovary syndrome complicated with insulin resistanceinto three groups who admitted in our hospital from May 2013 to May 2015.Different treatment methods were carried out：group A：behavioral therapy＋Diane-35scheme;B group：Behavior therapy＋Diane-35＋ Metformin Hydrochloride Tablets scheme;group C：behavioral therapy＋Diane-35＋rosiglitazone scheme.The treatment course lasted for 3menstrual cycles,recording the ovulation rate and the recovery of menstruation,detecting fast insulin（INS）,serum testosterone（T）,blood lipid and fast blood glucose（GLU）before and after treatment.Compare the changes of WHR and BMI before and after treatment.Results：After treatment,the ovulation rate and regular menstruation were significantly increased.The indexes of WHR、BMI、INS,and testosterone were decreased significantly than those with before treatment（P 0.05）.There was no significant statistical difference in lipid index before and after treatment（P〉0.05）.And there was no statistical significance in the clinical efficacy of treatment among three groups;There was showed statistical significance（P〈0.05）in ovulation rate and menstruation rate between group A and groupC.Conclusion：For the treatment of PCOS patients complicated with insulin resistance,it should be following the principle of individualized treatment,carefully consider the pros and cons in need and actively guide the behaviors of patients with treatment on the basis of proper selection of metformin,Diane-35 and rosiglitazone.Application of insulin sensitizes in combination with other drugs in the treatment of broad prospects,is expected to get a h

关 键 词：多囊卵巢综合征 胰岛素抵抗 盐酸二甲双胍 达因-35 罗格列酮 

分 类 号：R711.75[医药卫生—妇产科学]