复方左炔诺孕酮联合二甲双胍治疗多囊卵巢综合征临床观察  

Clinical observation of the treatment of polycystic ovarian syndrome by compound levonorgestrel progesterone with metformin

作　　者：黄晓梅 HUANG Xiaomei(Department of Gynaecology,Beijing Water Resources Hospital,Beijing 100036,China)

机构地区：[1]北京水利医院妇科,北京100036

出　　处：《安徽医药》2019年第5期995-997,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的观察复方左炔诺孕酮联合二甲双胍治疗多囊卵巢综合征(PCOS)的临床效果。方法选择2016年3月至2018年月在北京水利医院门诊就诊的PCOS病人58例,给予复方左炔诺孕酮片[每片含左炔诺孕酮(LNG)0.15 mg和炔雌醇(EE)0.03 mg]联合口服二甲双胍治疗,按28 d为1个月经周期,共服3个月经周期。观察病人月经恢复情况和多毛、痤疮的改善情况,检测病人治疗前、后血清性激素水平和胰岛素水平。结果有3例退出试验,55例(100%)恢复规律的月经,27例多毛、痤疮症状明显减轻。与治疗前比较,治疗后黄体生成素(LH)为(7.52±0.58)IU/L(t=91.21,P<0.01)、睾酮(T)为(1.75±0.06)nmol/L(t=226.22,P<0.01)、空腹胰岛素(F-Ins)为(13.27±2.23)mU/L(t=29.21,P<0.01)、胰岛素曲线下面积Ins-Auc为(108.00±10.3)(t=64.64,P<0.01)以及LH/FSH为(1.35±0.04)(t=203.08,P<0.01)均分别下降。治疗后体质量指数(BMI)(t=14.83,P<0.01)和腰臀比(WHR)(t=227.95,P<0.01)明显降低。结论复方左炔诺孕酮联合二甲双胍治疗PCOS有协同和互补作用,能显著改善临床症状,有效改善病人体内激素失调状况,还有降低血糖、减肥的作用。两药联合应用短期内未出现严重不良反应。Objective To observe the clinical efficacy of compound levonorgestrel progesterone combined with metformin in the treatment of polycystic ovarian syndrome.Methods Based on a sample of 58 PCOS patients of Beijing Water Resources Hospital from Mar 2016 to Feb 2018,a prescription of compound levonorgestrel progesterone combined with metformin was given for an observation period of 3 months,and the improvement of menstrual recovery,polytrichia,and acne was recorded.At the same time,the levels of serum sex hormones and insulin before and after the treatment were also compared.Results During the experiment,3 patients dropped out,which yielded a final sample of 55 patients.Menstruation was all recovered in all cases,and polytrichia and acne were significantly improved for 27 of them.After treatment,luteal generative hormone(LH)(7.52±0.58)IU/L(t=91.21,P<0.01),testosterone(T)(1.75±0.06)nmol/L(t=226.22,P<0.01),fasting insulin(F-Ins)(13.27±2.23)mU/L(t=29.21,P<0.01),area un-der insulin curve(Ins-Auc)(108.00±10.3)(t=64.64,P<0.01)and the LH/FSH ratio(1.35±0.04)(t=203.08,P<0.01)were all decreased.Meanwhile,body mass index(BMI)(t=14.83,P<0.01)and waist-to-hip ratio(WHR)(t=227.95,P<0.01)were also decreased after treatment.Conclusion There are collaborative and complementary effects of compound levonorgestrel progesterone and metformin on the treatment of PCOS,including improving clinical symptoms,decreasing luteal generative hormone.The treatment also helps prevent the long term risk of endometrial cancer and lose weight,which is more effective than the effects of using them separately.For the short term observation,there are no significant side effects.However,the risk of long term usage should still be examined.

关 键 词：多囊卵巢综合征 炔诺孕酮合剂炔雌醇 二甲双胍 月经失调 人体质量指数 

分 类 号：R711.75[医药卫生—妇产科学]