炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征伴胰岛素抵抗的临床效果  

Clinical effect of ethinylestradiol cycloproterone combined with metformin in the treatment of PCOS patients with insulin resistance

作　　者：黄晓晓 陈晓璐[1] 王晓艳[1] Huang Xiaoxiao;Chen Xiaolu;Wang Xiaoyan(Department of Obstetrics and Gynecology,the First People's Hospital of Taizhou,Taizhou,Zhejiang 318020,China)

机构地区：[1]台州市第一人民医院妇产科,浙江省318020

出　　处：《中国基层医药》2020年第6期650-654,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征(PCOS)伴胰岛素抵抗的临床效果。方法:选择2017年5月至2019年5月台州市第一人民医院收治的PCOS伴胰岛素抵抗患者90例进行研究。根据随机数字表法将患者分为对照组、治疗组各45例。对照组采用炔雌醇环丙孕酮治疗,观察组采用炔雌醇环丙孕酮联合二甲双胍治疗。比较两组临床疗效,治疗前后雌二醇(E 2)、睾酮(T)、促黄体生成素(LH)、促卵泡雌激素(FSH)水平以及胰岛素抵抗指数(HOMA-IR)、空腹血浆葡萄糖(FPG)、体质量指数(BMI)、空腹胰岛素(FINS)水平,并对两组的排卵、妊娠、月经恢复情况及不良反应进行分析。 结果:治疗组总有效率(97.77%)明显高于对照组的总有效率(77.77%),差异有统计学意义(χ 2=8.389, P=0.003)。治疗前,治疗组E 2、T、LH、FSH与对照组差异均无统计学意义(均 P>0.05)。治疗后,治疗组E 2[(112.90±18.90)pmol/L]、T[(1.30±0.78)nmol/L]、LH[(8.00±1.50)U/L]、FSH[(1.20±0.39)U/L],均显著低于对照组[E 2(128.90±19.95)pmol/L、T(2.19±1.00)nmol/L、LH(11.65±1.60)U/L、FSH(1.89±0.50)U/L],差异均有统计学意义( t=3.905、4.707、10.871、7.299,均 P<0.05)。治疗前,两组患者HOMA-IR、FPG、BMI、FINS水平差异均无统计学意义(均 P>0.05)。治疗后,治疗组患者HOMA-IR(2.19±0.50)、FPG[(4.30±1.19)mmol/L]、BMI[(22.40±1.89)kg/m 2]、FINS[(15.98±5.00)mU/L],均显著低于对照组[HOMA-IR(3.90±0.58)、FPG(6.09±1.20)mmol/L、BMI(24.69±4.60)kg/m 2、FINS(19.00±6.89)mU/L],差异均有统计学意义( t=14.979、7.105、3.089、2.379,均 P<0.05)。治疗组患者的排卵、妊娠以及月经恢复情况均明显高于对照组,差异均有统计学意义(χ 2=4.121、4.285、10.000,均 P<0.05)。治疗组不良反应发生率(13.33%)明显低于对照组(37.77%),差异有统计学意义(χ 2=7.066, P=0.007)。 结论:炔雌醇环丙孕酮联合二甲双胍对多囊卵巢综合征伴胰岛素抵抗患者的Objective To investigate the clinical effect of ethinylestradiol cycloproterone combined with metformin in the treatment of polycystic ovary syndrome(PCOS)with insulin resistance.Methods Ninety PCOS patients with insulin resistance admitted to the First People's Hospital of Taizhou from May 2017 to May 2019 were selected in the study.According to the random number table method,the patients were divided into control group and treatment group,with 45 cases in each group.The control group was treated with ethinylestradiol and cycloprogesterone,while the observation group was treated with ethinylestradiol and cycloprogesterone combined with metformin.The clinical effects of two groups were compared,including estradiol(E2),testosterone(T),luteinizing hormone(LH),follicle stimulating estrogen(FSH),insulin resistance index(HOMA-IR),fasting plasma glucose(FPG)before and after treatment.Body mass index(BMI)and fasting insulin(FINS)levels were measured.The ovulation,pregnancy,menstrual recovery and adverse reactions of the two groups were analyzed.Results The total effective rate of the treatment group(97.77%)was significantly higher than that of the control group(77.77%),the difference was statistically significant(χ^2=8.389,P=0.003).Before treatment,there were no statistically significant differences in E2,T,LH,FSH between the treatment group and the control group(all P>0.05).After treatment,the levels of E2[(112.90±18.90)pmol/L],T[(1.30±0.78)nmol/L],LH[(8.00±1.50)U/L]and FSH[(1.20±0.39)U/L]in the treatment group were significantly lower than those in the control group[E2(128.90±19.95)pmol/L,T(2.19±1.00)nmol/L,LH(11.65±1.60)U/L and FSH(1.89±0.50)U/L],the differences were statistically significant(t=3.905,4.707,10.871,7.299,all P<0.05).Before treatment,the levels of HOMA-IR,FPG,BMI and FINS between the two groups had no statistically significant differences(all P>0.05).After treatment,the levels of HOMA-IR(2.19±0.50),FPG[(4.30±1.19)mmol/L],BMI[(22.40±1.89)kg/m2],FINS[(15.98±5.00)mU/L]in the treatment group we

关 键 词：多囊卵巢综合征 胰岛素抵抗 炔雌醇 环丙孕酮 二甲双胍 性激素 血脂代谢 

分 类 号：R713[医药卫生—妇产科学]