二甲双胍联合奥利司他治疗肥胖型多囊卵巢综合征伴胰岛素抵抗的临床效果  

Clinical efficacy of metformin combined with orlistat in the treatment of obese polycystic ovary syndrome with insulin resistance

作　　者：康银林 李毅[1] 唐云琳 何文英 谢南清 KANG Yinlin;LI Yi;TANG Yunlin;HE Wenying;XIE Nanqing(Department of Gynaecology and Obstetrics,Guang′an People′s Hospital,Guang′an Sichuan 638000,China)

机构地区：[1]广安市人民医院妇产科,四川广安638000

出　　处：《江苏大学学报（医学版）》2024年第4期338-344,共7页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:研究肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)伴胰岛素抵抗患者采用二甲双胍联合奥利司他治疗的临床效果。方法:选择150例肥胖型PCOS伴胰岛素抵抗患者,随机分为对照组与研究组,每组各75例;对照组给予二甲双胍、炔雌醇环丙孕酮等基础治疗,研究组采用基础治疗联合奥利司他治疗;治疗3个月,比较两组人体测量学指标、糖脂代谢指标及性激素水平差异。结果:治疗3个月后,与对照组比较,研究组体重、体重指数、腰臀比、体脂率、空腹血糖、餐后2 h血糖、空腹胰岛素、糖化血红蛋白、稳态模型评估-IR(HOMA-IR)均明显降低(P<0.05);三酰甘油、总胆固醇、低密度脂蛋白胆固醇均明显降低(P<0.05),高密度脂蛋白胆固醇明显升高(P<0.05);黄体生成素(LH)、雌二醇、睾酮、泌乳素和LH/卵泡刺激素(FSH)明显降低(P<0.05),FSH比较差异无统计学意义(P>0.05)。结论:肥胖型PCOS伴胰岛素抵抗患者采用二甲双胍联合奥利司他治疗可更好地改善糖脂代谢,减轻体重及胰岛素抵抗,改善性激素紊乱。Objective:To investigate the clinical efficacy of metformin combined with orlistat in obese patients with polycystic ovary syndrome(PCOS)and insulin resistance.Methods:A total of 150 obese PCOS patients with insulin resistance were randomly divided into control group and research group,with 75 cases in each group.The control group was given basic treatment such as metformin and ethinylestradiol cycloproterone,and the research group was treated with basic treatment combined with orlistat.After 3 months of treatment,the differences in anthropometric indicators,glycolipid metabolism indicators and sex hormone levels between the two groups were compared.Results:After 3 months of treatment,compared with the control group,the body weight,body mass index(BMI),waist-to-hip ratio(WHR),body fat percentage,fasting plasma glucose(FPG),2 h postprandial plasma glucose(2hPG),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),and homeostasis model assessment-IR(HOMA-IR)of the research group were significantly decreased(P<0.05);and the triglyceride,total cholesterol,low density lipoprotein cholesterol in the research group were also significantly decreased(P<0.05),while high density lipoprotein cholesterol was significantly increased(P<0.05);the levels of luteinizing hormone(LH),estradiol,testosterone,prolactin and LH/follicle stimulating hormone(FSH)were greatly decreased(P<0.05),while there was no significant difference in FSH(P>0.05).Conclusion:Metformin combined with orlistat in the treatment of obese PCOS with insulin resistance could significantly improve the glucose and lipid metabolism,reduce weight and insulin resistance and improve sexual hormone disorder.

关 键 词：多囊卵巢综合征 肥胖 胰岛素抵抗 二甲双胍 奥利司他 性激素 糖代谢 脂代谢 

分 类 号：R711.75[医药卫生—妇产科学]