奥利司他对多囊卵巢综合征伴胰岛素抵抗患者的疗效及安全性  

Safety and efficacy of orlistat in patients with polycystic ovary syndrome and insulin resistance

作　　者：罗莉[1] 孙萍[1] 孙静[1] Luo Li;Sun Ping;Sun Jing(Department of Obstetrics and Gynaecology,Taizhou Hospital of Traditional Chinese Medicine,Taizhou 225300,China)

机构地区：[1]泰州市中医院妇产科,泰州225300

出　　处：《中国药物应用与监测》2024年第5期631-634,643,共5页Chinese Journal of Drug Application and Monitoring

摘　　要：目的 探讨奥利司他对多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)患者的治疗效果及安全性。方法 依据稳态模型法评估的胰岛素抵抗指数(HOMA-IR)选取2020年8月至2023年8月泰州市中医院收治的104例PCOS-IR患者,按随机数字表法分为对照组52例(失访2例)和试验组52例(失访5例)。对照组患者给予炔雌醇环丙孕酮,试验组患者给予奥利司他,两组均治疗3个月。对比两组患者机体测量学指标、糖脂代谢水平、激素水平及产生的不良反应。结果 治疗后,试验组患者BMI、体质量、腰围[分别为(25.74±1.08) kg·m^(-2)、(59.23±2.80) kg、(94.10±5.13) cm]均低于对照组[分别为(26.23±1.26) kg·m^(-2)、(60.51±2.31) kg、(96.5±5.20) cm](t=2.050、2.462、2.287,均P<0.05),总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、HOMA-IR[分别为(3.86±0.73) mmol·L^(-1)、(1.68±0.72) mmol·L^(-1)、(3.75±0.88) mmol·L^(-1)、(1.61±0.37)]均低于对照组[分别为(5.12±0.13) mmol·L^(-1)、(1.98±0.43) mmol·L^(-1)、(4.78±0.35) mmol·L^(-1)、(2.78±0.43)](t=12.007、2.508、7.659、14.323,均P<0.05);两组患者治疗后卵泡雌激素(FSH)差异无统计学意义[(6.71±0.69) mIU·mL^(-1) vs(6.79±0.72) mIU·mL^(-1),t=0.558,P>0.05)],试验组总睾酮(T)、血清黄体生成素(LH)、LH/FSH[(1.38±0.22) nmol·L^(-1)、(6.24±0.78) IU·L^(-1)、(0.93±0.15)]均低于对照组[(1.84±0.27) nmol·L^(-1)、(7.12±0.83) IU·L^(-1)、(1.05±0.17)](t=9.165、5.373、3.677,均P<0.05);两组不良反应发生率差异无统计学意义(8.50%vs 10.00%,χ^(2)=0.064,P>0.05)。结论 奥利司他治疗PCOS-IR患者能有效减重,调节糖脂代谢及性激素水平,改善胰岛素抵抗,且安全性良好。Objective To explore the therapeutic efficacy and safety of orlistat in patients with polycystic ovary syndrome(PCOS)and insulin resistance(IR)to provide reference for clinical medication.Methods Based on the homeostasis model assessment(HOMA)-IR,104 PCOS-IR patients admitted to Taizhou Hospital of Traditional Chinese Medicine from August 2020 to August 2023 were selected and divided into the control group(n=52,2 cases were lost for follow-up)and experimental group(n=52,5 cases were lost for follow-up)according to the random number table method.The patients in the control group were given ethinylestradiol and cyproterone acetate tablets,and those in the experimental group were given orlistat.The patients in both groups were treated for 3 months.Anthropometric indicators,glucose and lipid metabolism levels,hormone levels and adverse reactions were compared between the two groups.Results After treatment,the BMI weight,and waist circumference of the patients in the experimental group((25.74±1.08)kg·m^(-2),(59.23±2.80)kg,(94.10±5.13)cm)were lower than those in the control((26.23±1.26)kg·m^(-2),(60.51±2.31)kg,(96.5±5.20)cm)(t=2.050,2.462,2.287,all P<0.05).After treatment,the total cholesterol(TC),triglyceride(TG),fasting blood glucose(FPG)and HOMA-IR of the patients in the experimental group were(3.86±0.73)mmol·L^(-1),(1.68±0.72)mmol·L^(-1),(3.75±0.88)mmol·L^(-1) and(1.61±0.37)in the experimental group and(5.12±0.13)mmol·L^(-1),(1.98±0.43)mmol·L^(-1),(4.78±0.35)mmol·L^(-1) and(2.78±0.43)in the control(t=12.007,2.508,7.659,14.323,all P<00.05).There was no statistically significant difference in follicle stimulating hormone(FSH)between the two groups((6.71±0.69)mIU·mL^(-1) vs(6.79±0.72)mIU·mL^(-1),t=0.558,P>00.05).The testosterone(T),luteinizing hormone(LH)and LH/FSH were(1.38±0.22)nmol·L^(-1),(6.24±0.78)IU·L^(-1),(0.93±0.15)in the experimental group,which were lower than those of(1.84±0.27)nmol·L^(-1),(7.12±0.83)IU·L^(-1),(1.05±0.17)in the control(t=9.165,5.373,3.677,all P<0.05).Ther

关 键 词：多囊卵巢综合征 奥利司他 药物治疗 血糖 胰岛素抵抗 性激素 

分 类 号：R711.75[医药卫生—妇产科学] R969[医药卫生—临床医学]