二甲双胍与炔雌醇环丙孕酮片联用对多囊卵巢综合征患者相关激素分泌水平的影响

Impact of Metformin combination with Ethinylestradiol and Cyproterone tablets on relevant hormone levels in#br# patients with PCOS

摘要:

目的  观察并探讨二甲双胍（Met）与炔雌醇环丙孕酮片（达英-35）合用对多囊卵巢综合征（PCOS）患者相关激素分泌水平的影响。方法  选择2011年4月-2015年3月在该医院接受治疗的PCOS患者152例，按照随机数字法将152例患者分为观察组和对照组，每组76例。对照组月经后5d口服达英-35治疗，观察组在对照组基础上口服Met治疗。对两组治疗前后性激素水平[促黄体生成素（LH）、促卵泡激素（FSH）、睾丸素（TEST）]、稳态胰岛素评价指数（HOMA-IR）、胰岛素分泌指数（HOMA-β）进行比较，并评价综合疗效。结果  治疗前，两组LH、FSH、TEST、HOMA-IR和HOMA-β比较，差异无有统计学意义（P >0.05）；治疗后，观察组LH、FSH和TEST水平低于对照组（P <0.05）；治疗后，观察组HOMA-IR和HOMA-β低于对照组（P <0.05）；观察组总有效率为94.7%（72/76），对照组为76.3%（58/76），两组比较，差异有统计学意义（P <0.05）。结论  Met与达英-35联合治疗PCOS可以明显改善内分泌和胰岛素抵抗，疗效显著，是治疗PCOS的安全、有效方案。

Abstract:

Objective To observe and explore the clinical effect of Metformin (Met) combination with Ethinylestradiol and Cyproterone tablets (Diane-35) on relevant hormone levels in patients with polycystic overy syndrome (PCOS). Methods Totally 152 PCOS patients who accepted drug treatment during April 2011 and March 2015 in our hospital were selected and divided into two groups accorded to the random number method with 76 cases in each group. The control group was treated with oral Diane-35, while the observation group was treated with oral Diane-35 and Met. Sex hormone (LH, FSH and TEST) levels, insulin resistance index (HOMA-IR), insulin secretion index (HOMA-β) before and after treatment were recorded and compared between the two groups and were evaluated as integrated effect. Results The difference in LH, FSH, TEST, HOMA-IR or HOMA-β was not statistically significant between both groups before treatment (P > 0.05). After treatment LH, FSH, TEST, HOMA-IR and HOMA-β in the observation group were significantly lower than those in the control group (P < 0.05). The total effective rate was 94.7% (72/76) in the observation group and 76.3% (58/76) in the control group; the difference was statistically significant (P < 0.05). Conclusions Met combined with Diane-35 therapy can significantly improve endocrine function and IR in PCOS patients, and is thus a safe and effective treatment for PCOS.