达英-35联合二甲双胍治疗多囊卵巢综合征临床疗效分析

Analysis of Efficacy of Diane-35 Combined with Metformin in Treament of PCOS

目的观察达英-35联合二甲双胍对多囊卵巢综合征患者的临床疗效。方法将75例多囊卵巢综合征患者随机分为3组,经12周治疗后,比较各观察指标的变化。结果①二甲双胍组BM I、WHR、TC、TG、LDL、Ins0h、T、SG1h、SG 2h、Ins 1h、Ins 2h、AUGSG、AUG Ins治疗后低于治疗前(P<0.05),HDL治疗后明显高于治疗前(P<0.01),余无明显差异(P>0.05);②达英-35组平均卵泡数、T、LH、FSH/LH治疗后低于治疗前(P<0.05),SHBG、TC、LDL、TG治疗后高于治疗前(P<0.05),余治疗前后无明显差异(P>0.05);③达英-35与二甲双胍联合用药组T、平均卵泡数治疗后明显低于治疗前(P<0.01),BM I、LH、FSH/LH、SG1h、SG2h、Ins0h、Ins 1h、Ins2h、AUGSG、AUG Ins、TG治疗后低于治疗前(P<0.05),SHBG、HDL治疗后明显高于治疗前(P<0.01),TC治疗后高于治疗前(P<0.05),余治疗前后无明显差异(P>0.05)。结论达英-35与二甲双胍联合应用能有效地纠正高雄激素血症,同时改善胰岛素抵抗及脂代谢紊乱,并且提高排卵率,是目前治疗多囊卵巢综合征较理想的方法之一。

Objective To observe the efficacy of Diane -35 combined with metformin in treament of polycystic ovary syndrome （PCOS）. Methods 75 patients suffering PCOS were randomized into 3 groups ： metformin group （ n = 25 ）, Diane - 35 group （ n = 25 ）, Diane - 35 ＋ metformin group （ n = 25 ）. After a baseline work including body mass index（BMI） ,waist/hip ratio （WHR）, serum follicle stimulating hormone （ FSH ）, luteinzinghormone （ LH ）, testosterone （ T）, sex hormone - binding - globulin （SHBG）, glucose, and insulin concentration during oral glucose tolerance test （OGTT）, average follicle number,at the end of 3 months of treatment,all subjects were re -evaluated. Results ①After mefformin therapy, average follicle number, LH, FSH, LH/FSH, SGOh, SHBG remained unaltered （ P 〉 0.05 ）, significant decreases in concentration of BMI, WHR, TC, TG, LDL, Ins 0h, Ins 1h, Ins 2h, AUGSG,AUGIns,HDL were observed, （ P 〈0.05）, BMI,WHR,T,SGlh,SG 2h,Ins 2h,AUGSG, AUGIns（ P 〈0.05） were found in these PCOS suhjects;②After Diane -35 therapy,no change in BMI ,WHR ,FSH ,SG Oh ,SG 1h ,SG 2h ,Ins 0h ,Ins 1h ,Ins 2h ,AUGSG ,AUGIns ,HDL were observed, significant decreases in average follicle number ,T ,LH ,FSH/LH（ P 〈 0.05 ） , and an increase in concentration of SHBG, TC, LDL and TG （ P 〈 0.05 ） were found in these PCOS subjects. The rest no change（ P 〉 0.05 ） ;③After combination therapy, significant decreases in concentration of T,average follicle number （ P 〈 0.01 ） and BMI, LH, FSH/LH, SG lh, SG 2h, Ins 0h, Ins 1h, Ins 2h, AUGSG, AUGIns,TG（ P 〈0.05） ,and an increase in concentration of SHBG,HDL（ P 〈0.01 ）and TC（ P 〈0.05 ）were found,but no change in FSH ,SG Oh,LDL（ P 〉 0.05 ）were found. Conclusion The PCOS patients treated with Diane -35 combined with mefformin can correct hyperandrogen,improve insulin resistance （IR） and hyperlipermia,increase ovulation rate in PCOS infertile cases, so this therapy is one of better methods.