盐酸二甲双胍和马来酸罗格列酮治疗多囊卵巢综合征的临床研究

Effect of Metformin and Rosiglitazone Treatment on Polycystic Ovary Syndrome

目的:探讨应用胰岛素增敏剂盐酸二甲双胍和马来酸罗格列酮治疗多囊卵巢综合征(PCOS)的临床效果。方法:选择在我院就诊的PCOS患者55例,随机分成盐酸二甲双胍组30例和马来酸罗格列酮组25例,治疗疗程12周。观察两组患者用药前后体重、血糖及胰岛素水平、生殖激素水平变化及排卵、月经改善和不良反应情况。结果:①盐酸二甲双胍治疗后患者的体重降低(P<0.05),两组治疗后体重比较,差异有统计学意义(P<0.05);②两药治疗后基础胰岛素值、胰岛素曲线下面积及胰岛素抵抗指数均降低,且马来酸罗格列酮组治疗后数值低于盐酸二甲双胍组(P<0.05);③两药治疗后雄烯二酮、睾酮水平明显下降,与治疗前相比,差异有高度统计学意义(P<0.01)。④两药治疗后两组排卵率比较差异无统计学意义(P>0.05)。⑤盐酸二甲双胍组的不良反应有稀便、恶心,马来酸罗格列酮组有体重增加、水肿。结论:盐酸二甲双胍、马来酸罗格列酮均能改善PCOS患者的胰岛素抵抗。盐酸二甲双胍有轻微降低体重的作用,价格便宜;马来酸罗格列酮减轻胰岛素抵抗效果优于盐酸二甲双胍。

Objective： To study the clinical effects of metformin and rosiglitazone treatment in women with Polycystic Ovary Syndrome （ PCOS）. Methods： .55 women with PCOS were randomized in to two groups and treated for 12 weeks. Metformin group had 30 patients and rosiglitazone group had 25. Several biomedical parameters were recorded before and after the treatment, including weight, plasma level of glucose, sexual hormones and insulin. Menstruation changes and drug adverse reactions were also observed. Results. （1）Metformin can significantly decrease body weight （ P〈 0.05）,while rosiglitazone had no evident effect.（2）Both drugs can significantly decrease the basal insulin level, INSAUC level and insulin resistance level （HOMA IR）, rosiglitazone group decreased more （ P〈 0.05）. （3）Both drugs can significantly decrease the luteinizing, androstenedione and testosterone levels. （4）Ovulation rate in beth groups increased but had no difference. （5） Metformin＇s adverse reactions were diarrhea and nausea; rosiglitazone＇s were weight gaining and edema. Conclusions： Rosiglitazone and metformin can effectively improve insulin resistance of PCOS. Metformin is cheap and can decrease the body weight; rosiglitazone has better therapeutic effect on insulin resistance and hyperinsulinemia.