中药对多囊卵巢综合征患者糖脂代谢异常的调节作用

Advantages of Chinese Medicine for Treatment of Blood Sugar and Lipid Metabolic Disorders in Patients with Polycystic Ovarian Syndrome

目的研究中药对多囊卵巢综合征(PCOS)患者胰岛素抵抗和糖脂代谢异常的治疗优势,探讨其可能的作用机制。方法将100例PCOS患者分成中药组40例和西药组60例,后者又随机分为二甲双胍组和复方醋酸环丙孕酮(CPA)组各30例。比较3组患者治疗前和治疗3及6个周期后体重指数(BMI)、空腹血糖(FBG)、空腹胰岛素水平(FINS)、血脂指标,稳态模型法测定胰岛素抵抗指数(HOMA-IR);观察排卵恢复情况。结果中药组、二甲双胍组和CPA组分别有30例、22例和23例患者完成6个月治疗。中药组治疗6个月后FINS、FBG、HOMA-IR、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均下降,高密度脂蛋白胆固醇(HDL-C)上升(P<0.05);其中BMI、FINS、FBG、HOMA-IR、TC和LDL-C治疗后与CPA组比较差异有统计学意义(P<0.05),治疗组优于CPA组。排卵率中药组为53.3%(16/30)、二甲双胍组为27.3%(6/22),CPA组为21.7%(5/23)。中药组高于CPA组(P<0.01)。结论中药对PCOS患者有改善胰岛素抵抗、调节糖脂代谢与恢复排卵的作用。

Objective To study the advantages of Chinese medicine （CM） in treating insulin resistance and disorders of glucose and lipid metabolism in patients with polycystic ovarian syndrome （PCOS）, and to explore its underlying mechanisms. Methods One hundred PCOS patients were assigned to three groups： 40 patients in the CM group treated by CM, 30 in the WM1 group treated by metformin, and 30 in the WM2 group treated by cyproterone. Before treatment and at 3 cycles and 6 cycles after treatment, changes of body mass index （BMI）, fasting serum insulin （FINS） and fasting blood sugar （FBG） levels as well as lipid spectrum were measured and the homeostasis model of insulin resistance （HOMA-IR） was calculated. Meanwhile, the recovery of ovulation was observed. Results There were 30, 22 and 23 patients in the CM, WM1 and WM2 group respectively completed their 6-month treatments. Levels of FINS, FBG, HOMA-IR, total cholesterol （TC） and low-density lipoprotein cholesterol （LDL-C） were lowered and high-density lipoprotein cholesterol （HDL-C） level increased in the CM group after 6-month treatment, showing significant difference as compared with the baseline （ P 〈0.05）, and the difference in comparing with the WM2 group was statistically significant in terms of MBI, FINS, FBG, HOMA-IR, TC and LDL-C （ P 〈 0.05）. The ovulation rate was 53.3% （16/30） in the CM group, 27.3% （6/22） in the WM1 group and 21.7% （5/23） in the WM2 group, comparison between them showed a signifi- cant difference between the CM group and the WM2 group （ P 〈 0.01 ）. Conclusion CM is effective for the treatment of PCOS in improving insulin resistance, adjusting blood sugar and lipids levels and recovering ovulation.