复方醋酸环丙孕酮联合二甲双胍治疗青春期多囊卵巢综合征临床观察

Clinical observation of pubertal polycystic ovary syndrome treated by compound cyproterone acetate combined with metformin

目的观察青春期多囊卵巢综合征(PCOS)患者联合应用二甲双胍、复方醋酸环丙孕酮(达英-35)治疗前后激素水平的变化分析。方法将36例PCOS患者随机分成两组,对照组18例单独应用复方醋酸环丙孕酮治疗,观察组18例应用复方醋酸环丙孕酮联合二甲双胍治疗。比较两组患者用药前后血性激素水平、空腹血糖、空腹胰岛素、胰岛素抵抗指标、BMI、F-G评分、痤疮及卵巢多囊样改变等。结果两组患者治疗后血清雄激素水平、LH水平、LH/FSH比值较治疗前明显降低,多毛、痤疮症状及卵巢多囊样改变明显改善,差异有统计学意义(P<0.05或P<0.01),观察组患者空腹血糖、空腹胰岛素、胰岛素抵抗指标降低明显,同对照组比较,差异有统计学意义(P<0.01)。结论青春期PCOS患者使用复方醋酸环丙孕酮联合二甲双胍治疗,可明显改善内分泌失控状态。

Objective To observe and analyze the hormone level changes of pubertal patients with polycystic ovary syndrome （PCOS） before and after treatment by metformin and compound cyproterone acetate （diane-35）. Methods Thirty-six PCOS patients were evenly divided into two groups in random. In control group, the patients were only treaded by compound cyproterone acetate, while in observation group, besides compound cyproterone acetate, metformin was also added in the treatment. Such indexes like sex hormone level in serum, fasting blood-glucose, fasting insulin, insulin resistance, BMI, F-G score, acne, and ovary polycystic changes were compared before and after medication between the two groups. Results After the treatment, androgen level in serum, luteinizing hormone （LH） level, ratio between LH to follicle-stimulating hormone （FSH） in both groups were obviously lower than those before treatment. Symptoms like hairness, acne, and ovary polycystic changes after treatment were greatly bettered, there was statistical difference （P 0.05 or P 0.01）. Compared with the control group, patients in observation group whose fasting blood-glucose, fasting insulin, and index of insulin resistance distinctly decreased, there was significant difference （P 0.01）. Conclusion In the treatment of PCOS, compound cyproterone acetate combined with metformin can regulate the unbalanced state of endocrine.