摘要
目的综合评价炔雌醇环丙孕酮(达英-35)及其与二甲双胍联合应用对多囊卵巢综合征(PCOS)患者代谢指标的影响。方法在PubMed、EMBASE、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)等相关数据库,对2001年至2013年的中英文文献进行检索。纳入的研究包括达英-35单用组及达英-35与二甲双胍联用组,对纳入研究的质量进行评价,用Revman4.2.10软件进行Meta分析。结果共纳入19项临床试验,包括1 385例PCOS患者。其方法学质量的Jadad评分均≥3分。荟萃分析结果显示:(1)激素指标:与单用达英-35组比较,联用组卵泡刺激素(FSH)差异无统计学意义;黄体生成素(LH)、睾酮(T)均明显降低,差异有统计学意义。(2)脂代谢指标:与单用达英-35组比较,联用组低密度脂蛋白(LDL)差异和高密度脂蛋白(HDL)均差异无统计学意义;总胆固醇(TC)、总三酰甘油(TG)均有所降低,差异有统计学意义。(3)胰岛素指标:单用达英-35组与联用组空腹血糖(FBG)差异无统计学意义;但联用组空腹胰岛素(FIns)明显降低,差异有统计学意义。结论联合用药较达英-35单药治疗能更有效地纠正PCOS患者的代谢紊乱,改善胰岛素抵抗。
Objective To comprehensively assess the effect of Diane-35 and metformin for metabolic inde-xes in patients with PCOS.Methods The related datum during 2001 -2013 in PubMed、EMBASE、Cochrane Librar-y、CNKI、CBMdisc was collected during the year of 2001 -2013.The studies were involved in researches included Di-ane-35 group and combined group ed group of Diane-35 with mefformin.Quality assessment was conducted.Rev-man 4.2.10 was applied to perform the analysis.Results 19 RCTs with a Jadad scale above 3,were identified were brought into this research,including 1385 PCOS patients.Its Jadad was ≥3.The results of meta-analysis showed that:(1 )Hormonal level:Compared with Diane-35 group,the serum LH and T in the combined group were signifi-cantly lower than those in Diane-35 group.However,The level of FSH in the combined group was decreased.but with no significantly differences between these two groups.(2)Lipid metebolism:Compared with Diane-35 group,the lev-els of serum TG and TC in the combined group were significantly lower than those in Diane-35 group.AlthoughHow-ever,the level of LDL was decreased and the level of HDL was increased in the combined group with no significantly differences,these difference failed to achieve statistical significance.(3 )Insulin level:Compared with Diane -35 group,the level of serum FIns in the combined group was significantly lower than that in Diane-35 group,while the level of FBG in the combined group was decreased with no significantly differences.,but no the significance differ-ence.Conclusions The combination of Diane-35 with metformin may be associated with the improvements of meta-bolic indexes in patients with PCOS compared with Diane-35 only.
出处
《中国临床保健杂志》
CAS
2014年第2期127-131,共5页
Chinese Journal of Clinical Healthcare
基金
上海市科委基金(124119a5700)