二甲双胍联合激素治疗多囊卵巢综合征的近期以及远期疗效观察

Clinical induction on short-and long-term effects of metformin combined with hormone in treatment of polycystic ovary syndrome

目的探讨二甲双胍联合激素治疗多囊卵巢综合征(PCOS)的近期以及远期疗效。方法 74例PCOS患者随机分为两组各37例,对照组给予达英-35口服,观察组采用二甲双胍联合达英-35口服,比较两组患者的症状缓解情况、性激素、糖代谢相关指标、排卵和妊娠情况。结果治疗后观察组的症状改善情况明显优于对照组(P<0.05);治疗后两组的卵泡刺激素(FSH)水平无明显变化,黄体生成激素(LH)和睾酮(T)水平显著降低,LH/FSH比值也显著降低,性激素结合蛋白(SHBG)显著增高(P<0.05);组间比较差异无统计学意义(P>0.05)。对照组治疗前后糖代谢相关指标无明显变化(P>0.05),观察组治疗后体质指数(BMI)、腰臀比(WHR)、空腹胰岛素(Fins)、胰岛素抵抗指数(IR)显著降低(P<0.05),组间比较差异有统计学意义(P<0.05)。观察组排卵率和妊娠率均显著高于对照组(P<0.05)。结论二甲双胍联合激素治疗多囊卵巢综合征疗效显著,可以有效缓解症状,改善患者的内分泌与代谢紊乱,提高排卵率和妊娠率,值得在临床推广。

Objective To observe the short and long term efficacy of metformin combined with hormone in treatment of polycystic ovary syndrome（PCOS）. Methods Seventy-eight cases of patients were randomized into test group and control group, 37 cases in each group. The control group received treatment with Diane-35 while the test group received metformin combined with Diane-35. The remis- sion of symptoms, sex hormones, glucose metabolism-related indicators and ovulation and pregnancy of the two groups were compared af- ter treatment. Results The remission of symptoms of test group was much better than that of control group （P 〈 0.05 ）. After treat- ment, follicle stimulating hormone （FSH） levels of the two groups were not changed significantly, levels of luteinizing hormone （LH） and testosterone （T） and the ratio of LH to FSH were significantly reduced,and sex hormone binding protein （SHBG） was significantly higher （ P 〈 0.05 ）. There was no significant difference between the two groups （ P 〉 0.05 ）. There was no significant difference in glu- cose metabolism-related indicators before and after treatment in control group （ P 〉 0.05 ）. After treatment, body mass index （ BMI）, waist-hip ratio （WHR）, fasting insulin （Fins） and insulin resistance index （IR） were significantly reduced in test group （P 〈 0.05 ）. The difference between the two groups was statistically significant （ P 〈 0.05 ）. The rates of ovulation and pregnancy of test group were significantly higher than those of control group （P 〈 0.05 ）. Conclusions The efficacy of metformin combined with hormone in treat- ment of polycystic ovary syndrome is satisfactory. Such treatment can relieve symptoms effectively,improve endocrine and metabolic dis- orders ,raise rates of ovulation and pregnancy,which is worthy of clinical use.