炔雌醇环丙孕酮片联合生活方式干预治疗肥胖型多囊卵巢综合征的疗效观察

Effect of Diane-35 combined with? lifestyle intervention in the treatment of obesity-related polycystic ovarian syndrome

目的:探讨炔雌醇环丙孕酮片(达英-35)联合生活方式调整对肥胖型多囊卵巢综合征生殖内分泌和脂代谢的影响。方法:选取2011年7月至2013年7月来我院就诊的肥胖型多囊卵巢综合征不孕患者105例,随机分为观察组(53例)和对照组(52例)。对照组采用达英-35进行治疗,观察组在对照组基础上联合生活方式调整治疗。观察治疗前后患者体重、体重指数(BMI)及腰围指数(WHR),检测生殖激素、卵巢及子宫内膜变化,及观察月经恢复率、排卵率以及妊娠率。结果:观察组体重、BMI治疗后明显低于治疗前及对照组治疗后(P<0.05),WHR则无显著性差异。观察组治疗后的LH、T、LH/FSH、FINS、TG各指标与治疗前及对照组治疗后比较,差异有统计学意义(P<0.05)。观察组左、右卵巢体积治疗后明显低于治疗前及对照组治疗后(P<0.05)。观察组的月经恢复率、排卵率以及妊娠率均明显高于对照组(P<0.05)。结论:达英-35联合生活方式调整可改善肥胖型多囊卵巢综合征患者的生殖内分泌及脂代谢的水平,改善左、右卵巢体积及月经恢复率、排卵率以及妊娠率。

Objectives： To explore the effect of Diane -35 combined with lifestyle intervention on the reproductive endocrine and lipid metabolism of obesity -related polycystic ovarian syndrome （PCOS）. Methods： 105 infertility patients with obesity -related PCOS visited our hospital from July 2011 to July 2013 were randomly divided into observation group and control group, each of 52 patients. Patients in the control group were treated with Diane- 35 while observation group received additional lifestyle intervention. Body weight, body mass index （BM]） and waist circumference index （WHR） before and after treatment were observed; changes in reproductive hormone and ovarian and endometrium were detected, and recovery rate of menstruation, ovulation rate and pregnancy rate were observed. Results： The body weight and BMI of the observation group after treatment were obviously lower than those before treatment and the control group after treatment （ P 〈 0.05 ）, while WHR was of no significant difference. As for indexes such as LH, T, LI-I/FSH, FINS and TG, the difference between observation group after treatment and the control group after treatment or observation group before treatment was of significant differences （ P 〈 0.05 ）. The left, right ovarian volume of the observation group after treatment were obviously smaller than those before treatment and the control group after treatment（ P 〈 0.05 ）. The recovery rate of menstruation, ovulation rate and pregnancy rate of the observation group were significantly higher than the control group （ P 〈 0.05 ）. Conclu- sion： Diane -35 combined with lifestyle intervention can improve the reproductive endocrine and lipid metabolism of patients with obesity - related PCOS; improve left and right ovarian volume and recovery rate of menstruation, ovula- tion rate and pregnancy rate.