炔雌醇环丙孕酮合用二甲双胍治疗多囊卵巢综合征65例临床观察

Clinical observation of ethinyl estradiol cyproterone acetate and metformin treatment of polycystic ovary syndrome

目的探讨炔雌醇环丙孕酮(商品名达因-35)合用二甲双胍治疗多囊卵巢综合征(PCOS)患者65例临床疗效。方法将我院门诊65例PCOS患者随机分为观察组(炔雌醇环丙孕酮合用二甲双胍)和对照组(单用炔雌醇环丙孕酮),均治疗6个月,比较两组血中主要内分泌激素如黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、雌二醇(E2)、泌乳素(PRL)及空腹胰岛素(FINS),给予两组的临床症状体征进行评分(多毛评分、痤疮评分、卵巢体积评分),还比较了两组患者的体重指数(BMI)及腰臀比(WHR)。结果两组患者治疗后与治疗前比较,均可使PCOS患者LH、T、痤疮评分、多毛F-C评分及卵巢体积不同程度下降,差异有统计学意义(P<0.05),但炔雌醇环丙孕酮合用二甲双胍组疗效更明显。治疗后LH、T、FINS、痤疮评分及卵巢体积评分在组间比较均分别有统计学意义(P<0.05)。结论炔雌醇环丙孕酮合用二甲双胍治疗PCOS,能有效控制高雄激素血症,明显改善症状体征,疗效显著。炔雌醇环丙孕酮与二甲双胍两者具有协同作用,并能降低远期并发症的发生,两者合用对于PCOS的治疗效果优于单一使用炔雌醇环丙孕酮。

Objective To investigate the clinical efficacy of ethinyl estradiol cyproterone （trade name dyne-35） and met- formin treatment of PCOS. Methods 65 cases of path were randomly divided into obvervation group （ethinyl estradiol cyprot- crone acetate and metformin） and eontrol group （ethinyl estradlol cyproterone acetate alone）. After six months treatment, com- pared the major hormone, lutelnizing hormone （LH）, follicle stimulating hormone （FSH）, testosterone （T）, estradiol （E2）, prolactin （PRL）, and fasting insulin （FINS） between two groups. Gave the two groups of clinical symptoms and signs score （score hirsutism, ache score, ovarian volume score）, and compared the two groups of patients with clinical symptoms and signs score, a body mass index （BMI）, and （WHR）. Results The levels of LH, T, and signs scores （ache ratings, hirsutism score and ovarian volume score） of two groups had decreased after treatment. The efficacy of ethinyl estradiol cyproterone and met- formin group were more pronounced than the control group. After treatment, compared the levels of LH, T, FINS, the degree of ovarian volume reduced and acne scores of two groups had a significantly different （P^0.05）. Conclusion Ethinyl estradiol cyproterone and metforrnin treatment of PCOS can effectively control hyperandrogenisrn, significant improvement in symptoms, signs a significant effect. Two drugs have a synergistic effect. And reduce the incidence of long-term complications. The efficacy of two drugs combined for treatment of PCOS is better than single use of ethinyl estradiol cyproterone.