炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗的效果分析

Effect of ethinyloestradiol and cyproterone acetate combined with metformin in the treatment of polycystic ovary syndrome with insulin resistance

目的：探讨炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征（PCOS）合并胰岛素抵抗（IR）的效果。方法将2013年1月~2015年2月江西省妇幼保健院收治的190例PCOS合并IR患者随机分为观察组（n=95）与对照组（n=95），观察组接受炔雌醇环丙孕酮联合二甲双胍治疗，对照组接受炔雌醇环丙孕酮治疗。结果治疗前，两组患者体质量指数（BMI）、空腹胰岛素（FINS）、空腹血浆葡萄糖（FPG）、稳态模型评估法胰岛素抵抗指数（HOMA-IR）比较，差异无统计学意义（P〉0.05）；治疗后，观察组BMI、FINS、FPG、HOMA-IR显著低于对照组，差异有统计学意义（P〈0.05）。治疗前，两组患者促黄体生成素（LH）、LH/促卵泡雌激素（FSH）、睾酮（T）、雌二醇（E2）比较，差异无统计学意义（P〉0.05）；治疗后，观察组 LH、LH/FSH、T、E2显著低于对照组，差异有统计学意义（P〈0.05）。观察组排卵率、妊娠率显著高于对照组，差异有统计学意义（P〈0.05）。结论炔雌醇环丙孕酮联合二甲双胍治疗PCOS合并IR的效果确切，可改善内分泌代谢紊乱，提高妊娠率，值得临床推广应用。

Objective To investigate the effect of ethinyloestradiol and cyproterone acetate combined with metformin in the treatment of polycystic ovary syndrome（PCOS） with insulin resistance（IR）. Methods 190 cases of PCOS with IR ad-mitted into the Jiangxi maternal and child health hospital from January 2013 to February 2015 were divided into obser-vation group（n=95） and control group（n=95）,and observation group was given ethinyloestradiol and cyproterone acetate combined with metformin,while control group received ethinyloestradiol and cyproterone acetate. Results Before treat-ment,there were no obvious differences in the body mass index（BMI）,fasting insulin（FINS）,fasting plasma glucose（FPG） and homeostasis model of assessment for insulin resistence index （HOMA-IR） between two groups （P〉0.05）.After treat-ment,the BMI,FINS,FPG,HOMA-IR in observation group was obviously lower than that in control group respectively（P〈0.05）.Before treatment,there were no obvious differences in the luteinizing hormone（LH）,LH/follicle stimulating estrogen （FSH）,testosterone （T）,estradiol （E2） between two groups （P〉0.05）.After treatment,the LH,LH/FSH,T,E2 in observation group was obviously lower than that in control group respectively （P〈0.05）.The ovulation rate and pregnancy rate in ob-servation group was obviously higher than that in control group respectively （P〈0.05）. Conclusion The ethinyloestradiol and cyproterone acetate combined with metformin in the treatment of PCOS with IR shows good effect,shch as improv-ing endocrine and metabolic disorders and raising pregnancy rate,which is worthy of being popularized and applied.