达英-35联合二甲双胍治疗多囊卵巢综合征对激素、胰岛素抵抗的影响

Effect of Diane-35 combined with metformin therapy on hormones and insulin resistance of patients with polycystic ovary syndrome

目的比较达英-35联合二甲双胍与单纯达英-35治疗多囊卵巢综合征(PCOS)的临床疗效及对激素、胰岛素抵抗的影响,为有效改善临床症状、促进患者康复,选择最佳治疗方案提供参考依据。方法选取2013年5月-2014年6月该院126例PCOS患者,按照随机数字表法分为对照组与治疗组两组,每组各63例。对照组采用达英-35治疗,1片/d;治疗组在对照组治疗基础上采用二甲双胍治疗,1片/次,3次/d。两组连续治疗3个月后评价其临床疗效,治疗前、后性激素及胰岛素抵抗变化情况,排卵率、妊娠率及不良反应。结果治疗组总有效率96.8%(61/63),明显高于对照组的77.8%(49/63),差异有统计学意义(P<0.05)。两组患者治疗后各项性激素、胰岛素抵抗较治疗前明显改善,且治疗组改善较对照组明显,差异有统计学意义(P<0.05)。治疗组排卵者及妊娠者分别为59例、52例,分别占93.7%、82.5%,明显高于对照组的47例、32例,分别占74.6%、50.8%,差异有统计学意义(P<0.05)。治疗过程中两组均无不良反应发生。结论与单纯达英-35治疗相比,达英-35联合二甲双胍治疗可有效改善临床症状,促进排卵及妊娠,提高疗效,无明显不良反应发生,具有较高安全性,值得进一步研究推广。

Objective To compare the clinical effect of Diane-35 combined with metformin therapy in treatment of polycystic ovary syndrome （PCOS） and the impact on hormones and insulin resistance, provide reference basis for effectively improving clinical symptoms, promoting recovery, and choosing the optimal therapeutic regimen. Methods A total of 126 PCOS patients were selected from the hospital from May 2013 to June 2014, then they were divided into control group and treatment group according to random number table, 63 cases in each group. The cases in control group were treated by Diane-35, one pill per day ; the cases in treatment group were treated by metformin based on Diane-35, one pill per time, three times a day. After three months of continuous treatment, the clinical efficacies, changes of sex hormones and insulin resistance before and after treatment, ovulation rates, pregnancy rates, and adverse reactions in the two groups were e- valuated. Results The total effective rate in treatment group was 96. 8% （61/63）, which was statistically significantly higher than that in control group （77. 8%, 49/63） （P〈0. 05） . After treatment, sex hormones and insulin resistance in the two groups were improved com- pared with before treatment, especially in treatment group, there were statistically significant differences （P〈0. 05） . Tile ovulation rate and pregnancy rate in treatment group were 93.7 % （59 cases） and 82. 5 % （52 cases）, respectively, which were statistically significantly higher than those in control group [ （74. 6%, 47 cases） （50, 8%, 32 cases） ~ （P〈0. 05） . No adverse reactions occurred in the two groups in the course of treatment. Conclusion Compared with simple Diane-35 treatment, Diane-35 combined with metformin can effectively improve clinical symptoms, promote ovulation and pregnancy, and improve clinical efficacy, no significant adverse reaction occurs, the safety is high, the methocl is worthy of further research and promotion.