益肾化痰方联合二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗的临床评价

Clinical Assessment of “Yishen Huatan Decoction” with Metformin in the Treatment of Polycystic Ovary Syndrome with Insulin Resistance

目的:探讨益肾化痰方联合二甲双胍对多囊卵巢综合征合并胰岛素抵抗的临床疗效。方法:纳入符合观察标准的多囊卵巢综合征合并胰岛素抵抗患者90例,随机分为中药组、西药组、中西药组,每组各30例。中药组予益肾化痰方,西药组予二甲双胍,中西药组予益肾化痰方加二甲双胍,各组疗程均为3个月。观察治疗前后临床症状、妊娠情况,检测糖代谢指标与性激素水平的改善情况。结果:中西药组在基础体温(BBT)及月经改善方面的临床疗效明显优于单纯中药组及西药组(P<0.05)。中西药组与西药组可显著降低胰岛素(FINS)、稳态胰岛素评价指数(HOMA-IR)(P<0.01),而中药组无明显影响(P>0.05);中西药组与中药组能明显降低血清黄体生成素(LH)、睾酮(T)水平(P<0.01),而西药组仅可降低T水平(P<0.05)。结论:益肾化痰方联合二甲双胍可明显改善多囊卵巢综合征并胰岛素抵抗患者的临床症状和内分泌及糖代谢,恢复月经周期。

Objective： To assess the clinical efficacy of ＂Yishen Huatan Decoction＂combined with metformin in the treatment of polycystic ovary syndrome with insulin resistance. Methods： Ninety patients who met the inclusion and exclusion criteria were randomly assigned into＂Yishen Huatan Decoction ＂group,metformin group,and ＂Yishen Huatan Decoction ＂with metformin group,with 30 cases in each group. After 3-month continuous treatment,the primary outcome was the clinical symptoms,pregnancy and the improvement of the detection of glucose metabolism and the levels of sex hormone indicators.Results： The improvement of BBT and menstruation in combination group were better than＂Yishen Huatan Decoction＂group and metformin group（ P〈0. 05）. ＂Yishen Huatan Decoction ＂ with metformin group could significantly reduce FINS and HOMA-IR（ P〈0. 01）,while the＂Yishen Huatan Decoction＂group had no significant effect（ P〈0. 05）; the level of LH and T were significantly lower in ＂Yishen Huatan Decoction＂group and ＂Yishen Huatan Decoction ＂with metformin group（ P〈0. 01）. However,The metformin group can only reduce the level of T（ P〈0. 05）. Conclusion： ＂Yishen Huatan Decoction＂with metformin can significantly improve the clinical symptoms of glucose metabolism and endocrine of patients with polycystic ovary syndrome with insulin resistance,and recover menstrual cycle.