个体化饮食干预与二甲双胍治疗多囊卵巢综合征的临床对比观察

Effects of individualized dietary intervention and metformin in treatment of polycystic ovary syndrome:a clinical comparative observation

目的对比观察食物交换份法引导下的个体化饮食干预与二甲双胍药物治疗多囊卵巢综合征(PCOS)的临床疗效。方法将2013年6月-2015年12月在广州市妇女儿童医疗中心妇科内分泌就诊的75例合并胰岛素抵抗的PCOS患者随机分为食物交换份法引导下的饮食干预组(37例)和口服二甲双胍治疗组(38例)。对两组患者调控治疗3个月,比较干预前后排卵、体重、性激素及代谢指标改善情况。结果 64例患者完成全程3个月的观察治疗,其中饮食干预组31例、二甲双胍治疗组33例。干预前两组患者各项指标比较差异无统计学意义(P>0.05);干预后饮食干预组7例、二甲双胍组8例恢复排卵;治疗前、后两组患者体重(WT)、体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及总胆固醇(TC)等指标比较差异有统计学意义(均P<0.05),黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、高密度脂蛋白胆固醇(HDL-C)等指标变化差异无统计学意义(P>0.05);饮食干预组对WT、BMI的控制作用与二甲双胍组比较差异有统计学意义(P<0.05)。结论采用食物交换份法引导下的个体化饮食干预与二甲双胍药物治疗对PCOS患者均有恢复排卵作用,对多项代谢指标的改善疗效相当,饮食干预组对WT、BMI的控制效果更好,副作用小,疗效确切,适合长期使用。

Objective To compare and observe the clinical effects of food exchange portion-guided individualized dietary intervention and metformin in treatment of polycystic ovary syndrome（ PCOS）. Methods Seventy-five PCOS patients with insulin resistance treated in the hospital from June 2013 to December 2015 were selected and randomly divided into dietary intervention group（ 37 patients） and metformin group（ 38 patients）. The patients in the two groups were treated for three months,ovulation,body weight,sex hormones,and improvements of metabolic indexes before and after intervention were compared. Results A total of 64 patients completed the treatment for the whole three months,including 31 patients in dietary intervention group and 33 patients in metformin group. Before intervention,there was no statistically significant difference in the indexes between the two groups（ P〉0. 05）; after intervention,recovery of ovulation was observed in7 patients in dietary intervention group and 8 patients in metformin group. There were statistically significant differences in weight,body mass index（ BMI）,waist-to-hip ratio（ WHR）,fasting plasma glucose（ FPG）,fasting insulin（ FINS）,insulin resistance index（ HOMA-IR）,and total cholesterol（ TC） between before and after intervention in the two groups（ all P〈0. 05）; there was no statistically significant difference in the changes of luteinizing hormone（ LH）,follicle-stimulating hormone（ FSH）,testosterone（ T）,high-density lipoprotein cholesterol（ HDL-C） levels between before and after intervention in the two groups（ P〉0. 05）; there were statistically significant differences in the control effect on weight and BMI between the two groups（ P〈0. 05）. Conclusion Both food exchange portion-guided individualized dietary intervention and metformin can promote the recovery of ovulation in PCOS patients,the curative effects of the two methods are similar,the control effect of food exchange portion-guided individualized dietary intervention on weight and BMI is better,the adverse reactions are less,and the curative effect is exact,which is suitable for long-term application.