二甲双胍联合达英-35治疗肥胖型多囊卵巢综合征合并胰岛素抵抗的疗效分析

Therapy effect of Metformin and Diane-35 in obesity patients with polycystic ovary syndrome and insulin resistance

目的探讨二甲双胍联合达英-35治疗肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)合并胰岛素抵抗的临床效果。方法选择2015年1月—2016年12月就诊于天津医科大学第二医院并符合要求的PCOS患者共60例,根据患者自愿原则,结合单纯随机抽样方法,将研究对象分为对照组和试验组,每组30例。对照组患者采用单纯达英-35治疗,试验组患者采用达英-35联合二甲双胍治疗。随访4个月后,比较2组患者生殖激素水平、血糖水平和胰岛素抵抗水平。结果经过4个月的治疗后,对照组患者生殖激素水平下降,差别有统计学意义(P<0.05);血糖水平变化(5.3 mmol/L vs 5.5 mmol/L)和胰岛素抵抗(3.6 vs 3.9)与治疗前无统计学差别(P>0.05)。试验组患者生殖激素水平、血糖水平(4.5 mmol/L vs 5.4 mmol/L)和胰岛素抵抗(2.3 vs 3.8)均明显下降,与治疗前比较差别均有统计学意义(P<0.05)。试验组患者治疗后生殖激素和血糖、胰岛素抵抗均低于对照组,差别有统计学意义(P<0.05)。结论达英-35联合二甲双胍可有效改善肥胖型PCOS合并胰岛素抵抗患者的疗效。

Objective To analyzed the therapy effect of metformin in obesity patients with polycystic ovary syndrome（PCOS）and insulin resistance. Methods Based on clinical trial design,60 PCOS patients coexisted with insulin resistance were recruited according to the including and excluding criteria from Jan.2015 to Dec.2016.All patients were randomly categorized into control group（n=30）and experimental group（n=30）.The diane-35 was used for patients in control group,while the diane-35 and metformin were used for patients in experimental group. After 4 months follow-up,compared the sexual hormone,blood glucose and insulin resistance between control group and experimental group and analyzed the therapy effect of diane-35 combined with metformin for PCOS patients. Results After treatment for 4 months,the sexual hormone level significantly decreased in patients of control group,while there were no significant decreases for blood glucose（5.3 mmol/L vs 5.5 mmol/L）and insulin resistance（3.6 vs 3.9）.The sexual hormone level,blood glucose（4.5 mmol/L vs 5.4 mmol/L）and insulin resistance（2.3 vs 3.8）decreased significantly in patients of experimental group,all the changes were significant. In addition,the sexual hormone,blood glucose and insulin resistance for patients in experimental group were lower than those in patients of control group after treatment. Conclusion Diane-35 combined with metformin might effectively treat obesity PCOS patients coexists with insulin resistance.