维生素E联合二甲双胍治疗胰岛素抵抗型PCOS的抗炎抗氧化作用

目的探讨维生素E联合二甲双胍治疗胰岛素抵抗型多囊卵巢综合征(PCOS)患者的临床应用以及抗炎抗氧化作用.方法收集胰岛素抵抗型PCOS患者56例,随机分为对照组和观察组,对照组单独服用二甲双胍,观察组采用维生素E联用二甲双胍组,每组各28例.于月经或撤退性出血第3天开始口服二甲双胍片,0.5g/次,3次/d.维生素E联用二甲双胍组的二甲双胍剂量同对照组,维生素E 0.1g/次,3次/d;连续用药3个月.比较两组治疗前后血清中性激素、胰岛功能以及抗炎抗氧化作用.结果观察组黄体生成素(LH)、睾酮(T)以及黄体生成素/卵泡刺激素比值(LH/FSH)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)与对照组比较明显降低,差异有统计学意义(P<0.05).而观察组对胰岛素敏感性(ISI)上升更为显著(P<0.05),卵泡刺激素水平(FSH)与治疗前无显著差异.维生素E能显著降低PCOS体内的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)炎症相关指标,并且增强超氧物歧化酶(SOD)、过氧化氢酶(CAT)的活性,降低过氧化物丙二醛(MDA)、活性氧(ROS)水平.结论维生素E联合二甲双胍治疗胰岛素抵抗型PCOS效果显著,能够明显改善性激素水平,胰岛素抵抗,并降低炎症因子产生和氧化应激水平.

Objective To explore the clinical application of vitamin E combined with metformin in the treatment of polycystic ovary syndrome and its anti-inflammatory and antioxidant effects. Methods 56 cases with insulin-resistant PCOS insulin were randomly divided into the control group (n=28)and the experiment group(n=28). The control group was treated with metformin alone. The test group was treated with vitamin E in combination with metformin. On the 3rd day of menstrual or evacuation bleeding,metformin was taken orally,0.5g/times,3 times/day. The metformin dosage of vitamin E combined with metformin group was the same as the control group,vitamin E 0.1g/,3 times/day,and 3 months for continuous medication. Serum neutral hormones,pancreatic islet function and anti-inflammatory,antioxidant effects were compared before and after treatment in two groups. Results The experiment group was compared with the control group,the level of luteotropichor(LH),testosterone(T),the ration of LH/FSH,fasting plasma glucose(FPG),fasting serum insulin(FINS)and HOMA-IR decreased more obviously,and ISI increased significantly (P<0.05),but there was no significant difference between follicle stimulating hormone(FSH)and treatment(P>0.05). Vitamin E significantly reduced the inflammatory index of C-reactive protein,TNF-α,IL-6,and the activities of superoxide dismutase(SOD)and catalase(CAT)were enhanced with the reduce of Malondialdehyde(MDA)and reactive oxygen(ROS). Conclusion Vitamin E combined with metformin is effective in the treatment of insulin-resistant polycystic ovary syndrome,which can significantly improve sex hormone levels,insulin resistance,and reduce inflammatory factors and oxidative stress.