炔雌醇环丙孕酮片联合二甲双胍治疗对多囊卵巢综合征患者性激素及血清内脂素的影响

Effect of ethinylestradiol and cyproterone acetate tablets combined with metformin on sex hormone and serum visfatin in patients with polycystic ovarian syndrome

目的探讨炔雌醇环丙孕酮片联合二甲双胍治疗对多囊卵巢综合征患者性激素及血清内脂素水平的影响。方法选择2018年3月至2019年4月我院收治的多囊卵巢综合征患者46例,采用随机数字表法分为对照组和观察组,每组23例。对照组患者在月经周期最后1天口服炔雌醇环丙孕酮片治疗,连续服用21 d后停止,至下个月经周期最后1天继续按上述方法服药。观察组患者在对照组治疗的基础上加用二甲双胍肠溶片治疗,用法同炔雌醇环丙孕酮片。两组患者均连续治疗3个月经周期。检测比较两组患者治疗前后的血清促卵泡激素(FSH)、促黄体素(LH)、雌二醇(E2)、睾酮(T)、血清内脂素水平及不良反应发生情况。结果治疗3个月经周期后,观察组患者的FSH水平显著降低,两组患者的LH、T、E2水平均显著降低;观察组患者的FSH、LH、T水平显著低于对照组,E2水平高于对照组,差异有统计学意义(P<0.05);两组患者的血清内脂素水平均显著降低,观察组患者的水平显著低于对照组,差异有统计学意义(P<0.05)。治疗过程中,观察组患者头痛、血压升高等不良反应的总发生率略低于对照组,但差异无统计学意义(P>0.05)。结论炔雌醇环丙孕酮片联合二甲双胍肠溶片治疗可有改善多囊卵巢综合征患者的性激素分泌状况,降低血清内脂素水平,改善患者卵巢功能促进正常排卵,但不会增加不良反应的发生。

Objective To investigate the effects of ethinylestradiol and cyproterone acetate tablets combined with metformin on the levels of sex hormone and serum visfatin in patients with polycystic ovarian syndrome. Methods A total of 46 patients with polycystic ovarian syndrome admitted to our hospital from March 2018 to April 2019 were selected, and were randomly divided into control group and observation group, with 23 cases in each group. Patients in the control group were administered orally ethinylestradiol and cyproterone acetate tablets on the last day of the menstrual cycle, and stopped after 21 days of continuous administration, then the abovementioned administration was continued to the last day of next menstrual cycle, based on which patients in the observation group were additionally administered metformin enteric-coated tablets, with the same administration of ethinylestradiol and cyproterone acetate tablets. Patients in both groups were treated continuously for 3 menstrual cycles. Detection and comparison of serum follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), testosterone(T), serum visfatin levels and the prevalence of adverse reactions before and after treatment were performed to patients in the two groups. Results After 3 menstrual cycles of treatment, the level of FSH in the observation group significantly decreased, and the levels of LH, T and E2 in the two groups also significantly decreased. Compared to the control group, the observation group yielded lower levels of FSH, LH, T, while a higher level of E2, with the statistically significant differences(P<0.05). The level of serum visfatin of patients in the two groups significantly decreased, and the level of patients in the observation group was significantly lower than that in the control group, with the statistically significant differences(P<0.05). During treatment, the total incidence of adverse reactions including headache and blood pressure elevation in the observation group was slightly lower than that in the control group, but the difference was not statistically significant(P>0.05). Conclusion Employing ethinylestradiol and cyproterone acetate tablets in combination with metformin enteric-coated tablets can improve the secretion status of sex hormone in patients with polycystic ovarian syndrome, decrease serum visfatin level, improve ovarian function in order to promote normal ovulation, but which will not increase the occurrence of adverse reactions.