炔雌醇环丙孕酮联合二甲双胍治疗非肥胖型多囊卵巢综合征的疗效及安全性

The efficacy and safety of ethinylestradiol and cyproterone combined with metformin in the treatment of non-obese polycystic ovary syndrome

目的探究炔雌醇环丙孕酮联合二甲双胍治疗非肥胖型多囊卵巢综合征(PCOS)的疗效及安全性。方法选取2015年1月至2018年1月眉山市人民医院妇科收治的70例非肥胖型PCOS患者,按随机数字表法分为观察组和对照组,每组各35例。观察组给予炔雌醇环丙孕酮联合二甲双胍治疗,炔雌醇环丙孕酮每次1片,每日1次,二甲双胍每次500 mg,每日3次,治疗3周。对照组仅给予炔雌醇环丙孕酮片治疗,剂量、疗程同观察组。记录2组治疗后排卵率,治疗前后采集血清标本检测糖脂代谢指标水平、炎性因子水平,以及不良反应情况。结果治疗后观察组3、6个月排卵率(54. 29%,77. 14%)均显著高于对照组(31. 43%,54. 29%),差异有统计学意义(P<0. 05)。治疗后2组空腹血糖(FBG)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)水平显著降低,空腹胰岛素(FINS)、高密度脂蛋白胆固醇(HDL-C)水平显著升高,且观察组FBG、LDLC降低幅度及FINS、HDL-C升高幅度较对照组更显著,差异有统计学意义(P<0. 05)。治疗后2组白细胞介素10(IL-10)水平显著升高,IL-18、肿瘤坏死因子α(TNF-α)水平显著降低,且观察组IL-10升高幅度及IL-18、TNF-α降低幅度较对照组更显著,差异有统计学意义(P<0. 05)。2组患者不良反应情况比较差异无统计学意义(P>0. 05)。结论炔雌醇环丙孕酮联合二甲双胍治疗非肥胖型PCOS可有效促进排卵,改善糖脂代谢及减轻炎症反应,且安全性好。

Objective To explore the efficacy and safety of ethinylestradiol and cyproterone combined with metformin in the treatment of non-obese polycystic ovary syndrome(PCOS). Methods From January 2015 to January 2018,a total of 70 non-obese PCOS patients admitted to Meishan City People’s Hospital were divided into the observation group and the control group according to the random number table method,35 cases in each group,and the observation group was given ethinylestradiol and cyproterone combined with metformin treatment,ethinylestradiol and cyproterone 1 tablet each time,once a day,metformin 500 mg each time,3 times a day for 3 weeks. The control group was given only ethinylestradiol and cyproterone,the dose and duration of treatment were the same as those in the observation group. The ovulation rate after treatment was recorded,and serum samples were collected before and after treatment to detect the levels of lipid metabolism indexes and inflammatory factors. Results The ovulation rate of the observation group at 3 and 6 months(54. 29%,77. 14%)after treatment was significantly higher than that of the control group(31. 43%,54. 29%),the difference was statistically significant(P<0. 05). After treatment,the levels of fasting blood glucose(FBG)and low-density lipoprotein cholesterol(LDL-C)were significantly reduced,and the levels of fasting insulin(FINS)and high-density lipoprotein cholesterol(HDL-C)were significantly increased,and the decrease of FBG and LDL-C and the increase of FINS and HDL-C in the observation group were more significant than those of the control group,and the difference was statistically significant(P<0. 05). After treatment,the levels of interleukin 10(IL-10)was significantly increased,and the levels of IL-18 and tumor necrosis factor alpha(TNF-α)were significantly reduced. The increase of IL-10 and the decrease of IL-18 and TNF-α in the observation group were more significant than those of the control group,and the difference was statistically significant(P<0. 05). The adverse drug reaction between the two groups was not statistically significant(P>0. 05). Conclusion Ethinylestradiol and cyproterone combined with metformin in the treatment of non-obese PCOS can effectively promote ovulation,improve glucose and lipid metabolism,reduce inflammation and it has good safety.