PCOS患者应用维生素D辅助炔雌醇环丙孕酮治疗的效果观察

Observation on the effect of vitamin D assisted treatment with ethinyl estradiol and cyproterone in PCOS patients

目的:分析多囊卵巢综合征(Polycystic ovary syndrome,PCOS)常规治疗时行维生素D辅助治疗的临床效果。方法:选择2019年3月至2021年3月期间我院收治的107例PCOS患者作为研究对象,掷币法分为常规组(n=53)和辅疗组(n=54)。常规组患者口服炔雌醇环丙孕酮和二甲双胍,辅疗组患者在常规组的基础上加服维生素D辅助治疗,均持续3个月,比较两组患者治疗前后的内分泌激素情况、基础血清脂代谢指标水平、25-羟维生素D3(25-Hydroxy vitamin D3,25(OH)D3)水平、空腹胰岛素(Fasting insulin,FINS)水平、胰岛素抵抗情况以及相关体征变化。结果:辅疗组治疗3月后卵泡刺激素(Follicle-stimulating hormone,FSH)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)水平和常规组无显著差异(P>0.05),抗缪勒管激素(Anti-Mullerian hormone,AMH)、睾酮(Testosterone,T)、促黄体生成素(Luteinizing hormone,LH)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、胰岛素抵抗率、空腹胰岛素(Fasting insulin,FINS)、痤疮评分、体重指数、体毛评分和LH/FSH水平均较常规组低,25-羟维生素D3(25-Hydroxy vitamin D3,25(OH)D3)水平高于常规组(P<0.05)。结论:常规治疗基础上进行维生素D辅助治疗,可调节PCOS患者相关脂代谢、内分泌激素水平,改善其胰岛素抵抗、25(OH)D3水平和相关体征,效果良好,值得推广。

Objective:To analyze the clinical effects of vitamin D adjuvant therapy during routine treatment of polycystic ovary syndrome(PCOS).Methods:A total of 107 PCOS patients admitted to our hospital from March 2019 to March 2021 were selected as the research objects.According to the coin toss method was divided into the conventional group(n=53)and the adjuvant therapy group(n=54).Patients in the conventional group were given oral ethinyl estradiol,cyproterone and metformin,and patients in the adjuvant therapy group were treated with vitamin D adjuvant therapy on the basis of the routine group for 3 months.The endocrine hormones and basic serum levels,Lipid metabolism index levels,25-Hydroxy vitamin D3(25(OH)D3)levels,fasting insulin(FINS)levels,insulin resistance,and changes in related signs of the two groups were compared before and after treatment..Results:The levels of Follicle-stimulating hormone(FSH)and High-density lipoprotein cholesterol(HDL-C)in the adjuvant treatment group at the end of 3 months were not significantly different from those in the conventional group(P>0.05),Anti-Mullerian hormone(Anti-Mullerian hormone,AMH),Testosterone(T),Luteinizing hormone(LH),Low density lipoprotein cholesterol(LDL-C),Total cholesterol(TC),Triglyceride(TG),insulin resistance rate,fasting insulin(Fasting insulin,FINS),acne score,body mass index,body hair score and LH/FSH levels are lower than those of the conventional group,25-Hydroxy vitamin D3(25(OH)D3)levels are higher Routine group(P<0.05).Conclusion:Adjuvant vitamin D treatment based on conventional treatment can regulate the related lipid metabolism,endocrine hormone levels,and improve insulin resistance,25(OH)D3 levels and related signs in patients with PCOS.The effect is good and it is worthy of promotion.