炔雌醇环丙孕酮联合胰岛素增敏剂治疗多囊卵巢综合征疗效观察

Effect of ethinylestradiol and cyproterone combined with insulin sensitizer on polycystic ovary syndrome

目的探究炔雌醇环丙孕酮联合胰岛素增敏剂治疗多囊卵巢综合征疗效。方法选取广东省第一荣军医院妇科2018年8月—2020年8月收治的100例多囊卵巢综合征患者作为研究对象,采用随机数字表法将患者分为对照组(n=50)和观察组(n=50),2组患者均给予炔雌醇环丙孕酮治疗,观察组此外联合胰岛素增敏剂治疗,比较2组患者治疗前、治疗30 d后血清性激素、抗缪勒管激素(AMH)水平、代谢指标水平以及临床疗效(包括排卵、妊娠等)。结果治疗前,2组患者血清性激素、AMH水平比较,差异不具有统计学意义(P>0.05),治疗后,2组患者AMH、血清性激素水平均有所下降,且观察组低于对照组(P<0.05)。治疗前,2组患者代谢指标比较,差异不具有统计学意义(P>0.05),治疗后2组患者代谢指标水平均有所下降,且观察组低于对照组(P<0.05)。观察组治疗有效率高于对照组(P<0.05)。结论使用单一药物治疗具有局限性,将炔雌醇环丙孕酮与胰岛素增敏剂相联合治疗能够有效降低患者胰岛素代谢指标水平以及性激素水平,提高患者受孕几率,具有良好的治疗效果。

Objective To explore the efficacy of ethinylestradiol and cyproterone combined with insulin sensitizer in the treatment of polycystic ovary syndrome.Methods A total of 100 patients with polycystic ovary syndrome treated in the Department of Gynecology of the First Invalids Hospital of Guangdong Province from August 2018 to August 2020 were select-ed as the research object.The patients were divided into control group(n=50)and observation group(n=50).The pa-tients in both groups were given ethinylestradiol cyproterone.In addition,the observation group was treated with insulin sensi-tizer.The levels of serum sex hormone,anti-Müllerian hormone(AMH),metabolic index level and clinical efficacy(inclu-ding ovulation,pregnancy,etc.)before treatment and 30 days after treatment were compared.Results Before treatment,the levels of serum sex hormone and AMH had no significant difference between two groups(P>0.05).After treatment,the levels of AMH and serum sex hormone both decreased in two groups,and those in observation group were lower than those in control group(P<0.05).Before treatment,it had no significant difference in metabolic indexes(P>0.05).After treat-ment,the levels of metabolic indexes in the two groups decreased,and those in observation group were lower than those in control group(P<0.05).The effective rate of the observation group was higher than the control group(P<0.05).Conclu-sions Using single drug treatment has limitations.The combination of ethinylestradiol cyproterone and insulin sensitizer can reduce insulin metabolism and sex hormone levels,improve the probability of pregnancy,which have a good therapeutic effect.