二甲双胍联合克罗米芬治疗肥胖型多囊卵巢综合征的效果及对患者脂代谢、性腺功能的影响

Effect of Metformin Combined with Clomiphene in the Treatment of Obese Polycystic Ovary Syndrome and Its Effect on Lipid Metabolism and Gonadal Function

目的:探讨二甲双胍联合克罗米芬治疗肥胖型多囊卵巢综合征(PCOS)的临床效果及对患者脂代谢水平与性腺功能的影响。方法:选取2019年1月-2021年1月哈尔滨市第一医院60例肥胖型PCOS患者,随机分为对照组(30例,接受克罗米芬治疗)与研究组(30例,接受二甲双胍联合克罗米芬治疗),疗程均为3个月。比较两组治疗前后的甘油三酯(TG)、空腹血糖(FPG)、黄体生成素(LH)、餐后2 h血糖(2 h PG)、雌二醇(E2)、低密度脂蛋白胆固醇(LDL-C)、睾酮(T)、总胆固醇(TC)、卵泡刺激素(FSH)、高密度脂蛋白胆固醇(HDL-C)水平;比较两组的临床疗效及不良反应发生情况。结果:治疗前两组的FPG、LDL-C、2 h PG、TC、LH、FSH、TG、HDL-C、T、E2水平比较,差异均无统计学意义(P>0.05);治疗后研究组的FPG、2 h PG、LDL-C、TC、TG、LH、FSH、T水平均低于对照组,HDL-C水平高于对照组,差异均有统计学意义(P<0.05)。研究组的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论:二甲双胍联合克罗米芬可有效改善肥胖型PCOS患者性腺功能,提高患者脂代谢水平。

Objective:To investigate the clinical effect of Metformin combined with Clomiphene in the treatment of obese polycystic ovary syndrome(PCOS) and the effects on lipid metabolism and gonadal function.Method:A total of 60 obese PCOS patients in Harbin First Hospital from January 2019 to January 2021 were randomly divided into control group(30 cases,treated with Clomiphene) and study group(30 cases,treated with Metformin combined with Clomiphene) for a course of 3 months.The levels of triglyceride(TG),fasting plasma glucose(FPG),luteinizing hormone(LH),2 h postprandial plasma glucose(2 h PG),estradiol(E2),low density lipoprotein cholesterol(LDL-C),testosterone(T),total cholesterol(TC),follicle stimulating hormone(FSH) and high density lipoprotein cholesterol(HDL-C) were compared between the two groups before and after treatment.The clinical efficacy and adverse reactions of the two groups were compared.Result:There were no significant differences in the levels of FPG,LDL-C,2 h PG,TC,LH,FSH,TG,HDL-C,T and E2 between the two groups before treatment(P>0.05).After treatment,the levels of FPG,2 h PG,LDL-C,TC,TG,LH,FSH and T in the study group were lower than those in the control group,and the level of HDL-C in the study group was higher than that in the control group(P<0.05).The total effective rate of the study group was significantly higher than that of the control group(P<0.05).There was no significant difference in the total adverse reaction rate between the two groups(P>0.05).Conclusion:Metformin combined with Clomiphene can effectively improve gonadal function and lipid metabolism in obese PCOS patients.