奥利司他与二甲双胍治疗肥胖PCOS患者的效果

Effect of Orlistat and Metformin in the Treatment of Obese PCOS Patients

目的:探讨奥利司他与二甲双胍治疗肥胖多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的效果。方法:选取2020年2月—2022年2月福建医科大学附属龙岩第一医院收治的103例肥胖PCOS患者。根据随机数表法将其分为对照组(n=51)和观察组(n=52)。两组均给予常规治疗,对照组给予盐酸二甲双胍片,观察组给予奥利司他胶囊。比较两组临床疗效,治疗前、治疗4个月后脂代谢指标、人体测量学指标、性激素指标及不良反应。结果:治疗4个月后,观察组总有效率(88.46%)高于对照组(72.55%)(P<0.05)。治疗4个月后,观察组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组,高密度脂蛋白胆固醇(HDL-C)水平高于对照组(P<0.05)。治疗4个月后,观察组体重指数(BMI)、腰围、臀围均低于对照组(P<0.05)。治疗4个月后,两组卵泡刺激素(FSH)、雌二醇(E_(2))及睾酮(T)水平均降低(P<0.05),两组FSH、E_(2)、T水平比较差异均无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:在肥胖PCOS患者中,奥利司他和二甲双胍在调节性激素水平方面效果相当,但奥利司他对脂代谢、BMI及腰臀围改善更有优势,可显著提高临床疗效,且不增加不良反应发生率。

Objective: To investigate the effect of Orlistat and Metformin in the treatment of obese polycystic ovary syndrome(PCOS) patients. Method: A total of 103 obese PCOS patients admitted to Longyan First Hospital Affiliated to Fujian Medical University from February 2020 to February 2022 were selected. According to the random number table method, they were divided into control group(n=51) and observation group(n=52). Both groups were given routine treatment, the control group was given Metformin Hydrochloride Tablets, the observation group was given Orlistat Capsules. The clinical efficacy, lipid metabolism index, anthropometry index, sex hormone index before treatment and after 4 months of treatment and adverse reactions were compared between the two groups. Result: After 4months of treatment, the total effective rate of the observation group(88.46%) was higher than that of the control group(72.55%)(P<0.05).After 4 months of treatment, the levels of total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) were lower than those of the control group, and the level of high density lipoprotein cholesterol(HDL-C) was higher than that of the control group(P<0.05). After 4months of treatment, the body mass index(BMI), waist circumference and hip circumference of the observation group were lower than those of the control group(P<0.05). After 4 months of treatment, the levels of follicle stimulating hormone(FSH), estradiol(E_(2)) and testosterone(T) in the two groups were decreased(P<0.05), and there were no significant differences in the levels of FSH, E_(2)and T between the two groups(P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: In obese PCOS patients, Orlistat and Metformin are equally effective in regulating sex hormone levels, but Orlistat has the advantages in improving lipid metabolism, BMI and waist-hip circumference, which can significantly improve clinical efficacy, without increasing the incidence of adverse reactions.