二甲双胍与罗格列酮治疗胰岛素抵抗的非肥胖多囊卵巢综合征的效果比较

Effect Comparison of Metformin and Rosiglitazone in the Treatment of Non-obese Polycystic Ovary Syndrome with Insulin Resistance

目的:比较二甲双胍与罗格列酮治疗胰岛素抵抗(IR)的非肥胖多囊卵巢综合征(PCOS)的效果。方法:选择2018年10月—2021年10月福鼎市医院就诊的96例IR的非肥胖PCOS患者,按便利抽样法分为A组和B组,各48例。A组采用二甲双胍治疗,B组采用罗格列酮治疗。对比两组性激素水平、血清空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、月经情况、痤疮及多毛分级。结果:治疗6个月后,两组血清雌二醇(E_(2))、睾酮(T)水平较治疗前均下降,卵泡刺激素(FSH)较治疗前均上升,且B组均优于A组,差异均有统计学意义(P<0.05)。治疗6个月后,两组HOMA-IR、FINS水平较治疗前均下降,且B组均低于A组,差异均有统计学意义(P<0.05)。治疗6个月后,两组月经稀发发生率均较治疗前下降,月经周期较治疗前缩短,差异均有统计学意义(P<0.05),但两组对比,差异均无统计学意义(P>0.05)。治疗6个月后,两组改良Ferriman-Gallwey(mF-G)多毛评分较治疗前均降低,且痤疮严重程度较治疗前均缓解,差异均有统计学意义(P<0.05),但两组对比差异均无统计学意义(P>0.05)。结论:IR的非肥胖PCOS患者采用二甲双胍或罗格列酮治疗均能有效改善患者的IR和痤疮、多毛症状,降低FINS,从而调节患者的性激素水平和促进月经恢复,但罗格列酮在调节激素水平、改善IR的效果更好。

Objective:To compare the effect of Metformin and Rosiglitazone in the treatment of non-obese polycystic ovary syndrome(PCOS)with insulin resistance(IR).Method:A total of 96 non-obese PCOS patients with IR who admitted to Fuding Hospital from October 2018 to October 2021 were selected and divided into group A and group B according to the convenience sampling method,48 cases in each.Group A was treated with Metformin,and group B was treated with Rosiglitazone.The levels of sex hormones,serum fasting insulin(FINS),homeostasismodel assessment-insulin resistant(HOMA-IR),menstrual status,acne and hirsutism grading were compared between two groups.Result:After 6 months of treatment,the levels of serum estradiol(E_(2))and testosterone(T)in two groups decreased compared with those before treatment,while the levels of follicle stimulating hormone(FSH)increased compared with those before treatment,and those in group B were better than those in group A,the differences were statistically significant(P<0.05).After 6 months of treatment,the levels of HOMA-IR and FINS in two groups decreased compared with those before treatment,and those in group B were lower than those in group A,the differences were statistically significant(P<0.05).After 6 months of treatment,the incidence of rare menstruation in two groups decreased compared with those before treatment,and the menstrual cycle were shorter than those before treatment,the differences were statistically significant(P<0.05),but the differences between two groups were not statistically significant(P>0.05).After 6 months of treatment,the modified Ferriman-Gallwey(mF-G)hairy scores of two groups decreased compared with those before treatment,and the severity of acne were alleviated compared with those before treatment,the differences were statistically significant(P<0.05),but the differences between two groups were not statistically significant(P>0.05).Conclusion:In non-obese PCOS patients with IR,Metformin and Rosiglitazone treatment can effectively improve IR,acne and hirsutism,and reduce FINS,thus regulate the levels of sex hormones and promoting menstrual recovery,but Rosiglitazone has a better effect on regulating hormone level and improving IR.