针对肥胖型多囊卵巢综合征患者进行群组干预模式的临床疗效观察

Clinical observation of group intervention mode for obese patients with polycystic ovary syndrome

目的探讨针对肥胖型多囊卵巢综合征患者进行群组干预模式的临床疗效。方法选取60例体质量指数(BMI)≥25 kg/m^(2)的多囊卵巢综合征患者,辨证为痰湿证。根据随机数字表法分为治疗组(群组干预模式下控制体重+二甲双胍)与对照组(传统生活方式干预+二甲双胍),每组30例。比较两组BMI、内分泌代谢指标。结果两组患者BMI、腹围指标治疗前后比较,差异有统计学意义(P<0.05)。治疗后,治疗组BMI、腹围指标低于对照组,差异有统计学意义(P<0.05)。治疗组治疗后与治疗前比较,促黄体生成素(LH)水平下降明显,差异有统计学意义(P<0.05),睾酮(T)水平下降与治疗前比较,差异无统计学意义(P>0.05);治疗后,治疗组LH水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者空腹血糖(FPG)、血清胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)指标比较,差异无统计学意义(P>0.05);治疗6个月后,两组患者FPG、INS、HOMA-IR均低于治疗前,差异有统计学意义(P<0.05),且治疗组明显低于对照组,差异有统计学意义(P<0.05)。治疗组患者月经恢复总有效率83.3%明显高于对照组的60.7%,差异有统计学意义(P<0.05)。结论群组干预模式针对肥胖型PCOS患者更能有效减轻体重,改善内分泌指标,可以有效预防远期并发症的发生,值得临床广泛推广。

Objective To explore the clinical effect of group intervention mode for obese patients with polycystic ovary syndrome.Methods 60 patients with polycystic ovary syndrome with body mass index(BMI)≥25 were selected,and the syndrome differentiation was phlegm-dampness type.They were randomly divided into treatment group(group intervention mode weight control+metformin)and control group(traditional lifestyle intervention+metformin),with 30 cases in each group.After 6 months of treatment,body mass index and endocrine metabolism indexes of the two groups were observed.Results There were statistically signifi cant differences in BMI and abdominal circumference before and after treatment between the two groups(P<0.05).After treatment,BMI and abdominal circumference indexes of the treatment group were lower than those of the control group,and the difference was statistically significant(P<0.05).Luteinizing hormone(LH)level decreased significantly after treatment compared with before treatment,the difference was statistically signifi cant(P<0.05),while testosterone(T)level decreased with no statistically signifi cant difference compared with before treatment(P>0.05).After treatment,LH level in the treatment group was lower than that in the control group,and the difference was statistically signifi cant(P<0.05).Before treatment,there were no signifi cant differences in fasting blood glucose(FPG),serum insulin(INS)and insulin resistance index(HOMA-IR)between 2 groups(P>0.05).After 6 months of treatment,FPG,INS and HOMA-IR in 2 groups were lower than before treatment,the difference was statistically signifi cant(P<0.05),and the treatment group was signifi cantly lower than the control group,the difference was statistically signifi cant(P<0.05).The total effective rate of menses restoration in the treatment group was 83.3%,which was significantly higher than that in the control group(60.7%),and the difference was statistically significant(P<0.05).Conclusion Group intervention mode for obese PCOS patients can effectively reduce body weight,improve endocrine indicators,and effectively prevent the occurrence of long-term complications,which is worthy of widespread clinical promotion.