二甲双胍联合炔雌醇环丙孕酮在多囊卵巢综合征伴胰岛素抵抗患者中的应用效果

Application effect of Metformin combined with Ethinylestradiol and Cyproterone in patients with polycystic ovary syndrome with insulin resistance

目的探讨二甲双胍联合炔雌醇环丙孕酮在多囊卵巢综合征伴胰岛素抵抗患者中的应用效果。方法选取2021年2月至2022年1月临沂市兰山区枣园中心卫生院收治的80例多囊卵巢综合征伴胰岛素抵抗患者为研究对象,按照随机数字表法分为对照组和观察组,每组各40例。对照组于月经第5天口服炔雌醇环丙孕酮片,观察组在对照组基础上联合服用二甲双胍,连续治疗3个疗程。比较两组排卵期前及排卵期子宫内膜厚度,以及两组治疗前后卵泡刺激素(FSH)和黄体生成素(LH)水平的变化;同时随访12个月,统计两组患者的妊娠情况。结果观察组排卵期前及排卵期子宫内膜厚度大于对照组(P<0.05)。两组患者治疗后FSH均高于治疗前,LH均低于治疗前(P<0.05);且观察组治疗后FSH高于对照组,LH低于对照组(P<0.05)。观察组自然妊娠率高于对照组(P<0.05)。结论二甲双胍联合炔雌醇环丙孕酮治疗多囊卵巢综合征伴胰岛素抵抗患者效果明显,可调节体内性激素水平和子宫内膜厚度,有利于自然妊娠。

Objective To explore the application effect of Metformin combined with Ethinylestradiol and Cyproterone in patients with polycystic ovary syndrome with insulin resistance.Methods A total of 80 patients with polycystic ovary syndrome and insulin resistance in Lanshan Zaoyuan Central Hospital of Linyi City from February 2021 to January 2022 were selected and divided into control group and observation group by the random number table method,with 40 cases in each group.The control group was treated with Ethinylestradiol and Cyproterone Tablets at the fifth day of menstruation,while the observation group was treated with Metformin based on the control group.The treatment of the two groups lasted for 3 consecutive courses.The endometrial thicknesses before and during ovulation,and the changes of follicle stimulating hormone(FSH)and luteinizing hormone(LH)levels before and after treatment were compared between the two groups.The patients in the two groups were followed up for 12 months,whose pregnancy situation was counted.Results The thickness of endometrium in the observation group before and during ovulation was greater than that in the control group(P<0.05).After treatment,the level of FSH in the two groups was reduced(P<0.05),while the level of LH in the two groups was improved(P<0.05),and the level of FSH in the observation group was higher than that in the control group(P<0.05),the level of LH was lower than that in the control group(P<0.05).The natural pregnancy in the observation group was higher than that in the control group(P<0.05).Conclusion Metformin combined with Ethinylestradiol and Cyproterone is significantly effective in the treatment of polycystic ovary syndrome with insulin resistance,which can regulate the level of sex hormones and endometrial thickness,and is beneficial to the natural pregnancy.