炔雌醇环丙孕酮片联合二甲双胍治疗多囊卵巢综合征伴胰岛素抵抗的疗效研究

Study on efficacy of ethinylestradiol and cyproterone acetate tablets combined with metformin in polycystic ovary syndrome with insulin resistance

目的 分析炔雌醇环丙孕酮片联合二甲双胍治疗多囊卵巢综合征伴胰岛素抵抗的疗效。方法 84例多囊卵巢综合征伴胰岛素抵抗患者,根据随机数字表法分为对照组与观察组,每组42例。对照组患者给予炔雌醇环丙孕酮片治疗,观察组患者在对照组基础上增加二甲双胍治疗。比较两组患者治疗前后性激素指标(雌二醇、黄体生成素、促卵泡生成素)以及胰岛素抵抗指数,临床疗效,不良反应发生情况。结果 治疗前,两组雌二醇、黄体生成素、促卵泡生成素、胰岛素抵抗指数比较,差异无统计学意义(P>0.05)。治疗后,观察组雌二醇(51.56±3.21)pg/ml、黄体生成素(8.19±0.43)mIU/ml、促卵泡生成素(4.56±0.24)mIU/ml以及胰岛素抵抗指数(1.56±0.12)显著低于对照组的(71.72±4.51)pg/ml、(10.21±1.43)mIU/ml、(6.67±0.57)mIU/ml、(2.67±0.34),差异有统计学意义(P<0.05)。观察组治疗总有效率95.2%高于对照组的76.2%,差异有统计学意义(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 炔雌醇环丙孕酮片联合二甲双胍对于多囊卵巢综合征伴胰岛素抵抗的治疗效果确切,可改善性激素水平,缓解胰岛素抵抗,且安全性高,值得推广。

Objective To analyze the efficacy of ethinylestradiol and cyproterone acetate tablets combined with metformin in polycystic ovary syndrome with insulin resistance.Methods A total of 84 patients with polycystic ovary syndrome and insulin resistance were divided into a control group and an observation group according to random numerical table,with 42 cases in each group.The control group was treated with ethinylestradiol and cyproterone acetate tablets,and the observation group was treated with metformin on the basis of the control group.The sex hormone indexes(estradiol,luteinizing hormone,follicle-stimulating hormone)and insulin resistance index before and after treatment,clinical efficacy and occurrence of adverse reactions were compared between the two groups.Results Before treatment,there was no statistically significant difference in estradiol,luteinizing hormone,follicle-stimulating hormone and insulin resistance index between the two groups(P>0.05).After treatment,the observation group had estradiol of(51.56±3.21)pg/ml,luteinizing hormone of(8.19±0.43)mIU/ml,follicle-stimulating hormone of(4.56±0.24)mIU/ml and insulin resistance index of(1.56±0.12),which were significantly lower than those of(71.72±4.51)pg/ml,(10.21±1.43)mIU/ml,(6.67±0.57)mIU/ml and(2.67±0.34)in the control group,and the differences were statistically significant(P<0.05).The total effective rate of 95.2%in the observation group was higher than that of 76.2%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ethinylestradiol and cyproterone acetate tablets combined with metformin has a definite therapeutic effect on polycystic ovary syndrome with insulin resistance,and can improve hormone levels,relieve insulin resistance,and has high safety,which is worth promoting.