高剂量叶酸联合枸橼酸氯米芬对肥胖型多囊卵巢综合征患者的影响

Effect of high-dose folic acid combined with clomiphene citrate on obese patients with polycystic ovary syndrome

目的 探讨高剂量叶酸联合枸橼酸氯米芬对肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的影响。方法 选择2021年1月至2022年1月我院收治的180例肥胖型PCOS患者,利用随机数字表法分为对照组(枸橼酸氯米芬)和研究组(枸橼酸氯米芬+叶酸),每组90例,均治疗3个月经周期。比较两组临床疗效、性激素指标、糖代谢水平、脂代谢水平的变化及不良反应的发生率。结果 研究组的总有效率高于对照组(P<0.05)。治疗后,患者体质量指数、睾酮、促黄体生成素、促卵泡刺激素、空腹血糖、空腹胰岛素、三酰甘油、总胆固醇以及低密度脂蛋白较治疗前均降低,雌二醇、高密度脂蛋白较治疗前均升高,且研究组降低更明显,差异均具有统计学意义(P<0.05)。两组不良反应的总发生率差异不显著(P>0.05)。结论 高剂量叶酸联合枸橼酸氯米芬对肥胖型PCOS的疗效确切,能降低患者体质量,同时可改善其性激素、糖代谢及脂代谢水平,且安全性佳。

Objective To investigate the effect of high-dose folic acid combined with clomiphene citrate on obese patients with polycystic ovary syndrome(PCOS).Methods A total of 180 obese PCOS patients admitted to our hospital from January 2021 to January 2022 were divided into control group(clomiphene citrate)and study group(clomiphene citrate+folic acid)by random number table method,90 cases in each group,and treated for 3 menstrual cycles.The clinical efficacy,sex hormone indexes,changes in glucose metabolism,lipid metabolism and the incidence of adverse reactions were compared between the two groups.Results Compared with the control group,the total effective rate of the study group was significantly increased(P<0.05).After treatment,body mass index,testosterone,luteinizing hormone,follicle-stimulating hormone,fasting blood glucose,fasting insulin,triacylglycerol,total cholesterol and low density lipoprotein of all the patients were decreased compared with before treatment,while estradiol and high density lipoprotein were significantly increased,and the reduction was more obvious in the study group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion High-dose folic acid combined with clomiphene citrate is effective in the treatment of obese PCOS,which can reduce the body mass of patients,improve the levels of sex hormones,glucose metabolism and lipid metabolism,with good safety.