二甲双胍联合复方醋酸环丙孕酮治疗多囊卵巢综合征患者对胰岛素抵抗及性激素影响
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摘要
目的探讨二甲双胍联合复方醋酸环丙孕酮治疗多囊卵巢综合征对胰岛素抵抗及性激素的影响。方法选取多囊卵巢综合征96例,采用随机数字表法随机将其分为观察组48例与对照组48例,观察组采用二甲双胍联合复方醋酸环丙孕酮进行治疗,对照组采用复方醋酸环丙孕酮进行治疗。两组均治疗6个月。检测比较两组治疗前后空腹血糖(FBG)、空腹胰岛素水平(FINS)、胰岛素抵抗指数(HOMA-IR)及卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)、睾酮(T)水平,记录比较两组治疗期间不良反应发生情况。结果治疗前,两组FBG、FINS、HOMA-IR及FSH、LH、E_2、T水平比较差异均无统计学意义(P>0.05)。治疗后,观察组FBG、FINS、HOMA-IR及FSH、LH、T水平均较治疗前明显降低,对照组FSH、LH及T水平均较治疗前降低,差异有统计学意义(P<0.05)。治疗后,观察组FBG、FINS、HOMA-IR及FSH、LH、T水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组不良反应发生率比较差异无统计学意义(P>0.05)。结论二甲双胍联合复方醋酸环丙孕酮治疗多囊卵巢综合征能够显著改善患者胰岛素抵抗及性激素水平。
Objective To investigate the effect of metformin combined with compound cyproterone acetate on insulin resistance and sex hormones in patients with polycystic ovary syndrome(PCOS). Methods Ninety-six patients with PCOS were randomly divided into observation group(n=48) and control group(n=48) according to random number table. The observation group was treated with metformin combined with compound cyproterone acetate, while the control group was treated with compound cyproterone acetate.Both groups were treated for 6 months. The levels of fasting blood glucose(FBG), fasting insulin(FINS), HOMA insulin resistance index(HOMA-IR), follicle stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E_2) and testosterone(T) were measured and compared between the two groups. Adverse reactions in both groups during the treatment period were recorded and compared. Results Before treatment, there was no significant difference in the levels of FBG, FINS and HOMA-IR as well as in FSH, LH, E_2 and T between the two groups(P>0.05). After treatment, FBG, FINS, HOMA-IR, FSH, LH, and T in the observation group were significantly lower than those before treatment, and FSH, LH and T levels were lower than those before treatment, suggesting significant differences(P<0.05). After treatment, the levels of FBG, FINS, HOMA-IR, FSH, LH and T in the observation group were lower than those in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions during the treatment between the two groups(P>0.05). Conclusion Metformin combined with compound cyproterone acetate can significantly improve insulin resistance and sex hormone levels in patients with PCOS.
Objective To investigate the effect of metformin combined with compound cyproterone acetate on insulin resistance and sex hormones in patients with polycystic ovary syndrome(PCOS). Methods Ninety-six patients with PCOS were randomly divided into observation group(n=48) and control group(n=48) according to random number table. The observation group was treated with metformin combined with compound cyproterone acetate, while the control group was treated with compound cyproterone acetate.Both groups were treated for 6 months. The levels of fasting blood glucose(FBG), fasting insulin(FINS), HOMA insulin resistance index(HOMA-IR), follicle stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E_2) and testosterone(T) were measured and compared between the two groups. Adverse reactions in both groups during the treatment period were recorded and compared. Results Before treatment, there was no significant difference in the levels of FBG, FINS and HOMA-IR as well as in FSH, LH, E_2 and T between the two groups(P>0.05). After treatment, FBG, FINS, HOMA-IR, FSH, LH, and T in the observation group were significantly lower than those before treatment, and FSH, LH and T levels were lower than those before treatment, suggesting significant differences(P<0.05). After treatment, the levels of FBG, FINS, HOMA-IR, FSH, LH and T in the observation group were lower than those in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions during the treatment between the two groups(P>0.05). Conclusion Metformin combined with compound cyproterone acetate can significantly improve insulin resistance and sex hormone levels in patients with PCOS.
引文
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[12] 项守奎,王龙,吴阳,等.多囊卵巢综合征患者血清维生素D水平与抑郁症的关系[J].临床荟萃,2015,30(6):649-653.
[13] 郝红卫,刘东珍.吡格列酮联合醋酸环丙孕酮对多囊卵巢综合症患者胰岛素抵抗及生殖激素水平的影响[J].海南医学院学报,2015,21(9):1245-1247.
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[15] 冷芹,魏兆莲.多囊卵巢综合征病因、发病机制及治疗的最新研究进展[J].国际生殖健康/计划生育杂志,2018,37(1):57-61,75.
[16] 王金英.二甲双胍联合复方醋酸环丙孕酮对多囊卵巢综合征患者糖脂代谢及激素水平的影响[J].中国药物经济学,2017,12(6):42-44.
[17] 李明秀.二甲双胍在多囊卵巢综合征治疗中的作用初探[J].现代养生(下半月版),2018(1):83-84.
[18] 邹珺,高世芳,山洁.肥胖型多囊卵巢综合征患者应用醋酸环丙孕酮联合二甲双胍治疗后胰岛素抵抗变化[J].当代医学,2017,23(10):67-68.
[19] 林琳,刘复权.复方醋酸环丙孕酮治疗多囊卵巢综合征[J].国外医学妇幼保健分册,2003,14(6):371-372,375.DOI:10.3969/j.issn.1673-5293.2003.06.019.
[20] 魏颖.复方醋酸环丙孕酮与二甲双胍干预对改善多囊卵巢综合征内分泌的影响分析[J/CD].实用妇科内分泌杂志(电子版),2016,3(7):20,22.
[21] 林淑鑫.二甲双胍对多囊卵巢综合征患者卵巢功能、性激素水平及胰岛素抵抗的影响[J].中国医药科学,2017,7(23):57-59.
[2] Yousuf S D,Ganie M A,Zargar M A,et al.The Lys469glu/K469E polymorphism of the inflammatory gene intercellular adhesion molecule-1 lacks any apparent role in the polycystic ovary syndrome in kashmiri women:A case control study[J].Asian Pac J Cancer Prev,2017,18(11):2925-2930.
[3] 高丽华,张彩兰,刘旭阳,等.利拉鲁肽治疗多囊卵巢综合征合并2型糖尿病患者的初步临床研究[J].临床荟萃,2016,31(5):539-542.
[4] 杨滢,尹家瑶.二甲双胍联合炔雌醇环丙孕酮对多囊卵巢综合征患者性激素水平、胰岛功能、排卵和妊娠影响[J].临床误诊误治,2018,31(2):73-76.
[5] Dixit J D,Sharief S A,Goyal M K,et al.Plexiform angiomyxoid myofibroblastic tumor (PAMT) of stomach with synchronous bilateral cystic ovarian neoplasms,a rare case presentation[J].Indian J Surg Oncol,2016,7(1):82-85.
[6] 杨定会.复方醋酸环丙孕酮联合二甲双胍对多囊卵巢综合征患者内分泌及血脂、血糖的影响[J].黑龙江医药,2018,31(2):316-317.
[7] 朱凌燕,龚甜,刘文淑,等.二甲双胍与复方醋酸环丙孕酮对多囊卵巢综合征患者内分泌、糖及脂代谢的影响研究[J].中国妇幼保健,2014,29(36):6013-6014.
[8] 乐杰.妇产科学[M].7版.北京:人民卫生出版社,2008:381-388.
[9] 周伟伟,李霞.抗苗勒管激素与非肥胖型多囊卵巢综合征合并胰岛素抵抗的关系[J].国际妇产科学杂志,2017,44(1):118-120.
[10] 裘瑾.多囊卵巢综合征[J].武警医学院学报,2006,15(2):163-165.DOI:10.3969/j.issn.1008-5041.2006.02.038.
[11] 黄凤,周全,毛巧玲,等.多囊卵巢综合征患者不良妊娠结局研究现状[J].中国医师杂志,2018,20(5):793-796.DOI:10.3760/cma.j.issn.1008-1372.2018.05.052.
[12] 项守奎,王龙,吴阳,等.多囊卵巢综合征患者血清维生素D水平与抑郁症的关系[J].临床荟萃,2015,30(6):649-653.
[13] 郝红卫,刘东珍.吡格列酮联合醋酸环丙孕酮对多囊卵巢综合症患者胰岛素抵抗及生殖激素水平的影响[J].海南医学院学报,2015,21(9):1245-1247.
[14] 刘妮,皮丹,刘春梅.百令胶囊联合炔雌醇环丙孕酮、二甲双胍对多囊卵巢综合征患者脂代谢、胰岛素抵抗的影响[J].海南医学院学报,2018,24(2):224-227.
[15] 冷芹,魏兆莲.多囊卵巢综合征病因、发病机制及治疗的最新研究进展[J].国际生殖健康/计划生育杂志,2018,37(1):57-61,75.
[16] 王金英.二甲双胍联合复方醋酸环丙孕酮对多囊卵巢综合征患者糖脂代谢及激素水平的影响[J].中国药物经济学,2017,12(6):42-44.
[17] 李明秀.二甲双胍在多囊卵巢综合征治疗中的作用初探[J].现代养生(下半月版),2018(1):83-84.
[18] 邹珺,高世芳,山洁.肥胖型多囊卵巢综合征患者应用醋酸环丙孕酮联合二甲双胍治疗后胰岛素抵抗变化[J].当代医学,2017,23(10):67-68.
[19] 林琳,刘复权.复方醋酸环丙孕酮治疗多囊卵巢综合征[J].国外医学妇幼保健分册,2003,14(6):371-372,375.DOI:10.3969/j.issn.1673-5293.2003.06.019.
[20] 魏颖.复方醋酸环丙孕酮与二甲双胍干预对改善多囊卵巢综合征内分泌的影响分析[J/CD].实用妇科内分泌杂志(电子版),2016,3(7):20,22.
[21] 林淑鑫.二甲双胍对多囊卵巢综合征患者卵巢功能、性激素水平及胰岛素抵抗的影响[J].中国医药科学,2017,7(23):57-59.