炔雌醇环丙酮联合二甲双胍治疗多囊卵巢综合征胰岛素抵抗的临床疗效

中国基层医药 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.06.003

Xiaoxiao Huang, Xiaolu Chen, Xiaoyan Wang

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Before treatment, there were no statistically significant differences in E2, T, LH, FSH between the treatment group and the control group (all P>0.05). After treatment, the levels of E2[(112.90±18.90)pmol/L], T[(1.30±0.78)nmol/L], LH[(8.00±1.50)U/L]and FSH[(1.20±0.39)U/L] in the treatment group were significantly lower than those in the control group[E2(128.90±19.95) pmol/L, T(2.19±1.00) nmol/L, LH(11.65±1.60)U/L and FSH(1.89±0.50)U/L], the differences were statistically significant(t=3.905, 4.707, 10.871, 7.299, all P 0.05). After treatment, the levels of HOMA-IR (2.19±0.50), FPG[(4.30±1.19)mmol/L], BMI[(22.40±1.89)kg/m2], FINS[(15.98±5.00)mU/L] in the treatment group were significantly lower than those in the control group[HOMA-IR(3.90±0.58), FPG (6.09±1.20) mmol/L, BMI (24.69±4.60)kg/m2, FINS (19.00±6.89)mU/L], the differences were statistically significant(t=14.979, 7.105, 3.089, 2.379, all P<0.05). 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引用次数: 0

摘要

目的探讨炔雌醇环丙酮联合二甲双胍治疗胰岛素抵抗型多囊卵巢综合征（PCOS）的临床疗效。方法选择2017年5月至2019年5月在台州市第一人民医院住院的90例胰岛素抵抗型多囊卵巢综合征患者进行研究。根据随机数表法，将患者分为对照组和治疗组，每组45例。对照组用炔雌醇和环孕酮治疗，观察组用炔雄醇和环孕激素联合二甲双胍治疗。比较两组治疗前后的临床疗效，包括雌二醇（E2）、睾酮（T）、黄体生成素（LH）、卵泡刺激素（FSH）、胰岛素抵抗指数（HOMA-IR）、空腹血糖（FPG）。测量体重指数（BMI）和空腹胰岛素（FINS）水平。分析两组患者的排卵、妊娠、月经恢复情况及不良反应。结果治疗组总有效率（97.77%）明显高于对照组（77.77%），差异有统计学意义（χ2=8.389，P=0.003），治疗组E2〔（112.90±18.90）pmol/L〕、T〔（1.30±0.78）nmol/L〕、LH〔（8.00±1.50）U/L〕和FSH〔（1.20±0.39）U/L）显著低于对照组〔E2（128.90±19.95）pmol/L、T（2.19±1.00）nmol/L、LH（11.65±1.60）U/L和FSH（1.89±0.50）U/L】，差异有统计学意义（T=3.905、4.707、10.871、7.299，均P＜0.05）。治疗，治疗组HOMA-IR（2.19±0.50）、FPG[（4.30±1.19）mmol/L]、BMI[（22.40±1.89）kg/m2]、FINS[（15.98±5.00）mU/L]水平显著低于对照组[HOMA-IR（3.90±0.58）、FPG（6.09±1.20）mmol/L、，治疗组妊娠及月经恢复率均显著高于对照组（χ2=4.121、4.285、10.000，均P<0.05），不良反应发生率（13.33%）显著低于对照组（37.77%），结论炔雌醇环丙酮联合二甲双胍治疗多囊卵巢综合征胰岛素抵抗具有显著的临床疗效，可缓解内分泌代谢紊乱和胰岛素抵抗，值得临床推广应用。关键词：多囊卵巢综合征；胰岛素抵抗；乙炔雌二醇；Gyproterone；二甲双胍；性激素；脂质代谢

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Clinical effect of ethinylestradiol cycloproterone combined with metformin in the treatment of PCOS patients with insulin resistance

Objective To investigate the clinical effect of ethinylestradiol cycloproterone combined with metformin in the treatment of polycystic ovary syndrome (PCOS) with insulin resistance. Methods Ninety PCOS patients with insulin resistance admitted to the First People's Hospital of Taizhou from May 2017 to May 2019 were selected in the study.According to the random number table method, the patients were divided into control group and treatment group, with 45 cases in each group.The control group was treated with ethinylestradiol and cycloprogesterone, while the observation group was treated with ethinylestradiol and cycloprogesterone combined with metformin.The clinical effects of two groups were compared, including estradiol (E2), testosterone (T), luteinizing hormone (LH), follicle stimulating estrogen (FSH), insulin resistance index (HOMA-IR), fasting plasma glucose (FPG) before and after treatment.Body mass index (BMI) and fasting insulin (FINS) levels were measured.The ovulation, pregnancy, menstrual recovery and adverse reactions of the two groups were analyzed. Results The total effective rate of the treatment group (97.77%) was significantly higher than that of the control group (77.77%), the difference was statistically significant (χ2=8.389, P=0.003). Before treatment, there were no statistically significant differences in E2, T, LH, FSH between the treatment group and the control group (all P>0.05). After treatment, the levels of E2[(112.90±18.90)pmol/L], T[(1.30±0.78)nmol/L], LH[(8.00±1.50)U/L]and FSH[(1.20±0.39)U/L] in the treatment group were significantly lower than those in the control group[E2(128.90±19.95) pmol/L, T(2.19±1.00) nmol/L, LH(11.65±1.60)U/L and FSH(1.89±0.50)U/L], the differences were statistically significant(t=3.905, 4.707, 10.871, 7.299, all P 0.05). After treatment, the levels of HOMA-IR (2.19±0.50), FPG[(4.30±1.19)mmol/L], BMI[(22.40±1.89)kg/m2], FINS[(15.98±5.00)mU/L] in the treatment group were significantly lower than those in the control group[HOMA-IR(3.90±0.58), FPG (6.09±1.20) mmol/L, BMI (24.69±4.60)kg/m2, FINS (19.00±6.89)mU/L], the differences were statistically significant(t=14.979, 7.105, 3.089, 2.379, all P<0.05). The ovulation, pregnancy and menstrual recovery in the treatment group were significantly higher than those in the control group (χ2=4.121, 4.285, 10.000, all P<0.05). The incidence of adverse reactions in the treatment group (13.33%) was significantly lower than that in the control group (37.77%), the difference was statistically significant between the two groups (χ2=7.066, P=0.007). Conclusion Ethinylestradiol cycloproterone combined with metformin in the treatment of PCOS with insulin resistance has significant clinical efficacy, can alleviate the endocrine metabolic disorders and insulin resistance, it is worthy of clinical application and promotion. Key words: Polycystic ovary syndrome; Insulin resistance; Ethinyl estradiol; Gyproterone; Metformin; Sex hormones; Lipid metabolism

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.