达英-35和二甲双胍对多囊卵巢综合征患者性激素水平及胰岛素抵抗的影响
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摘要
目的探讨达英-35和二甲双胍对多囊卵巢综合征(PCOS)患者性激素水平及胰岛素抵抗的影响。方法将56例PCOS患者随机分为治疗组(达英-35和二甲双胍)和对照组(达英-35)各28例,比较两组的临床症状及月经恢复情况,两组治疗前后性激素[促黄体生成素(LH)、促卵泡生成素(FSH)、睾酮(T)、雌激素(E2)]及稳态模型胰岛素抵抗指数(HOMA-IR)的变化情况,两组排卵受孕情况及不良反应。结果治疗组LH、FSH、T及HOMA-IR治疗后均较治疗前明显降低,而E2较治疗前明显升高(P<0.05)。治疗组排卵率、受孕率均明显高于对照组(P<0.05),且流产率低于对照组,差异有统计学意义(P<0.05)。结论达英-35和二甲双胍联用具有协同作用,能更有效地降低LH、T,纠正PCOS代谢紊乱,显著改善PC0S患者的内分泌况,提高排卵率和妊娠率,且胰岛素素抵抗相关指标得到明显改善,但仍需大量临床随机对照研究的进一步证实。
Objective To investigate the impact of Diane-35 and Metformin for sex hormone levels and insulin resistance in patients with polycystic ovary syndrome.Methods 56 patients with PCOS were randomly divided into treatment group(Diane-35 and Metformin) and the control group(Diane-35),with 28 cases in each group,the clinical symptoms and menstrual recovery before and after treatment of sex hormones(LH,FSH,T,E2) and HOMA-IR changes,two sets of ovulation,pregnancy and adverse reactions were compared between two groups.Results The level of LH,FSH,T,and HOMA-IR in the treatment group were significantly reduced than before treatment,while the E2 was significantly increased(P < 0.05).The ovulation rate,pregnancy rate in the treatment group were significantly higher than those in the control group(P < 0.05).And the abortion rate was lower than the control group,with statistical significant difference(P < 0.05).Conclusion Diane-35 and Metformin has a synergistic effect,and they can more effectively lower LH,T,correct PCOS metabolic disorders,significantly improve endocrine conditions,increase ovulation rate and pregnancy rate,and insulin resistance factors related indicators significantly be improved,but still needs a large number of randomized controlled clinical trial to be further confirmed.
Objective To investigate the impact of Diane-35 and Metformin for sex hormone levels and insulin resistance in patients with polycystic ovary syndrome.Methods 56 patients with PCOS were randomly divided into treatment group(Diane-35 and Metformin) and the control group(Diane-35),with 28 cases in each group,the clinical symptoms and menstrual recovery before and after treatment of sex hormones(LH,FSH,T,E2) and HOMA-IR changes,two sets of ovulation,pregnancy and adverse reactions were compared between two groups.Results The level of LH,FSH,T,and HOMA-IR in the treatment group were significantly reduced than before treatment,while the E2 was significantly increased(P < 0.05).The ovulation rate,pregnancy rate in the treatment group were significantly higher than those in the control group(P < 0.05).And the abortion rate was lower than the control group,with statistical significant difference(P < 0.05).Conclusion Diane-35 and Metformin has a synergistic effect,and they can more effectively lower LH,T,correct PCOS metabolic disorders,significantly improve endocrine conditions,increase ovulation rate and pregnancy rate,and insulin resistance factors related indicators significantly be improved,but still needs a large number of randomized controlled clinical trial to be further confirmed.
引文
[1]乐杰.妇产科学[M].7版.北京:人民卫生出版社,2008:315-318.
[2]苗晋华,安爱军,郝晓菁.二甲双胍治疗多囊卵巢综合征的研究进展[J].实用药物与临床,2009,12(2):130-131.
[3]ZHANG Jing,XU Liangzhi,WU Taixiang,et al.The efects of Diane-35 and meformin in treatment of polycystic ovary syndrome:an up-dmed systematic review[J].Gynecol Endocrinol,2008,24(10):590-600.
[4]张贤莉.二甲双胍治疗多囊卵巢综合征的临床观察[J].临床合理用药杂志,2010,3(10):70-71.
[5]袁雄洲,苑国富,张新颖,等.多囊卵巢综合征患者性激素水平与胰岛素抵抗相关性分析[J].标记免疫分析与临床,2012,19(1):8-9.
[6]Jones MR,Wilson SG,Muiiin BH,et al.Polymorphism of the follistatingene in polycystic ovary syndrome[J].Mol Hum Reprod,2007,13(4):237-241.
[7]Khorram O,Helliwell JP,Katz S,et al.Two weeks of metformin im-proves clomilphhene citrate-induced ovulation and metabolic profilesin women with polyeystic ovary syndrome[J].Fertil Stefil,2006,85(5):1448-1451.
[8]李剑,杜帅先,胡丽华.多囊卵巢综合征性激素水平检测[J].临床血液学杂志,2009,22(4):204-205.
[9]罗金,尹太郎,王雅琴,等.黄芪多糖联合达英-35对多囊卵巢综合征患者胰岛素抵抗、雄激素及脂代谢的影响[J].中国误诊学杂志,2009,9(28):6812-6813.
[10]蔡春环,翟军,魏秀臻.二甲双胍联合达英-35治疗多囊卵巢综合征胰岛素抵抗患者的疗效观察[J].中国医学创新,2009,6(5):11-12.
[11]宋晓风,石峻,马雁南.达英-35联合二甲双胍治疗多囊卵巢综合征52例[J].陕西医学杂志,2010,39(6):707-708.
[12]孙世艳,王真.二甲双胍对多囊卵巢综合征合并高胰岛素血症患者血清胰岛素及性激素的影响[J].黑龙江医学,2010,34(7):506-507.
[2]苗晋华,安爱军,郝晓菁.二甲双胍治疗多囊卵巢综合征的研究进展[J].实用药物与临床,2009,12(2):130-131.
[3]ZHANG Jing,XU Liangzhi,WU Taixiang,et al.The efects of Diane-35 and meformin in treatment of polycystic ovary syndrome:an up-dmed systematic review[J].Gynecol Endocrinol,2008,24(10):590-600.
[4]张贤莉.二甲双胍治疗多囊卵巢综合征的临床观察[J].临床合理用药杂志,2010,3(10):70-71.
[5]袁雄洲,苑国富,张新颖,等.多囊卵巢综合征患者性激素水平与胰岛素抵抗相关性分析[J].标记免疫分析与临床,2012,19(1):8-9.
[6]Jones MR,Wilson SG,Muiiin BH,et al.Polymorphism of the follistatingene in polycystic ovary syndrome[J].Mol Hum Reprod,2007,13(4):237-241.
[7]Khorram O,Helliwell JP,Katz S,et al.Two weeks of metformin im-proves clomilphhene citrate-induced ovulation and metabolic profilesin women with polyeystic ovary syndrome[J].Fertil Stefil,2006,85(5):1448-1451.
[8]李剑,杜帅先,胡丽华.多囊卵巢综合征性激素水平检测[J].临床血液学杂志,2009,22(4):204-205.
[9]罗金,尹太郎,王雅琴,等.黄芪多糖联合达英-35对多囊卵巢综合征患者胰岛素抵抗、雄激素及脂代谢的影响[J].中国误诊学杂志,2009,9(28):6812-6813.
[10]蔡春环,翟军,魏秀臻.二甲双胍联合达英-35治疗多囊卵巢综合征胰岛素抵抗患者的疗效观察[J].中国医学创新,2009,6(5):11-12.
[11]宋晓风,石峻,马雁南.达英-35联合二甲双胍治疗多囊卵巢综合征52例[J].陕西医学杂志,2010,39(6):707-708.
[12]孙世艳,王真.二甲双胍对多囊卵巢综合征合并高胰岛素血症患者血清胰岛素及性激素的影响[J].黑龙江医学,2010,34(7):506-507.