中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
7期
1045-1047
,共3页
多囊卵巢综合征%胰岛素抵抗%屈螺酮炔雌醇片%二甲双胍
多囊卵巢綜閤徵%胰島素牴抗%屈螺酮炔雌醇片%二甲雙胍
다낭란소종합정%이도소저항%굴라동결자순편%이갑쌍고
Polycystic ovarian syndrome%Iinsulin resistance%Drospirenone and ethinylestradiol tablets%Metformin
目的 观察屈螺酮炔雌醇片联合二甲双胍对多囊卵巢综合征(PCOS)患者胰岛素抵抗的影响.方法 将62例PCOS患者采用随机数字表法分为观察组和对照组,每组31例.对照组给予屈螺酮炔雌醇片治疗,1片/d,21 d为1个疗程,停药后月经来潮的第5天开始下一个疗程,连续服药6个疗程.观察组给予屈螺酮炔雌醇片联合二甲双胍治疗,前药用法相同,二甲双胍0.5g/次,3次/d.治疗前后分别检测2组患者性激素水平和胰岛素抵抗指数,并比较2组排卵率和妊娠率.结果 治疗6个疗程后,2组患者黄体生成素、黄体生成素/卵泡刺激素比值、睾酮、雌二醇和胰岛素抵抗指数水平均较明显低于治疗前[观察组:(8.8 ±2.7)U/L比(14.2±3.6) U/L,(0.9±0.3)比(2.0±0.5),(1.8 ±0.6) mmol/L比(2.7±0.8) mmol/L,(96±20) pmol/L比(139±24)pmol/L,(1.6±0.6)比(3.7±0.9);对照组:(11.2±3.1)U/L比(14.3±3.3)U/L,(0.9±0.3)比(1.3±0.5),(2.1±0.6)mmol/L比(2.7±0.8)mmol/L,(115±22)pmol/L比(136±26) pmol/L,(2.8±0.7)比(3.7±0.9),均P＜0.01];卵泡刺激素明显高于治疗前[观察组:(10.2±2.4) U/L比(6.9±1.5) U/L;对照组:(8.8±1.7)U/L比(7.0 ±1.5)U/L,均P＜0.01];观察组治疗后各指标与对照组治疗后比较,差异均有统计学意义(均P＜0.01);观察组患者排卵率和妊娠率均明显高于对照组,差异有统计学意义[64.5％ (20/31)比38.7％(12/31),38.7％(12/31)比16.1％ (5/31)](P＜0.05).结论 屈螺酮炔雌醇片联合二甲双胍能改善PCOS患者高雄激素状态和胰岛素抵抗,从而提高患者排卵率及妊娠率.
目的 觀察屈螺酮炔雌醇片聯閤二甲雙胍對多囊卵巢綜閤徵(PCOS)患者胰島素牴抗的影響.方法 將62例PCOS患者採用隨機數字錶法分為觀察組和對照組,每組31例.對照組給予屈螺酮炔雌醇片治療,1片/d,21 d為1箇療程,停藥後月經來潮的第5天開始下一箇療程,連續服藥6箇療程.觀察組給予屈螺酮炔雌醇片聯閤二甲雙胍治療,前藥用法相同,二甲雙胍0.5g/次,3次/d.治療前後分彆檢測2組患者性激素水平和胰島素牴抗指數,併比較2組排卵率和妊娠率.結果 治療6箇療程後,2組患者黃體生成素、黃體生成素/卵泡刺激素比值、睪酮、雌二醇和胰島素牴抗指數水平均較明顯低于治療前[觀察組:(8.8 ±2.7)U/L比(14.2±3.6) U/L,(0.9±0.3)比(2.0±0.5),(1.8 ±0.6) mmol/L比(2.7±0.8) mmol/L,(96±20) pmol/L比(139±24)pmol/L,(1.6±0.6)比(3.7±0.9);對照組:(11.2±3.1)U/L比(14.3±3.3)U/L,(0.9±0.3)比(1.3±0.5),(2.1±0.6)mmol/L比(2.7±0.8)mmol/L,(115±22)pmol/L比(136±26) pmol/L,(2.8±0.7)比(3.7±0.9),均P＜0.01];卵泡刺激素明顯高于治療前[觀察組:(10.2±2.4) U/L比(6.9±1.5) U/L;對照組:(8.8±1.7)U/L比(7.0 ±1.5)U/L,均P＜0.01];觀察組治療後各指標與對照組治療後比較,差異均有統計學意義(均P＜0.01);觀察組患者排卵率和妊娠率均明顯高于對照組,差異有統計學意義[64.5％ (20/31)比38.7％(12/31),38.7％(12/31)比16.1％ (5/31)](P＜0.05).結論 屈螺酮炔雌醇片聯閤二甲雙胍能改善PCOS患者高雄激素狀態和胰島素牴抗,從而提高患者排卵率及妊娠率.
목적 관찰굴라동결자순편연합이갑쌍고대다낭란소종합정(PCOS)환자이도소저항적영향.방법 장62례PCOS환자채용수궤수자표법분위관찰조화대조조,매조31례.대조조급여굴라동결자순편치료,1편/d,21 d위1개료정,정약후월경래조적제5천개시하일개료정,련속복약6개료정.관찰조급여굴라동결자순편연합이갑쌍고치료,전약용법상동,이갑쌍고0.5g/차,3차/d.치료전후분별검측2조환자성격소수평화이도소저항지수,병비교2조배란솔화임신솔.결과 치료6개료정후,2조환자황체생성소、황체생성소/란포자격소비치、고동、자이순화이도소저항지수수평균교명현저우치료전[관찰조:(8.8 ±2.7)U/L비(14.2±3.6) U/L,(0.9±0.3)비(2.0±0.5),(1.8 ±0.6) mmol/L비(2.7±0.8) mmol/L,(96±20) pmol/L비(139±24)pmol/L,(1.6±0.6)비(3.7±0.9);대조조:(11.2±3.1)U/L비(14.3±3.3)U/L,(0.9±0.3)비(1.3±0.5),(2.1±0.6)mmol/L비(2.7±0.8)mmol/L,(115±22)pmol/L비(136±26) pmol/L,(2.8±0.7)비(3.7±0.9),균P＜0.01];란포자격소명현고우치료전[관찰조:(10.2±2.4) U/L비(6.9±1.5) U/L;대조조:(8.8±1.7)U/L비(7.0 ±1.5)U/L,균P＜0.01];관찰조치료후각지표여대조조치료후비교,차이균유통계학의의(균P＜0.01);관찰조환자배란솔화임신솔균명현고우대조조,차이유통계학의의[64.5％ (20/31)비38.7％(12/31),38.7％(12/31)비16.1％ (5/31)](P＜0.05).결론 굴라동결자순편연합이갑쌍고능개선PCOS환자고웅격소상태화이도소저항,종이제고환자배란솔급임신솔.
Objective To observe the influence of drospirenone and ethinylestradiol tablets combined with metformin on insulin resistance in patients with polycystic ovary syndrome.Methods Sixty-two patients with polycystic ovary syndrome were selected and randomly divided into control group and observation group,with 31 cases in each group.Patients of the control group were given drospirenone and ethinylestradiol tablets from the 5th day of the menstrual cycle for a total of 21 days with 6 menstrual cycles.Patients of the observation group were given metformin in addition.Sex hormone level and insulin resistance index were measured before and after treatment.The ovulation and pregnancy rates were evaluated in two groups.Results After 6 courses treatment,luteinizing hormone,luteinizing hormone/follicle stimulating hormone ratio,testosterone,estradiol and insulin resistance showed a significantly reduction compared with those before treatment [observation group(14.2 ± 3.6)U/L,(2.0 ± 0.5),(2.7 ± 0.8) mmol/L,(139 ± 24) pmol/L,(3.7 ± 0.9) ; control group (14.3 ± 3.3) U/L,(2.1 ± 0.5),(2.7 ±0.8) mmol/L,(136 ± 26) pmol/L,(3.7 ± 0.9)] ; follicle-stimulating hormone was significantly higher than before treatment [observation group (6.9 ± 1.5) U/L,control group (7.0 ± 1.5) U/L] (P ＜ 0.01).There were significant differences between the observation group and control group after treatment [luteinizing hormone (8.8 ±2.7) U/L vs (11.2 ±3.1) U/L,follicle stimulating hormone (10.2 ±2.4) U/L vs (8.8 ± 1.7) U/L,luteinizing hormone/follicle stimulating hormone (0.9 ± 0.3) vs (1.3 ± 0.5),testosterone (1.8 ± 0.6) mmol/L vs (2.1 ±0.6) mmol/L,estradiol (96 ± 20) pmol/L vs (115 ± 22) pmol/L,insulin resistance (1.6 ± 0.6) vs (2.8 ±0.7)] (P ＜0.01).The ovulation and pregnancy rates were significantly higher in the observation group compared with those in control group[64.5％ (20/31) vs 38.7％ (12/31),38.7％ (12/31) vs 16.1％ (5/31)](P ＜ 0.05).Conclusions Drospirenone and ethinylestradiol tablets combined with metformin can improve the elevated androgen levels and insulin resistance in patients with polycystic ovary syndrome.The ovulation and pregnancy rates are significantly improved with drospirenone and ethinylestradiol tablets combined with metformin.
