中国临床保健杂志
中國臨床保健雜誌
중국림상보건잡지
CHINESE JOURNAL OF CLINICAL HEALTHCARE
2014年
2期
127-131
,共5页
多囊卵巢综合征%二甲双胍%炔雌醇%环丙孕酮%Meta分析
多囊卵巢綜閤徵%二甲雙胍%炔雌醇%環丙孕酮%Meta分析
다낭란소종합정%이갑쌍고%결자순%배병잉동%Meta분석
Polycystic Ovary Syndrome%Metformin%Ethinyl Estradiol%Cyproterone%Meta-Analysis
目的：综合评价炔雌醇环丙孕酮（达英-35）及其与二甲双胍联合应用对多囊卵巢综合征（PCOS）患者代谢指标的影响。方法在PubMed、EMBASE、Cochrane Library、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）等相关数据库，对2001年至2013年的中英文文献进行检索。纳入的研究包括达英-35单用组及达英-35与二甲双胍联用组，对纳入研究的质量进行评价，用Revman4．2．10软件进行Meta分析。结果共纳入19项临床试验，包括1385例PCOS患者。其方法学质量的Jadad评分均≥3分。荟萃分析结果显示：（1）激素指标：与单用达英-35组比较，联用组卵泡刺激素（FSH）差异无统计学意义；黄体生成素（LH）、睾酮（T）均明显降低，差异有统计学意义。（2）脂代谢指标：与单用达英-35组比较，联用组低密度脂蛋白（LDL）差异和高密度脂蛋白（HDL）均差异无统计学意义；总胆固醇（TC）、总三酰甘油（TG）均有所降低，差异有统计学意义。（3）胰岛素指标：单用达英-35组与联用组空腹血糖（FBG）差异无统计学意义；但联用组空腹胰岛素（FIns）明显降低，差异有统计学意义。结论联合用药较达英-35单药治疗能更有效地纠正PCOS患者的代谢紊乱，改善胰岛素抵抗。
目的：綜閤評價炔雌醇環丙孕酮（達英-35）及其與二甲雙胍聯閤應用對多囊卵巢綜閤徵（PCOS）患者代謝指標的影響。方法在PubMed、EMBASE、Cochrane Library、中國期刊全文數據庫（CNKI）、中國生物醫學文獻數據庫（CBM）等相關數據庫，對2001年至2013年的中英文文獻進行檢索。納入的研究包括達英-35單用組及達英-35與二甲雙胍聯用組，對納入研究的質量進行評價，用Revman4．2．10軟件進行Meta分析。結果共納入19項臨床試驗，包括1385例PCOS患者。其方法學質量的Jadad評分均≥3分。薈萃分析結果顯示：（1）激素指標：與單用達英-35組比較，聯用組卵泡刺激素（FSH）差異無統計學意義；黃體生成素（LH）、睪酮（T）均明顯降低，差異有統計學意義。（2）脂代謝指標：與單用達英-35組比較，聯用組低密度脂蛋白（LDL）差異和高密度脂蛋白（HDL）均差異無統計學意義；總膽固醇（TC）、總三酰甘油（TG）均有所降低，差異有統計學意義。（3）胰島素指標：單用達英-35組與聯用組空腹血糖（FBG）差異無統計學意義；但聯用組空腹胰島素（FIns）明顯降低，差異有統計學意義。結論聯閤用藥較達英-35單藥治療能更有效地糾正PCOS患者的代謝紊亂，改善胰島素牴抗。
목적：종합평개결자순배병잉동（체영-35）급기여이갑쌍고연합응용대다낭란소종합정（PCOS）환자대사지표적영향。방법재PubMed、EMBASE、Cochrane Library、중국기간전문수거고（CNKI）、중국생물의학문헌수거고（CBM）등상관수거고，대2001년지2013년적중영문문헌진행검색。납입적연구포괄체영-35단용조급체영-35여이갑쌍고련용조，대납입연구적질량진행평개，용Revman4．2．10연건진행Meta분석。결과공납입19항림상시험，포괄1385례PCOS환자。기방법학질량적Jadad평분균≥3분。회췌분석결과현시：（1）격소지표：여단용체영-35조비교，련용조란포자격소（FSH）차이무통계학의의；황체생성소（LH）、고동（T）균명현강저，차이유통계학의의。（2）지대사지표：여단용체영-35조비교，련용조저밀도지단백（LDL）차이화고밀도지단백（HDL）균차이무통계학의의；총담고순（TC）、총삼선감유（TG）균유소강저，차이유통계학의의。（3）이도소지표：단용체영-35조여련용조공복혈당（FBG）차이무통계학의의；단련용조공복이도소（FIns）명현강저，차이유통계학의의。결론연합용약교체영-35단약치료능경유효지규정PCOS환자적대사문란，개선이도소저항。
Objective To comprehensively assess the effect of Diane-35 and metformin for metabolic inde-xes in patients with PCOS.Methods The related datum during 2001 -2013 in PubMed、EMBASE、Cochrane Librar-y、CNKI、CBMdisc was collected during the year of 2001 -2013.The studies were involved in researches included Di-ane-35 group and combined group ed group of Diane-35 with mefformin.Quality assessment was conducted.Rev-man 4.2.10 was applied to perform the analysis.Results 19 RCTs with a Jadad scale above 3,were identified were brought into this research,including 1385 PCOS patients.Its Jadad was ≥3.The results of meta-analysis showed that:(1 )Hormonal level:Compared with Diane-35 group,the serum LH and T in the combined group were signifi-cantly lower than those in Diane-35 group.However,The level of FSH in the combined group was decreased.but with no significantly differences between these two groups.(2)Lipid metebolism:Compared with Diane-35 group,the lev-els of serum TG and TC in the combined group were significantly lower than those in Diane-35 group.AlthoughHow-ever,the level of LDL was decreased and the level of HDL was increased in the combined group with no significantly differences,these difference failed to achieve statistical significance.(3 )Insulin level:Compared with Diane -35 group,the level of serum FIns in the combined group was significantly lower than that in Diane-35 group,while the level of FBG in the combined group was decreased with no significantly differences.,but no the significance differ-ence.Conclusions The combination of Diane-35 with metformin may be associated with the improvements of meta-bolic indexes in patients with PCOS compared with Diane-35 only.
