CAJ | 학술논문

目的：探讨复方醋酸环丙孕酮联合二甲双胍治疗多囊卵巢综合征（PCOS）合并胰岛素抵抗的效果和可能机制。方法选取本院2013年1月~2014年1月的120例PCOS合并胰岛素抵抗患者作为研究对象，随机分为CPA组和联合组，各60例。 CPA组给予复方醋酸环丙孕酮治疗，联合组给予复方醋酸环丙孕酮联合二甲双胍治疗，比较两组的效果。结果 CPA组的有效率为93.3%（56/60），联合组的有效率为98.3%（59/60），两组比较差异无统计学意义（P>0.05）。联合组治疗后的LH、FSH、T水平显著低于CPA组治疗后，SHBG水平显著高于CPA组治疗后，差异有统计学意义（P<0.05）。联合组治疗后的空腹胰岛素水平显著低于CPA组治疗后，GIR水平显著高于CPA组治疗后，差异有统计学意义（P<0.05）。联合组治疗后的HDL-C水平显著高于CPA组治疗后，LDL-C水平显著低于CPA组治疗后，差异有统计学意义（P<0.05）。结论复方醋酸环丙孕酮联合二甲双胍可以用来治疗PCOS合并胰岛素抵抗，具有临床可行性。
목적：탐토복방작산배병잉동연합이갑쌍고치료다낭란소종합정（PCOS）합병이도소저항적효과화가능궤제。방법선취본원2013년1월~2014년1월적120례PCOS합병이도소저항환자작위연구대상，수궤분위CPA조화연합조，각60례。 CPA조급여복방작산배병잉동치료，연합조급여복방작산배병잉동연합이갑쌍고치료，비교량조적효과。결과 CPA조적유효솔위93.3%（56/60），연합조적유효솔위98.3%（59/60），량조비교차이무통계학의의（P>0.05）。연합조치료후적LH、FSH、T수평현저저우CPA조치료후，SHBG수평현저고우CPA조치료후，차이유통계학의의（P<0.05）。연합조치료후적공복이도소수평현저저우CPA조치료후，GIR수평현저고우CPA조치료후，차이유통계학의의（P<0.05）。연합조치료후적HDL-C수평현저고우CPA조치료후，LDL-C수평현저저우CPA조치료후，차이유통계학의의（P<0.05）。결론복방작산배병잉동연합이갑쌍고가이용래치료PCOS합병이도소저항，구유림상가행성。
Objective To explore the effectiveness and mechanism of cyproterone acetate combined with metformin in the treatment of polycystic ovary syndrome (PCOS) with insulin resistance. Methods 120 cases of PCOS with insulin re-sistance from January 2013 to January 2014 in our hospital were selected and randomly divided into the CPA group and the combination group,60 cases in each group.The effect of two groups was compared. Results The effective rate of the CPA group was 93.3%(56/60),the effective rate of the combination group was 98.3%(59/60),there was no significant difference (P>0.05).The level of LH,FSH,T after treatment in combination group was lower than that in CPA group after treatment,the level of SHBG after treatment in combination group was higher than that in CPA group after treatment, with significant difference (P<0.05).The level of fasting insulin after treatment in combination group was lower than that in CPA group after treatment,the level of GIR after treatment in combination group was higher than that in CPA group after treatment,with significant difference (P<0.05).The level of HDL-C after treatment in combination group was higher than that in CPA group after treatment,the level of LDL-C after treatment in combination group was lower than that in CPA group after treatment,with significant difference (P<0.05). Conclusion Cyproterone acetate combined with met-formin can be used to treat PCOS with insulin resistance,and it has clinical feasibility.