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目的观察环丙孕酮联合二甲双胍或吡格列酮治疗多囊卵巢综合征(PCOS)合并胰岛素抵抗(IR)不孕妇女的疗效。方法 PCOS合并IR不孕妇女150例随机均分为两组,分别采用环丙孕酮复合吡格列酮(A组)或二甲双胍(B组)治疗3个月。比较治疗前后激素水平、脂质和糖代谢情况,观察治疗后两组的妊娠率及药物不良反应。结果治疗后,两组黄体生成素(LH)、雄烯二酮(A2)、睾酮(T)、空腹胰岛素(FIns)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)和IR均较治疗前降低(P<0.05),高密度脂蛋白(HDL-C)较治疗前升高(P<0.05)。治疗后两组妊娠率相仿(50.7%vs.53.3%)(P>0.05);A组体重增加和水肿的发生率分别为29.3%和24.0%,高于B组的2.7%和1.3%(P<0.01)。A组胃肠道反应发生率低于B组(12.0%vs.36.0%)(P<0.01)。结论环丙孕酮联合二甲双胍或吡格列酮治疗PCOS合并IR的不孕患者均能取得较好的临床效果。
Objective To observe the curative effect of cyproterone combined with metformin or pioglitazone on women with polycystic ovary syndrome (PCOS) and insulin resistance (IR) infertility. Methods One hundred and fifty women with PCOS and IR infertility were randomly divided into two groups. The patients were treated with either cyproterone combined with pioglitazone (group A) or metformin (group B) for 3 months. The hormone levels, lipid and glucose metabolism were compared before and after treatment, and the pregnancy rates and adverse drug reactions were observed after treatment. Results After treatment, the levels of LH, A2, T, FIns, TC, TG, LDL LDL-C) and IR were lower than before treatment (P <0.05), and HDL-C was higher than before treatment (P <0.05). The pregnancy rates of the two groups were similar (50.7% vs.53.3%) after treatment (P> 0.05). The incidences of body weight gain and edema in group A were 29.3% and 24.0% respectively, higher than those in group B (2.7% vs 1.3% <0.01). The incidence of gastrointestinal reactions in group A was lower than that in group B (12.0% vs.36.0%) (P <0.01). CONCLUSIONS: Both cyproterone combined with metformin and pioglitazone can achieve better clinical outcomes in infertile patients with PCOS combined with IR.