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目的探讨胰岛素抵抗型多囊卵巢综合征(PCOS)患者采用二甲双胍联合屈螺酮炔雌醇药物临床疗效,为临床PCOS治疗提供可靠依据。方法选取2013年1月至2016年1月收治于汶上县人民医院70例胰岛素抵抗型PCOS患者,随机分为观察组及对照组,每组35例。其中,观察组给予二甲双胍联合屈螺酮炔雌醇治疗,对照组给予枸橼酸氯米芬胶囊治疗。对比两组治疗3个疗程后促黄体生成激素(LH)、卵泡生成激素(FSH)、睾酮(T)、空腹血糖(FBG)、空腹胰岛素水平(FIN)及排卵、妊娠情况。结果治疗前,两组LH、FSH、T、FBG和FIN等指标比较,差异无统计学意义(P>0.05)。治疗后,观察组LH、FSH、T、FIN水平均低于对照组,差异均有统计学意义(P<0.05);两组FBG水平比较,差异无统计学意义(P>0.05)。治疗3个疗程结束后,观察组排卵率、妊娠率均高于对照组,未受孕率低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论二甲双胍联合屈螺酮炔雌醇治疗胰岛素抵抗型PCOS患者临床疗效显著,可显著改善患者激素水平,缓解症状,提高受孕率。
Objective To investigate the clinical efficacy of metformin combined with drospirenone ethinyl estradiol in patients with insulin resistance-induced polycystic ovary syndrome (PCOS) and provide a reliable basis for clinical PCOS treatment. Methods Seventy patients with insulin resistance PCOS admitted to Wenshang County People’s Hospital from January 2013 to January 2016 were randomly divided into observation group and control group with 35 cases in each group. The observation group was treated with metformin and drospirenone ethinyl estradiol, while the control group was treated with clomiphene citrate capsule. The levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), fasting blood glucose (FBG), fasting insulin (FIN) and ovulation and pregnancy were compared between the two groups after 3 courses of treatment. Results Before treatment, there was no significant difference in the indexes of LH, FSH, T, FBG and FIN between the two groups (P> 0.05). After treatment, the levels of LH, FSH, T and FIN in the observation group were lower than those in the control group (P <0.05). There was no significant difference in FBG levels between the two groups (P> 0.05). After 3 courses of treatment, the ovulation rate and pregnancy rate of observation group were higher than that of control group, and the rate of non-pregnancy was lower than that of control group (P <0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion Metformin combined with drospirenone ethinyl estradiol in the treatment of patients with insulin resistance PCOS significant clinical effect, can significantly improve the patient’s hormone levels, relieve symptoms and improve the pregnancy rate.