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目的探讨生活方式调整、二甲双胍及罗格列酮治疗多囊卵巢综合征(PCOS)的临床疗效。方法将106例 PCOS 患者随机分为单纯生活方式调整(锻炼及饮食控制)、生活方式调整+二甲双胍与生活方式调整+罗格列酮治疗3组,分别为43、36、27例,共有60例(分别为22、21、17例)患者完成治疗,观察3组患者治疗前、后排卵情况,比较体重指数(BMI)、腰围、腰围与臀围比值(WHR)、血清睾酮、空腹真胰岛素水平、血脂、稳态模型法测定的胰岛素抵抗指数(HOMA-IR)、空腹血糖与胰岛素比值(GIR)、定量胰岛素敏感检测指数(QUICKI)的变化。结果治疗前3组患者年龄、BMI、腰围、WHR、睾酮水平、空腹真胰岛素水平、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)比较,差异均无统计学意义(P>0.05)。单纯生活方式调整组的43例患者中22例完成治疗,23%(5/22)恢复排卵;生活方式调整+二甲双胍组的36例患者中21例完成治疗,43%(9/21)恢复排卵;生活方式调整+罗格列酮组的27例患者中17例完成治疗,59%(10/17)恢复排卵。3组患者的恢复排卵率比较,差异无统计学意义(P>0.05);但生活方式调整+罗格列酮组较单纯生活方式调整组恢复排卵率高,且差异有统计学意义(P<0.05)。治疗后3组患者的 BMI、腰围、WHR、睾酮、TC、TG、LDL-C、HDL-C 比较,差异均无统计学意义(P>0.05)。结论生活方式调整、二甲双胍、罗格列酮对 PCOS 患者均有恢复排卵作用。
Objective To investigate the clinical effects of lifestyle adjustment, metformin and rosiglitazone in the treatment of polycystic ovary syndrome (PCOS). Methods One hundred and six patients with PCOS were randomly divided into three groups: lifestyle adjustment (exercise and diet control), lifestyle adjustment + metformin and lifestyle adjustment + rosiglitazone treatment. (22 cases, 21 cases, 17 cases, respectively) were observed. The ovulation before and after treatment was observed. The body mass index (BMI), waist circumference, waist circumference and hip circumference (WHR), serum testosterone, fasting true insulin , Blood fat, insulin resistance index (HOMA-IR), fasting blood glucose and insulin ratio (GIR) and quantitative insulin sensitivity index (QUICKI) measured by steady-state model. Results Before treatment, the age, BMI, waist circumference, WHR, testosterone level, true fasting insulin, total cholesterol, TG, HDL- Protein-cholesterol (LDL-C), the difference was not statistically significant (P> 0.05). Among 43 patients in the lifestyle adjustment group, 22 completed treatment and 23% (5/22) regained their ovulation. In the lifestyle modification group, 36 of 36 patients completed treatment and 43% (9/21) of ovulation resumed ; Lifestyle adjustment 17 patients in rosiglitazone group of 27 patients completed treatment, 59% (10/17) to restore ovulation. There was no significant difference between the three groups in the recovery ovulation rate (P> 0.05), but the lifestyle adjustment + rosiglitazone group had higher ovulation rate than the lifestyle adjustment group, and the difference was statistically significant (P < 0.05). There was no significant difference in BMI, waist circumference, WHR, testosterone, TC, TG, LDL-C and HDL-C between the three groups after treatment (P> 0.05). Conclusion Lifestyle adjustment, metformin and rosiglitazone may restore ovulation in PCOS patients.