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目的观察联合运用复方醋酸环丙孕酮和二甲双胍治疗多囊卵巢综合征(Pcos)疗效。方法选用空腹胰岛素测定值高或具有胰岛素抵抗的多囊卵巢综合征患者48例。给予复方醋酸环丙孕酮1片/d,连服21d,待撤退性出血第五天开始下一周期治疗,同时给予二甲双胍500mg,3次/d口服,治疗3个疗程后,停药3个月,测用药前、停药后及停药3个月后血清性激素水平及胰岛素释放水平。结果用药后28例伴有多毛、痤疮、黑棘皮者症状明显改善,36例有规律月经,测基础体温有排卵,治疗后黄体生成素(LH)水平明显降低,LH/FSH比例恢复正常,睾酮(T)降至正常,空腹胰岛素(F-Ins),胰岛素曲线下面积明显下降,与治疗前比较差异有统计学意义(P<0.01)。但停药6个月后,26例已恢复排卵性月经的患者又相继闭经。LH、FSH、T、F-Ins又有所上升,与治疗前比较差异无统计学意义(P>0.05)。结论复方醋酸环丙孕酮联合二甲双胍治疗多囊卵巢综合征具有明显改善患者症状,提高排卵率,改善患者高雄激素症候群及内分泌失调状态。
Objective To observe the curative effect of compound cyproterone acetate and metformin on polycystic ovary syndrome (Pcos). Methods Forty-eight patients with polycystic ovary syndrome with fasting insulin or insulin resistance were selected. Given cyproterone acetate tablets / d, and even served 21d, withdrawal bleeding to be the fifth day start the next cycle of treatment, while giving metformin 500mg, 3 times / d orally, after 3 courses of treatment, withdrawal of 3 Month, before test medication, after stopping and stopping 3 months after the level of serum sex hormone and insulin release levels. Results After treatment, the symptoms of 28 cases with hirsutism, acne and acanthosis nigricans were significantly improved, and 36 cases had regular menstruation. Ovulation was found on the basis of body temperature. After treatment, the levels of LH, FSH and FSH returned to normal. (T) decreased to normal, fasting insulin (F-Ins), insulin area under the curve decreased significantly compared with before treatment was statistically significant (P <0.01). However, after 6 months of withdrawal, 26 patients who had recovered from anovulatory menstruation were also amenorrhea. LH, FSH, T, F-Ins increased again, with no significant difference compared with before treatment (P> 0.05). Conclusions The compound cyproterone acetate combined with metformin in the treatment of polycystic ovary syndrome can significantly improve the symptoms of patients, improve the ovulation rate, and improve the patient’s hyperandrogenism syndrome and endocrine disorders.