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目的:观察健脾清补肾方联合二甲双胍对肥胖型多囊卵巢综合征(PCOS)患者内分泌及糖脂代谢的影响。方法:中西医结合治疗组:34例肥胖PCOS患者应用二甲双胍500mg/次,3次/d,同时口服健脾补肾方每日1剂,早晚分服,共3个月;西药组:34例肥胖PCOS患者单用二甲双胍500mg/次,3次/d,连续3个月。比较治疗前后临床症状、内分泌及糖脂代谢指标的改变。结果:治疗后中西医结合组中20例患者恢复了月经,西药组中16例患者恢复了月经。两组患者治疗前后腰臀比、促黄体生成素、雄激素、空腹胰岛素、胰岛素曲线下面积明显降低,胰岛素敏感指数明显提高,有显著性差异(P<0.05)。在血脂改善方面,中西医结合组患者治疗后,总胆固醇、甘油三酯、低密度脂蛋白、载脂蛋白B均明显下降(P<0.05,P<0.01);西药组患者治疗后,只有总胆固醇、载脂蛋白B下降,余指标无明显改变。结论:健脾补肾方联合二甲双胍可明显降低肥胖型多囊卵巢综合征患者促卵泡素、雄激素水平,提高胰岛素的敏感性,降低血脂水平,减少二甲双胍的副作用,提高患者依从性,尤其是对血脂的改善明显优于西药组。
Objective: To observe the effects of “Jianpi Qing Bushen Decoction” and metformin on endocrine and glucose and lipid metabolism in obese patients with polycystic ovary syndrome (PCOS). Methods: Integrative Medicine group: 34 cases of obese patients with PCOS metformin 500mg / time, 3 times / d, while spleen and Kidney side of oral administration of one day sooner or later, a total of 3 months; western medicine group: 34 cases of obesity PCOS patients with metformin 500mg / time, 3 times / d, for 3 months. Before and after treatment, clinical symptoms, endocrine and glucose and lipid metabolism index changes. Results: After treatment, 20 patients in Integrative Medicine Group recovered their menstruation, and 16 patients in Western Medicine Group recovered their menstruation. Before and after treatment, waist-hip ratio, luteinizing hormone, androgen, fasting insulin, insulin area under the curve were significantly decreased, insulin sensitivity index increased significantly, with significant difference (P <0.05). In the improvement of blood lipids, the levels of total cholesterol, triglyceride, low density lipoprotein, and apolipoprotein B were significantly decreased in patients receiving traditional Chinese and western medicine (P <0.05, P <0.01) Cholesterol, apolipoprotein B decreased, the remaining indicators no significant change. Conclusion: Jianpi Bushen Recipe combined with metformin can significantly reduce follicle-stimulating hormone and androgen levels in patients with obese polycystic ovary syndrome, improve insulin sensitivity, reduce blood lipid levels, reduce the side effects of metformin and improve patient compliance, especially for lipid Improve significantly better than western medicine group.