黄连素干预多囊卵巢综合征患者胰岛素抵抗的临床观察

【目的】探讨黄连素单药使用对多囊卵巢综合征(PCOS)患者胰岛素抵抗(IR)的临床疗效。【方法】将60例PCOS-IR患者随机分为治疗组和对照组各30例。治疗组脱落4例,对照组脱落1例,最终治疗组26例、对照组29例完成试验。治疗组给予黄连素口服治疗,对照组给予二甲双胍口服治疗,2组疗程均为3个月。观察2组患者治疗前后体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)及胰岛素(FINS)、口服葡萄糖耐量试验(OGTT)的餐后2 h血糖(OGTT2h PG)及胰岛素(OGTT2h INS)、血脂总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、性激素卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)及LH/FSH比值]等指标的变化情况。【结果】治疗后,2组均能降低PCOS-IR患者BMI、HOMA-IR、TC、TG及LDL-C水平(P0.05或P0.01),但组间比较差异无统计学意义(P0.05);治疗组还能使PCOS-IR患者血中T及LH水平以及LH/FSH比值较治疗前及对照组显著下降,差异均有统计学意义(P0.05或P0.01)。【结论】黄连素能改善PCOS-IR患者的HOMA-IR,降低血中性激素水平,调节血脂代谢,其疗效与二甲双胍相当。

Clinical Observation of Berberine in Intervening Insulin Resistance of Polycystic Ovary Syndrome

Objective To evaluate the clinical efficacy of berberine for the treatment of insulin resistance (IR) in women with polycystic ovary syndrome (PCOS).Methods Sixty PCOS-IR women were randomized into treatment group and control group,30 cases in each group.At the end of the trial,26 cases in the treatment group (4 cases dropped out) and 29 cases in the control group (one case dropped out) completed the trial.The treatment group was treated with berberine orally,and the control group was treated with metformin orally,the treatment for the two groups lasting 3 months.Before and after treatment,we observed the parameters of body mass index (BMI),homeostasis model of assessment for insulin resistance index (HOMA-IR),fasting plasma glucose (FPG),fasting insulin (FINS),2-hour postprandial glucose after oral glucose tolerance test (OGTT2hPG) and 2-hour postprandial insulin after OGTT (OGTT2hINS),blood lipid levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C),and sexual hormones of follicle-stimulating hormone (FSH),luteotropic hormone (LH),testosterone (T) and LH/FSH ratio.Results BMI,HOMA-IR,TC,TG and LDL-C of the two groups were decreased after treatment (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),but the differences between the two groups were insignificant(P ＞ 0.05).Serum levels of T and LH as well as LH/FSH ratio in the treatment group were also decreased (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment and those in the control group after treatment).Conclusion Berberine can improve HOMA-IR,decrease serum sexual hormones levels,and regulate the blood metabolism in PCOS-IR women,and its effect is similar to that of metformin.