运动对多囊卵巢综合征患者的胰岛素抵抗和性激素的影响

目的：多囊卵巢综合征(PCOS)是造成生育期妇女不孕的原因之一，临床多表现为月经稀少或闭经、不孕、多毛和肥胖等一组征候群，胰岛素抵抗和高雄激素血症是其基本特征：本研究旨在探讨耐力运动对PCOS患者的高胰岛素和高雄激素血症的调节作用，为临床康复治疗开拓新的应用领域。方法：20例PCOS患者根据干预方法的不同分为运动组(n=11)和药物组(n=9)。运动组在低热卡饮食的基础上，实施每次60min以上中等强度运动，慢跑总路程6—8kin，每周运动5天以上，连续3个月。药物组服用达因-35(Diane-35，Cyproteroneacetate)，每日1片，连用21天，停药7天后再服第2个周期，依此类推，共服3个周期。结果：BMI、血清胰岛素、胰岛素敏感性在运动前后均显著降低，药物组则无变化；血清睾酮、黄体生成素以及黄体生成素／卵泡刺激素比值在运动组和治疗组治疗前后均见有显著降低，两组之间无统计学差异。结论：低热卡饮食加运动治疗有利于改善胰岛素抵抗，降低高黄体生成素和高睾酮血症作用，提示运动是治疗PCOS经济、安全、有效的辅助手段之一。

Effects of exercise training on insulin resistance and sex hormone in obese women with polycystic ovary syndrome

Objective:Polycystic ovary syndrome(PCOS)is an common cause of premenopausal women for endocrine infertility with characteristics of hyperandrogenism and insulin resistance,which manifests a group of clinical symptoms with amenorrhea,infertility,hirsutism,obesity,etc.This study is to investigate the modulatory effects of exercise training on hyperinsulinemia and hyperandrogenemia to provide clue for treatment of PCOS in field of clinical rehabilitation.Method:Twenty patients with PCOS were divided into exercise training group(ETG,n=11)and drug group(DG,n=9)according to different intervention.Based on low calorie diets,the ETG performed moderate intensity exercise training with more than60min per day such as jogging for6-8km for more than5days per week up to time of3months.Oral administration of Diane-35(Cyproterone acetate)was token for3months in DG(One tablet per day for21days as a cycle).Result:Body mass index(BMI),the levels of serum insulin and insulin sensitivity index decreased significantly in ETG and not in DG after a3-month interventions.Serum testosterone(T),Serum luteinizing hormone(LH)and the ratios of luteinizing hormone/follicle stimulating hormone(LH/FSH)decreased significantly in both ETG and DG,which was not significantly statistical differences between two groups after two interventions.Conclusion:Exercise training with low calorie diets can improve insulin resistance and decrease serum LH and T levels,which indicats that exercise training is an available,safe,and economical adjuvant therapy for obese women with PCOS.