复方醋酸环丙孕酮联合二甲双胍对多囊卵巢综合征患者内分泌及代谢功能的影响

目的:观察复方醋酸环丙孕酮联合二甲双胍对多囊卵巢综合征(PCOS)患者内分泌及代谢功能的影响。方法:将63例PCOS患者随机分为对照组(31例)和观察组(32例)。对照组患者于月经来潮第5日服用复方醋酸环丙孕酮1片,每日1次,21 d为1个疗程,服用1个疗程后停药等待撤退性出血后第5日起开始下个疗程,共5个疗程;观察组患者在对照组治疗的基础上服用二甲双胍500 mg,每日2次。观察两组患者治疗前后多毛评分、痤疮评分、卵巢体积、内分泌指标促卵泡激素(FSH)、黄体生成素(LH)、LH/FSH、雌二醇(E2)、总睾酮(T)、性激素结合球蛋白(SHBG)、硫酸脱氢表雄酮(DHEAS)]、代谢指标空腹血糖(FBG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]及不良反应发生情况。结果:治疗前两组患者临床症状、内分泌指标、代谢指标比较,差异均无统计学意义(P>0.05);治疗后两组患者临床症状、LH、FSH、LH/FSH、E2、T、DHEAS均显著低于同组治疗前,且观察组低于对照组,SHBG、TG、HDL显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05);TC显著高于同组治疗前(P<0.05),但组间比较差异无统计学意义(P>0.05);观察组患者FINS显著高于对照组,差异有统计学意义(P<0.05)。两组患者治疗前后FBG及对照组治疗前后FINS比较,差异均无统计学意义(P>0.05)。两组患者治疗期间均未见明显不良反应发生。结论:复方醋酸环丙孕酮联合二甲双胍可显著改善PCOS患者内分泌及代谢功能,安全性较好。

Effects of Compound Cyproterone Acetate Combined with Metformin on Endocrine and Metabolic Function of Patients with Polycystic Ovarian Syndrome

OBJECTIVE：To observe the effects of Compound cyproterone acetate combined with metformin on endocrinologic and metabolic function of patients with polycystic ovarian syndrome（PCOS）. METHODS：63 PCOS patients were randomly divided into observation group（32 cases）and control group（31 cases）. Control group was treated with one Compound cyproterone acetate tablet orally once a day since the fifth day of menstruation;a treatment course lasted for 21 days,and the following treatment course was supplied on the fifth day after withdrawal bleeding;there were a total of 6 treatment courses. Observation group was additionally treated with metformin 500 mg orally twice a day on the basis of control group. Hirsutism score,acne score,ovarian volume,FSH,LH,E2,T,SHBG,DHEAS,FPG,FINS,TC,TG,HDL,LDL and the occurrence of ADR were observed in 2groups before and after treatment. RESULTS：Before treatment,there was no statistical significance in clinical symptom,endocrinologic index and metabolic index between 2 groups（P〉0.05）. The clinical symptom,LH,FSH,E2,T and DHEAS of 2 groups after treatment were significantly lower than before;the observation group was lower than the control group. SHBG,TG and HDL of2 groups after treatment were significantly higher than before;the observation group was higher than the control group;there was statistical significance（P〈0.05）. TC of 2 groups was significantly higher than before（P〈0.05）;there was no statistical significance between 2 groups（P〉0.05）. FINS of observation group was significantly higher than control group;there was statistical significance（P〈0.05）. There was no statistical significance in FBG of 2 groups and FINS of control group before and after treatment（P〉0.05）. No obvious ADR was found in 2 groups during treatment. CONCLUSIONS：Compound cyproterone acetate combined with metformin can improve endocrinologic and metabolic function of PCOS patients with good safety.