复方醋酸环丙孕酮联合二甲双胍治疗多囊卵巢综合征的疗效及对内分泌代谢的影响

目的探讨复方醋酸环丙孕酮联合二甲双胍治疗多囊卵巢综合征（PCOS）的疗效及其对内分泌与代谢的影响。方法将该院2011年12月至2012年12月收治的72例PCOS患者按照1∶1比例随机分为2组,每组各36例,对照组单纯给予复方醋酸环丙孕酮治疗,观察组在对照组基础上联合二甲双胍治疗,并对2组患者的相关指标进行统计学分析。结果治疗后2组患者多毛评分、痤疮评分、卵巢体积均较治疗前改善（P〈0.05）;但观察组改善程度较对照组显著,差异有统计学意义（P〈0.05）;治疗后观察组患者黄体生成素（LH）、卵泡刺激素（FSH）、黄体生成素/卵泡刺激素比值（LH/FSH）、雌二醇（E2）、总睾酮（T）、硫酸脱氢表雄酮（DHEAS）、性激素结合球蛋白（SHBG）各项指标变化幅度均优于对照组（P〈0.05）;观察组治疗后空腹胰岛素（FINS）、低密度脂蛋白（LDL）显著降低（P〈0.05）,总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）显著上升（P〈0.05）;LDL、TC、HDL各指标变化优于对照组,差异均有统计学意义（P〈0.05）。结论复方醋酸环丙孕酮联合二甲双胍在PCOS的治疗上有显著优势,可明显改善患者的内分泌及代谢功能,且临床疗效及安全性均较好。

Endocrine and metabolic effects of metformin in combination with compound cyproterone acetate in women with polycys-tic ovarian syndrome

Objective To investigate the endocrinologic and metabolic effects of metformin in combination with compound cyproterone acetate on patients with polycystic ovarian syndrome .Methods 72 cases of PCOS patients in our hospital were randomly divided into two groups according to the ratio of 1∶1 from December 2011 to December 2012 ,36 cases in each group .The control group were given compound cyproterone acetate treatment ,the observation group were based on the combination of metformin therapy ,and two related indicators were statistically analyzed .Re-sults After treatment ,patients with hirsutism score ,acne score ,improved ovarian volume than those of before treat-ment（P〈0 .05） ,but the degree of improvement in observation group is than those of in the control group was signifi-cantly（P〈0 .05） .After treatment ,changes of LH ,FSH ,LH/FSH ,E2 ,T ,DHEAS ,SHBG in patients of treatment are higher than the control group（P〈0 .05） .FINS ,LDL of observation group after treatment ,decreased significantly （P〈0 .05） ,TC ,TG ,HDL increased significantly （P〈0 .05） ,changes of LDL ,TC ,HDL in the observation group is more than those in the control group（P〈0 .05） .Conclusion Compound cyproterone acetate combined with metform-in in the treatment of PCOS has significant advantages ,it can significantly improve the patient′s endocrine and meta-bolic functions ,and the clinical efficacy and safety can be protected .