达英-35联合二甲双胍治疗多囊卵巢综合征的临床疗效观察

目的探讨达英-35联合二甲双胍治疗多囊卵巢综合征的临床疗效。方法选择2011年1月～2012年1月在我院治疗的多囊卵巢综合征患者60例，采用随机数字表将纳入的患者分为观察组和对照组，每组各30例。对照组自月经第5天起服用达英-35（复方醋酸环丙孕酮片）每晚1片，连用21d，停药后月经来潮第5天开始下一疗程，共3个疗程。观察组同时联合应用二甲双胍0．5g口服，每日3次，疗程同前，比较两组患者治疗前后促卵泡素（FSH）、黄体生成素（LH）、睾酮（T）、空腹胰岛素（FINS）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、胰岛素抵抗指数的变化。结果两组患者痤疮明显改善，但多毛无明显改善，停药均有撤退出血、月经恢复。观察组无效3例，对照组无效9例，两组治疗后的总有效率分别为90．0％、70．0％，观察组治疗后的疗效明显优于对照组（P〈0．05）。治疗后，观察组患者的LH、FSH、T及IR均较治疗前明显降低，且观察组较对照组降低幅度更显著，但观察组患者的E2水平较对照组升高更显著（P〈0．05）。观察组患者的TC、TG水平均较对照组显著降低，但HDL较对照组显著升高（P〈0．05）。结论达英-35联合二甲双胍治疗多囊卵巢综合征可以改善其临床症状，提高疗效，且明显改善患者的性激素水平，降低血脂水平，改善血脂代谢紊乱，值得推广和应用。

Clinical efficacy of diane-35 combined with metformin in treatment of polycystic ovary syndrome

Objective To explore the clinical efficacy of diane-35 combined metformin in treatment of polycystic ovary syndrome. Methods From January 2011 to January 2012,60 patients with polycystie ovary syndrome were divided into observation group and control group, 30 cases in each group. Control group from the 5th day menstruation taken diane-35 （compound cyproterone acetate tablets） per night a day for 21 days, after stopped menstruation begins next course of 5 days, a total of three courses. Observation group combined with mefformin 0.5 g orally, 3 times a day with the former. The follicle stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone （T）, fasting insulin （FINS）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein （HDL） , insulin resistance index were compared between two groups. Results There was significant improvement in acne patients, but no significant improvement in hir- sutism, withdrawal had withdrawal bleeding, menstrual recovery. Observation group invalid 3 cases,control group invalid 9 eases, the total effective rate of two groups was 90.0%, 70.0% respectively, the effect of observation group were significantly better than the control group （P 〈 0.05）. After treatment, the LH, FSH, T and IR of two groups significantly reduced than before treatment and the control group but E2 levels in observation group increased more significantly than in the control group （P 〈 0.05）. The TC, TG, HDL of observation group improved more significant than the control group （P 〈 0.05）. Conclusion Diane-35 combined with mefformin in treatment of polycystic ovary syndrome can improve the clinical symptoms, improve efficacy, and significantly improve the patient＇s hormone levels, lower blood lipid levels, improve dyslipidemia, worthy of promotion and application.