桂枝茯苓丸联合黄连素对多囊卵巢综合征伴胰岛素抵抗患者的影响

目的:观察桂枝茯苓丸联合黄连素对多囊卵巢综合征(PCOS)伴胰岛素抵抗患者的影响.方法:112例PCOS患者随机分为观察组(桂枝茯苓丸联合黄连素)和对照组(达英-35联合二甲双胍),各56例,比较两组患者治疗前后糖代谢、血脂水平、性激素水平的变化,观察临床表现和排卵及妊娠情况.结果:治疗后两组空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)明显下降(P＜0.05).两组空腹血糖(FPG),FINS,HOMA-IR无差异性.观察组患者总胆固醇(TC)、甘油三酯(TG)水平明显下降.两组的高密度脂蛋白(HDL-C)上升明显,尤其观察组HDL-C[(1.91-±0.29)mmol·L-1]改善程度较对照组[(1.63±0.28)mmol·L-1]明显(P＜0.05).两组患者雄激素(T)、黄体生成素(LH)、LH/卵泡刺激素(FSH)明显下降,FSH,雌二醇(E2)水平明显上升(P＜0.05或0.01).观察组LH,LH/FSH,E2改善程度较对照组明显(P＜0.05),且观察组月经稀发、痤疮、卵巢体积增大改善的程度较对照组明显(P＜0.05),排卵率明显高于对照组.结论:桂枝茯苓丸联合黄连素治疗PCOS合胰岛素抵抗的患者,能通过不同途径改变空腹胰岛素和雄激素水平,改善胰岛素敏感度,恢复月经周期,提高妊娠率.

Influence of Guizhi Fuling Pill Combined with Berberine on Polycystic Ovary Syndrome with Insulin Resistance

Objective: To observe influence of Guizhi Fuling pill combined with berberine on polycystic ovary syndrome (PCOS) with insulin resistance patients. Method: One hundred and twelve cases with PCOS were randomly divided into observation group (Guizhi Fuling pill combined with berberine) and control group (diane-35 combined with metformin), glucose metabolism, lipid levels, sex hormone levels,clinical manifestations and ovulation and pregnancy were observed before and after treatment. Result: After the treatment, the level of fasting insulin(FINS), homeostasis model assessment of insulin resistance(HOMA-IR) was decreased significantly (P<0.05). Fasting plasma glucose (FPG), FINS, HOMA-IR between two groups had no difference (P>0.05). The level of total cholesterol (TC),triglycerides cholesterol (TG) in observe group were significantly decreased (P>0.05). High-density lipoprotein cholesterol(HDL-C) in two groups increased significantly, especially degree of HDL-C in observation group was better than that in control grousignificantly (P<0.05). Luteinizing hormone(LH), LH/FSH, estriol(E₂)in two groups decreased significantly and follicle-stimulating hormone (FSH), E₂ increased significantly (P<0.05 or 0.01). especially The improvement degree of LH, LH/FSH, E₂, oligomenorrhea, acne, ovarian volume in observation group was better than those in control group (P<0.05). Ovulation was significantly higher than that in control group (P<0.05). Conclusion: Guizhi Fuling pill combined with berberine can decrease insulin resistance, changing the fasting insulin and androgen levels in different ways, improving insulin sensitivity, restoring menstrual cycle, improving the pregnancy rate.