达英-35联合二甲双胍治疗多囊卵巢综合征不孕的疗效及其对患者内分泌性激素和代谢的影响

目的：探讨达英-35联合二甲双胍治疗多囊卵巢综合征(PCOS)不孕的疗效及其对患者性激素和代谢指标的影响。方法选择2014年1月至2015年8月期间我院妇产科收治的PCOS不孕患者84例，根据随机数字表法随机分为对照组和观察两组，每组42例，对照组给予达英-35治疗，观察组则联合应用二甲双胍治疗，比较两组患者治疗前后的性激素、和代谢指标的变化，并比较排卵率及妊娠率。结果观察组患者治疗后的胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)及胰岛素抵抗指数(HOMA-IR)分别为(4.89±1.68) mmol/L、(1.48±0.51) mmmol/L、(4.62±1.24) mmol/L及(2.26±0.69)，均较治疗前显著降低，且低于对照组，差异均有统计学意义(P<0.05)；观察组与对照组黄体生成素(LH)、催乳素(PRL)、睾酮(T)治疗后分别为(8.72±1.16) U/L、(15.44±2.77) pmol/L、(1.93±0.71) nmol/L和(9.44±1.20) U/L、(17.55±2.15) pmol/L、(2.27±0.62) nmol/L，均较治疗前明显降低，雌二醇（E2）分别为(58.99±4.78) pmol/L和(53.92±5.18) pmol/L均明显增高，且组间比较差异均有统计学意义(P<0.05)；观察组患者的排卵率及妊娠率分别为73.81%、52.38%，均明显高于对照组的52.38%、28.57%，差异均有统计学意义(P<0.05)。结论达英-35联合二甲双胍治疗多囊卵巢综合征不孕可有效调节患者性激素水平，改善糖、脂代谢及胰岛素抵抗，提高排卵及妊娠率。

Clinical effect of Diane-35 combined with metformin on infertility of patients with polycystic ovary syndrome and its influence on sex hormones and metabolism

Objective To investigate the clinical effect of Diane-35 combined with metformin on infertility of patients with polycystic ovary syndrome (PCOS) and its influence on sex hormones and metabolic index. Methods A total of 84 cases of infertile women with polycystic ovary syndrome, who admitted to Department of Obstetrics and Gy-necology of the People's Hospital of Foshan from Jan. 2014 to Aug. 2015, were selected and randomly divided into the control group and the observation group according to the random number table, with 42 cases in each group. The control group was treated with Diane-35, and the observation group was treated with Diane-35 combined with metformin. The changes of sex hormones and metabolism index were compared before and after the treatment, and the ovulation and preg-nancy rate were compared too. Results After treatment, the cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG) and insulin resistance index (HOMA-IR) in observation group were (4.89 ± 1.68) mmol/L, (1.48 ± 0.59) mmol/L, (4.62 ± 1.24) mmol/L and (2.26 ± 0.69), respectively, which were significantly lower than those before treatment, and also significantly lower than those in the control group. All of the above differences were statistically significant (P<0.05). The luteinizing hormone (LH), prolactin (PRL), testosterone (T) in the observation group and the control group were (8.72 ± 1.16) U/L, (15.44±2.77) pmol/L, (1.93±0.71) nmol/L and (9.44±1.20) U/L, (17.55±2.25) pmol/L, (2.27±0.62) nmol/L, re-spectively, which were significantly lower than those before the treatment, while stradiol (E2) was respectively (58.99 ± 4.78) pmol/L and (53.92±5.18) pmol/L, which were significantly higher than that before the treatment. There were signif-icant differences in all of these parameters between the two groups (P<0.05). The ovulation rate and pregnancy rate in ob-servation group were respectively 73.81%and 52.38%, which were significantly higher than 52.38%and 28.57%in the control group (P<0.05). Conclusion Diane-35 combined with metformin can effectively regulate the sex hormone lev-els of infertile women with polycystic ovary syndrome, improve glucose and lipid metabolism and insulin resistance, and increase the rate of ovulation and pregnancy.