复方环丙孕酮联合胰岛素增敏剂对非肥胖多囊卵巢综合征伴有胰岛素抵抗患者治疗效果的观察

目的探讨比较单独应用复方环丙孕酮（CPA）与CPA联合胰岛素增敏剂治疗非肥胖多囊卵巢综合征（P-COS）伴有胰岛素抵抗患者治疗效果的差异，以及二甲双胍和罗格列酮两种胰岛素增敏剂对于上述患者治疗效果的差异。方法68例非肥胖PCOS合并胰岛素抵抗（IR）患者随机分成3组，A组26例，单独应用CPA3个周期；B组23例。应用CPA＋MTE治疗3个周期；C组19例，应用CPA＋罗格列酮治疗3个周期。采取自身对照及组间对照法，比较用药前后血清胰岛素水平、IR指数、体重指数（BMI）、性激素等指标的差异。结果3组病人治疗后T及LH／FSH均较治疗前明显降低，B组、C组病人空腹胰岛素，IR指数等显著改善，B组、C组之间上述指标无显著差异。结论非肥胖型PCOS伴有IR患者应用胰岛素增敏剂，可以明显改善内分泌、代谢紊乱，二甲双胍与罗格列酮比较无显著差异。

Treatment effect of cyproterone acetatea combined with insulin sensitizer on nonobese patients with polycystic ovary syndrome and insulin resistance

Objective： To observe the treatment effect of insulin sensitizing agents - metformin and rosiglitazone combined with cyproterone acetatea （CPA） on nonobese women with polycystic ovary syndrome （PCOS） and insulin resistance （IR）. Methods： 68 patients with PCOS and IR were randomly divided into group A , B and C. 26 patients in group A were given cyproterone acetatea （CPA） for 3 months , 23 patients in group B were given metformin and CPA for 3 months. 19 patients in group C were given CPA and Rosiglitazone for 3 months. The clinical feature, reproductive hormone, OGTT, IRT, Homa IR, Homaβ and AUCINS were observed and calculated before and after CPA or insulin sensitizing agents treatment. Results ： After 3 months treatment with CPA or insulin sensitizers, the serum T level and LH/FSH decreased in both A, B and C groups. The index of glucose metabolism and insulin resistance were significantly improved as compared with those of pretreatment in B and C group also. But there were no significant difference between group B and C. Conclusion： Insulin sensitizing agents -rosiglitazone and metformin used to treat PCOS women with insulin resistance and hyperinsulinemia is a quite effective method, there is no significant difference between metformin and rosiglitazone about their treatment effect, metformin would be commended according to safety and payment.