二甲双胍治疗多囊卵巢综合征的疗效

目的观察二甲双胍单用及联合应用氯菧酚胺治疗多囊卵巢综合征（PCOS）患者的疗效。方法30例PCOS患者应用二甲双胍治疗3及6个周期，比较治疗前、后的体重指数、腰臀比、月经周期、排卵率、受孕率、空腹血糖、胰岛素、稳态模式评估胰岛素抵抗指数（HOMA—IR）、性激素和血脂的变化。22例加用氯菧酚胺治疗3个周期，观察月经周期、卵泡反应、排卵率及受孕率。结果二甲双胍治疗3及6个周期后，空腹胰岛素、HOMA—IR、总睾酮、游离睾酮、黄体生成素均显著下降（P值均〈0．01）；排卵率分别为43％及54％，受孕者各2例。联合治疗组排卵率为74％，4例受孕。结论二甲双胍治疗可显著改善PCOS患者的胰岛素抵抗、高雄激素血症、性激素异常及月经紊乱，改善卵泡发育，增加排卵率，提高受孕机会。

Observations on therapeutic effects of metformin in patients with polycystic ovarian syndrome

Objective To determine the clinical,biochemical,hormonal and ultrasonografic effects of met- formin in patients with polycystic ovarian syndrome(PCOS)alone or combind with clomiphene.Method 30 women with PCOS were enrolled in this prospective study,menstrual pattern as well as body mass index(BMI),waist-hip ratio(WHR),serum levels of fasting glucose,insulin,HOMA-IR,lipids,total testosterone(T),free testosterone (FT),dehydroepiandrosterone(DHEA)and luteinizing hormone(LH)were assessed before and after treatment. They were given 1.5g of metformin per day individually for 3 and 6 cycles,and then reevaluated after the treat- ment.22 patients were given combind metformin and clomiphene for the next 3 cycles and again menstrual pattern, ovulation rate and pregnancy rate were obvsered.Results After 3 and 6 cycles,the levels of fasting insulin,T,FT, LH and HOMA-IR decreased significantly;and simultaneously with ovulation rates 43% and 54% and 2 cases of pregnan- cy for each respectively.After the combined use of metformin and clomiphene,the ovulation rate rose up to 74% and 4 ca- ses conceived.Conclusion Merformin therapy may improve insulin resistance,hyperandrogenemia,abnormality of sex hormones,menstrual cyclicity,ovulation rate and fertility in women with PCOS.