摘要
目的探讨小檗碱(BBR)作为胰岛素增敏剂对多囊卵巢综合征(PCOS)的治疗效果。方法 2009年10月至2010年10月在哈尔滨医科大学附属第一医院将因不孕症就诊的PCOS合并胰岛素抵抗(IR)的患者随机分为4组,A组:复方环丙孕酮(CPA)+BBR;B组:CPA+二甲双胍(MET);C组:CPA+BBR+MET;D组:单用CPA。治疗前及治疗3个月后检测临床表现、性激素、糖脂代谢指标并加以比较。结果 A、B、C、D4组治疗后患者体重、BMI、WHR均降低,体重与BMI的改善4组间无统计学意义;WHR的改善A、C组更为显著(P<0.01)。A、B、C3组治疗后FIN、FPG以及HomaIR、AUCINS均明显下降,治疗前后比较差异有统计学意义(P<0.01);FIN、HomaIR、AUCINS降低程度表现为:C组优于A及B组(P<0.01);D组仅表现为AUCINS在治疗后有所下降。A、B、C3组治疗后TG、TC、LDL-C均有下降,HDL-C有所升高(P<0.05),A、C组优于B组(P<0.01),但C组与A组比较TG降低及HDL-C升高更显著(P<0.01),D组患者血脂变化在治疗前后无显著差异。与治疗前比较,A、B、C、D4组患者治疗后睾酮均降低(P<0.01),但组间比较无统计学意义,A、C组LH治疗后降低,且C组降低更为显著(P<0.05)。结论 BBR是针对PCOS有效的治疗药物,能够改善高胰岛素血症,调节血脂,减轻体重,具有良好的改善IR的作用。
Objective To study the therapeutic effects of berberine（BBR） on PCOS patients with insulin resistance as an insulin sensitizer. Methods Between Oct. 2009 and Oct. 2010 PCOS patients with insulin resistance asking for infertile treatment were randomly divided into 4 groups. In the First Affiliated Hospital of Harbin Madical University Group A were given BBR and CPA; Group B were given metformin （MET） and CPA; Group C were given BBR, MET and CPA; and group D were given CPA. The clinical feature, gonadal hormone, serum glucose, insulin and lipid profile were assessed priOr to and after 3 months of therapy and compared between the groups. Results In four groups, the parameter of weight, BMI, WHR were all decreased after treatment, there was no difference between four groups about weight and BMI, but WHR was decreased greater in A and C groups （P 〈 0. 01 ）. After treatment the FIN, FPG, Homa IR and AUCINS were decreased significantly compared with baseline （ P 〈 0. 01 ） ; Moreover group C therapeutic effects on FIN, Homa IR and AUCINS were much better than A and B groups（P 〈0. 01 ）. Only AUCINS was ameliorated in group D after therapy. The serum TC, TG, LDL-C level were decreased and HDL-C increased in A, B and C group after treatment; the parameters above were ameliorated better in group A and C compared with group B; TG and HDL-C were ameliorated better in group C than group A. Compared with baseline the T level of all the patients were decreased after treatment, there was no difference between four groups; LH level of group A and group C was decreased after treatment, furthermore which was decreased better in group C than group A. Conclusion BBR can be used as an effective anti-PCOS agent. The excellent effect on insulin resistance through ameliorating hyperinsulinism, regulating lipid metabolism, losing weight has no significant difference between MET. Furthermore there has synergism between BBR and MET. BBR is benefit for PCOS patients to administrate for longtime for its safety and inexpensive.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2011年第9期684-687,共4页
Chinese Journal of Practical Gynecology and Obstetrics
