摘要
目的探讨个体化饮食干预对多囊卵巢综合征(PCOS)不孕病人胰岛素抵抗(IR)及妊娠影响。方法选取PCOS不孕病人179例,随机分为观察组(n=97)和对照组(n=82)。对照组病人应用炔雌醇环丙孕酮片(达英-35)联合二甲双胍治疗,观察组应用达英-35治疗联合个体化饮食干预。比较两组干预前后糖代谢指标、性激素水平变化,随访统计排卵率和妊娠率。结果干预后,观察组的体质量指数(BMI)、体质量(WT)和腰臀比(WHR)均显著低于对照组(t=5.340~7.565,P<0.05),两组空腹血糖(FBG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、血清睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)和LH/FSH比较差异无显著性(P>0.05);观察组月经复常率、排卵率及妊娠率依次为96.77%、90.32%、51.61%,均显著高于对照组84.85%、71.21%、36.36%,差异有显著性(χ~2=4.121~9.717,P<0.05)。结论个体化饮食干预能够降低PCOS不孕病人的BMI、WT及WHR,改善生殖内分泌环境,恢复月经周期,提高排卵率及妊娠率,且无副作用,适合长期应用。
Objective To investigate the effect of individualized dietary intervention on insulin resistance（IR）and pregnancy in infertile patients with polycystic ovary syndrome（PCOS）.Methods A total of 179 infertile patients with PCOS were enrolled and randomly divided into observation group with 97 patients and control group with 82 patients.The patients in the control group were treated with ethinylestradiol and cyproterone acetate tablets（Diane-35）combined with metformin,and those in the observation group were treated with Diane-35 combined with individualized dietary intervention.The two groups were compared in terms of the changes in glucose metabolism indices and sex hormone levels after intervention,and follow-up was performed to obtain ovulation rate and pregnancy rate.Results After intervention,the observation group had significantly lower body mass index（BMI）,body weight（WT）,and waist-to-hip ratio（WHR）than the control group（t=5.340-7.565,P〈0.05）,while there were no significant differences between the two groups in fasting blood glucose,fasting insulin,homeostasis model assessment of insulin resistance,serum testosterone,luteinizing hormone,follicle-stimulating hormone,and LH/FSH（P〈0.05）.The observation group had significantly higher menstruation normalization rate,ovulation rate,and pregnancy rate than the control group（χ-2=4.121-9.717,P〈0.05）.Conclusion Individualized dietary intervention can reduce BMI,WT,and WHR of infertile patients with PCOS,improve the reproductive endocrine environment,restore menstrual cycle,and improve ovulation rate and pregnancy rate without any side effect,and therefore,it is suitable for long-term application.
作者
葛秋迎
于艳丽
刘秀荣
GE Qiuying;YU Yanli;LIU Xiurong(Department of Obstetrics and Gynecology, Kailuan Majiagou Hospital of Tangshan City, Tangshan 063021, China)
出处
《青岛大学医学院学报》
CAS
2017年第5期523-527,共5页
Acta Academiae Medicinae Qingdao Universitatis
基金
河北省卫生和计划生育委员会医学科学研究课题计划项目(13010520171117)
关键词
多囊卵巢综合征
胰岛素抗药性
个体化饮食干预
妊娠
polycystic ovary syndrome
insulin resistance
individualized dietary intervention
pregnancy
