摘要
目的:探究地屈孕酮联合吡格列酮治疗多囊卵巢综合征(PCOS)疗效及对患者胰岛素抵抗、卵巢功能及血清AMH、FSH水平的影响。方法:选取2020年9月-2023年5月本院收治的PCOS患者147例,随机数字表法分为对照组(n=73)和观察组(n=74),均在月经周期第5天开始服用地屈孕酮治疗,观察组加用吡格列酮治疗;治疗3个月后比较两组临床疗效,治疗前后空腹血糖(FPG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗指数(HOMA-IR)、卵泡个数、卵巢体积、抗苗勒激素(AMH)、卵泡刺激素(FSH)、睾酮(T)和促黄体生成素(LH)水平的变化情况和不良反应发生情况。结果:治疗后观察组总有效率(96.0%)高于对照组(84.9%),观察组与对照组FPG、FINS、HOMA-IR(2.14±0.49、3.19±0.97)、卵泡个数(7.11±0.76个、11.19±1.24个)、卵巢体积(23.18±3.04ml、31.51±4.13ml)、AMH(20.96±4.52pmol/L、28.75±5.64pmol/L)、FSH(5.19±0.51mIU/ml、5.56±0.63mIU/ml)、T(40.76±5.38nmol/L、51.65±6.24nmol/L)、LH(3.27±0.83mIU/ml、5.54±1.01mIU/ml)水平均低于治疗前,且观察组均低于对照组(均P<0.05);两组不良反应发生率(9.5%、6.5%)无差异(P>0.05)。结论:地屈孕酮联合吡格列酮治疗PCOS疗效提高,可纠正患者胰岛素抵抗,改善卵巢功能,降低血清AMH和性激素水平,且安全性较好。
Objective:To investigate the effect of dydrogesterone combined with pioglitazone for treating patients with polycystic ovary syndrome(PCOS),and to study its influence on the insulin resistance,the ovarian function and the.levels of serum anti Mullerian hormone(AMH)and follicle-stimulating hormone(FSH)of the patients with polycystic ovary syndrome.Methods:A total of 147 patients with PCOS were selected and were divided into 74 patients in observation group and 73 patients in control group randomly according to the random number table method from September 2020 to May 2023.The patients in the two groups were treated with dydrogesterone starting from the fifth day of the menstrual cycle,and the patients in the observation group were treated with pioglitazone additionally.The efficacy,the changes of the fasting blood glucose(FPG)and fasting insulin(FINS)levels,the value of homeostasis model assess-ment of insulin resistance(HOMA-IR),the number of follicles,the ovarian volume,and the levels of AMH,FSH,testosterone(T)and luteinizing hormone(LH)levels before and after treatment,and the adverse reactions rate of the patients were compared between the two groups.Results:The total effective rate(96.0%)of the patients in the obser-vation group was significantly higher than that(84.9%)of the patients in the control group.The levels of the FPG and FINS,the HOMA-IR value,the number of follicles,the ovarian volume,and the levels of AMH,FSH,T and LH of the patients in the two groups after treatment had decreased significantly.The levels of the FPG and FINS of the pa-tients in the observation after treatment were significantly lower than those of the patients in the control group.The HOMA-IR value,the number of follicles,the ovarian volume,and the levels of AMH,FSH,T and LH of the pa-tients in the observation after treatment were 2.14±0.49,7.11±0.76,23.18±3.04ml,20.96±4.52 pmol/L,5.19±0.51 mIU/ml,40.76±5.38 nmol/L and 3.27±0.83 mIU/ml,respectively,and which were significantly lower than those(3.19±0.97,11.19±1.24,31.51±4.13ml,28.75±5.64 pmol/L,5.56±0.63 mIU/ml,51.65±6.24 nmol/L and 5.54±1.01 mIU/ml,respectively)of the patients in the control group(all P<0.05).There was no significant differ-ence in the incidence of the adverse reactions(9.5%vs.6.5%)of the patients between the two groups(P>0.05).Con-clusion:Dydrogesterone combined with pioglitazone for treating the patients with PCOS has higher therapeutic effect,and which can correct the insulin resistance,improve the ovarian function,reduce the serum AMH and sex hormone levels of the patients,and with the good safety.
作者
张琦荃
吴恬
ZHANG Qiquan;WU Tian(Huzhou Maternal and Child Health Care Hospital,Zhejiang Province,313000;Lanxi People's Hospital,Zhejiang Province)
出处
《中国计划生育学杂志》
2024年第2期288-292,共5页
Chinese Journal of Family Planning
基金
湖州市科技局公益技术研究项目(2023GYB12)。
关键词
多囊卵巢综合征
地屈孕酮
吡格列酮
临床疗效
胰岛素抵抗
卵巢功能
性激素
Polycystic ovary syndrome
Dydrogesterone
Pioglitazone
Clinical efficacy
Insulin resistance
Ovarian function
Sex hormone
