综合治疗肥胖型多囊卵巢综合征38例.docVIP

综合治疗肥胖型多囊卵巢综合征38例[摘要] 目的 探讨达因35联合二甲双胍及改变生活方式对肥胖型多囊卵巢综合征的短期疗效。方法 38例PCOS伴肥胖患者在改变生活方式同时分为两组，A组18例患者用达因35联合二甲双胍治疗，B组患者20例仅口服二甲双胍，3个月后观察月经恢复情况、多毛、肥胖、痤疮、卵巢体积大小及体重指数改善情况等。分别于停药后的次月月经周期第2～4天（闭经者不限）晨8时空腹抽肘静脉血测性激素及血胰岛素、血糖、血甘油三酯。结果 3个月后A组患者月经恢复快于B组患者。从BMI、LH、T三指标看A组的治疗效果比B组好，差异极显著；对FBS、INS、TG等指标而言则B组治疗效果好，差异具有显著性。结论 多囊卵巢综合征的治疗因人而异。如果追求降低体重、降低雄激素和恢复月经的短期目标，宜采用达因35联合二甲双胍及改变生活方式治疗；若欲达到降低血脂、血糖和胰岛素等远期目标，则不宜联合达因35。 [关键词] 多囊卵巢综合征； 肥胖； 达因35； 二甲双胍 [中图分类号] R711.75 [文献标识码] A [文章编号] 1673-9701（2009）13-05-03 Combined Modality Therapy for 38 Cases of Obese Polycystic Ovary Syndrome SONG Shuqin Department of Obstetrics and Gynecology，The Affiliated Hospital of Putian College，Fujian 351100 [Abstract] ObjectiveTo investigate the short term effect of metformin combined with diane-35 and changing life style on the polycystic ovary syndrome of obese patients. Methods38 patients were randomly divided into two groups. Group A（n = 18） were treated with metformin combined with diane-35 and changing life style and group B（n = 20） were treated with metformin only. The situation in menstruation recovery，hairiness，obese and acne，ovarian volume and body mass index were observed after 3 months. Sex hormone，insulin，glucose and triglycerides were separately tested by drawing blood specimens at the early morning empty stomach on days of 2～4 in the first menstrual cycle after drug withdrawl. ResultsMenstruation recovery，hairiness and acne in group A significantly improved compared with group B；BMI，LH and Tin in group A showed significantly better than group B，while FBS，INS and TG in group B showed significantly better than group A. ConclusionThe treatment in polycystic ovary syndrome should be given different. If the immediate objective is to low weight，decrease the level of sex hormone and recover menstruation，metformin combined with diane-35 and changing life style should be used，while if the long-term objective is to decrease serum insulin，serum glucose and serum triglycerides，diane-35 sho