生活方式调整联合达英与二甲双胍治疗青春期多囊卵巢综合征的疗效分析

目的观察生活方式调整联合达英与二甲双胍治疗青春期多囊卵巢综合征(Polycystic OvarySyndrome,PCOS)的疗效。方法将在本院妇科门诊就诊的青春期PCOS患者85例随机分为A组(生活方式调整组,28例);B组(药物治疗组,口服达因-35和二甲双胍,28例)和C组(生活方式调整联合药物,29例),观察6个月后3组不同处理方法的相关指标的变化及随后促排卵情况。结果 3种治疗方法均可使青春期PCOS患者的卵巢体积、促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、体重指数(BMI)、空腹血糖、血清空腹胰岛素和胰胰岛素抵抗均有不同程度下降,与治疗前比较,有统计学差异(p<0.05);其中,联合治疗的各项指标下降更明显,优于单独治疗(p<0.05),月经恢复正常率为96.55%,排卵率达82.26%。结论生活方式调整联合药物治疗能明显改善青春期PCOS患者胰岛素的敏感性,降低体重指数,改善体内生殖内分泌环境,有利于产生规律的排卵月经周期。生活方式调整联合达英与二甲双胍是治疗青春期多囊卵巢综合征的较理想的方法。

LIFESTYLE MODIFICATION COMBINED WITH DIANE -35 AND METFORMIN IN THE MANAGEMENT OF ADOLESCENT GIRLS WITH POLYCYSTIC OVARY SYNDROME

Objective To observe the effect of lifestyle modification combined with Diane - 35 and metform- in on adolescent polycystic ovary syndrome （PCOS）. Methods 85 cases with adolescent polycystic ovary syndrome （PCOS） were randomly divided into treatment group A （lifestyle modification, 28cases）, group B （Diane -35 and metformin therapy, 28 cases）and group C（lifestyle modification combined with Diane- 35 and mefformin,29cases）. All cases were treated for 6 months, the changes of indexes including ovarian volume, body mass index（ BMI）, follicle stimulating hormone（FSH） ,luteinizing hormone（LH） ,testosterone（T） ,fasting blood glucose （FBG）, and fasting in- sulin（FINS） and HOMA - IR were observed before and after treatment. The differences of recovery of menstruation and the ovulation rate were also evaluated. Results The ovarian volumes, BMI, levels of LH, T, FINS and FBG, and HOMA- IR after treatment in the three groups decreased to various degrees, there was significant difference （p 〈 0. 05）. Theses indexes decreased obviously in group C compared with group A and group B, there was significant difference（p 〈 0. 05 ） ;The degree of menstrual recovery and ovulation rate were 96.55% and 82.26% respectively, were significantly higher than those in group A and group B （p 〈 0.05 ）. Conclusion Lifestyle modification com- bined with Diane - 35and metformin can improve obviously insulin sensitivity in adolescent girls with PCOS, low BMI, improve the endocrine disorder and promote the recovery of normal menstruation and induce ovulation, and indicated which was an ideal therapy for adolescent PCOS.