綜合治療肥胖型多囊卵巢綜合征３８例

[摘要] 目的 探討達因35聯合二甲雙胍及改變生活方式對肥胖型多囊卵巢綜合征的短期療效。方法 38例PCOS伴肥胖患者在改變生活方式同時分為兩組，A組18例患者用達因35聯合二甲雙胍治療，B組患者20例僅口服二甲雙胍，3個月后觀察月經恢復情況、多毛、肥胖、痤瘡、卵巢體積大小及體重指數改善情況等。分別于停藥后的次月月經周期第2～4天（閉經者不限）晨8時空腹抽肘靜脈血測性激素及血胰島素、血糖、血甘油三酯。結果 3個月后A組患者月經恢復快于B組患者。從BMI、LH、T三指標看A組的治療效果比B組好，差異極顯著；對FBS、INS、TG等指標而言則B組治療效果好，差異具有顯著性。結論 多囊卵巢綜合征的治療因人而異。如果追求降低體重、降低雄激素和恢復月經的短期目標，宜采用達因35聯合二甲雙胍及改變生活方式治療；若欲達到降低血脂、血糖和胰島素等遠期目標，則不宜聯合達因35。

[關鍵詞] 多囊卵巢綜合征； 肥胖； 達因35； 二甲雙胍

[中圖分類號] R711.75 [文獻標識碼] A [文章編號] 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 should better not be combined used.

[Key Words]Polycystic ovary syndrome； Obese； Diane-35； Metformin

多囊卵巢綜合征（Polycystic ovary syndrome，PCOS）在育齡婦女中的發病率高達6%～8%，臨床特征主要是肥胖、多毛和痤瘡[1]。近年來，對PCOS的治療觀念已不僅僅限于促排卵和妊娠。PCOS與糖尿病、高血壓、心血管疾病和子宮內膜癌等密切相關[1]，尋求有效的治療方法是目前PCOS研究的主要目的。我院對PCOS的治療進行了積極的探索，對2004年1月～2008年7月來就診的肥胖型多囊卵巢綜合征患者38例進行綜合治療的效果進行評價，綜合治療包括口服避孕藥達因35，二甲雙胍及改變生活方式，現將結果報道如下。……