中药对胰岛素抵抗多囊卵巢综合征患者性激素和胰岛素水平的影响及疗效观察

摘要

目的：探讨中药治疗对胰岛素抵抗多囊卵巢综合征(PCOS-IR)患者的临床治疗效果，并测定性激素和胰岛素水平的变化。方法：选择92例 PCOS-IR 患者随机分为观察组和对照组，每组46例。对照组采用二甲双胍药物治疗，观察组在服用西药的基础上再采用疏肝理气、补肾健脾中药进行治疗，两组均连续治疗4个月。同时检测治疗前后两组血清性激素和胰岛素水平的变化，对两组的临床治疗效果、并发症和不良反应情况进行比较分析。结果：两组患者经治疗后，血清黄体生成素(LH)、睾酮(T)、空腹胰岛素(F-INS)的水平较治疗前均有很大程度下降，差异有统计学意义(P 均<0.01)；观察组 LH、T 及 F-INS 下降水平较对照组略大，但差异无统计学意义(P>0.05)；两组患者血清 FSHFBG 水平比较，差异无统计学意义(P>0.05)。观察组总有效率明显高于对照组，差异有统计学意义(P<0.05)；两组患者在治疗过程中均未出现比较严重的并发症和不良反应现象。结论：采用中西药联合应用对治疗 PCOS-IR 患者治疗效果明显，可降低血清 LH、T、F-INS 水平，提高胰岛素敏感性，改善临床症状，提高排卵率和妊娠率，具有治疗彻底、无特殊的并发症和不良反应特点，可作为对 PCOS-IR 患者治疗的首选方法。%Objective:To study traditional Chinese medicine treatment for insulin resistance polycystic ovary syndrome(PCOS-IR) patients clinical treatment effect and the determination of hormones and insulin level of change.Methods:A total of 92 patients with PCOS-IR were randomly divided into observation group and control group,each group of each 46 cases.The comparison group used the metformin drug therapy,the observation group took western medicine again on the basis of the kidney and liver,spleen qi of traditional Chinese medicine treatment;Two groups were treated for 4 months. At the same time testing the two groups before and after treatment serum sex hormones and insulin levels and changes of two groups of patients in clinical outcomes,complications and adverse reaction of comparative analysis.Results:Two groups of patients after treatment,serum luteinizing hormone(LH), testosterone(T),fasting insulin(F-INS) level was before treatment greatly decreased significant difference(P<0.01);The observation group LH,T and F-INS down level was slightly larger group,but there was no significant difference(P>0.05);Two groups of patients serum FSH/FBG level were no significant difference(P>0.05).Clinical effects of patients with compared to control group,the efficient was obviously higher than those in the control group,the difference was statistically significance(P<0.05);Two groups of patients in the treatment process all did not appear serious complications and adverse reaction phenomenon.Conclusion:The combined traditional Chinese and western pharmaceutical application in the treatment of PCOS patients by obvious effect,can reduce serum LH,T,F -INS,increase the level of insulin sensitivity,improve clinical symptoms,improve the ovulation rate and pregnancy rate.Therapeutic thoroughly,no special complications of disease and adverse reaction characteristics,can be used as in PCOS patients by the preferred method of treatment.