目的 探讨不同治疗方案对多囊卵巢综合征患者胰岛素抵抗及性激素、排卵的影响.方法 选择2009年4月-2011年3月在妇产科门诊就诊的多囊卵巢综合征患者68例作为研究对象.随机将其分为观察组和对照组,各34例.两组患者均予以达英-35,于月经第1天或黄体酮撤药性出血的第1天起口服,1片/d,连续服用21 d,停药7 d后重复,共治疗3个月.对照组加用二甲双胍250 mg/次,3次/d,餐后口服,1周后剂量增至500 mg/次,3次/d,连续治疗3个月.观察组在达英-35治疗基础上加用罗格列酮400 mg,1次/d,早餐后口服,连续治疗3个月.结果 治疗后两组FINS、HOMA-IR、LH、FSH、E2、T、A水平均降低,且排卵率提高,治疗前后比较差异有统计学意义(P<0.05或P<0.01).治疗后,观察组在改善FINS、HOMA-IR、LH、FSH、E2、T、A水平,提高排卵率方面与对照组比较差异有统计学意义(P<0.05).结论 在达英-35治疗基础上,加用罗格列酮比二甲双胍能更快更好地改善PCOS的胰岛素抵抗,改善性激素水平,提高促排卵成功率.%Objective To investigate the effects of different treatments for insulin resistance, sex hormones and ovulation of polycystic ovary syndrome( PCOS )patients. Methods 68 PCOS patients hospitalized in the department of obstetrics and gynecology from April 2009 to March 2011 were selected as subjects,and were randomly divided into experimental group and control group,34 cases in each group. Both groups were orally given diane-35 from 1st day of menstrual cycle or progesterone herbal withdrawal bleeding, 1 tablet daily for 21 d,then a 7 days pause,and the course lasted for 3 months. Control group was additionally given metformin, 250 mg each time orally after diet( dose increased to 500 mg each time a week later ),3 times daily for 3 months. Experimental group were given rosiglitazone in addition to diane-35,400 mg each time, once daily after breakfast for 3 months. Results Treatments for both groups had reduced patients' FINS, HOMA-IR, LH, FSH, E2, T, A levels and increased ovulation significantly( P < 0. 05 or P < 0. 01 ). And all these indicators were improved more significantly after treatment in experimental group compared with control group( P <0. 05 ). Conclusion Diane-35 plus rosiglitazone can improve insulin resistance, sex hormone level and ovulation rate faster and better than diane-35 plus metformin in PCOS patients.
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