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目的比较罗格列酮与二甲双胍治疗多囊卵巢综合征(polycystic ovarian syndrome,PCOS)胰岛素抵抗患者排卵障碍的临床效果。方法 56例PCOS胰岛素抵抗患者随机分为对照组和观察组各28例,对照组给予二甲双胍500mg/次,3次/d,口服;观察组给予罗格列酮4mg/次,1次/d,口服;2组均连续用药3个月。比较2组治疗前、后空腹血糖、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、血清睾酮、黄体生成素(luteinizing hormone,LH)/促卵泡激素(follicle-stimulating hormone,FSH)、体质量指数及排卵率。结果 2组治疗前、后空腹血糖、FSH水平与治疗前比较差异无统计学意义(P>0.05);2组治疗后FINS、HOMA-IR、血清睾酮、LH、LH/FSH均较治疗前下降(P<0.05),排卵率均较治疗前提高(P<0.05),观察组治疗后FINS、HOMA-IR及排卵率与对照组比较差异有统计学意义(P<0.05);对照组治疗后体质量指数较治疗前下降(P<0.05),观察组治疗前、后体质量指数比较差异无统计学意义(P>0.05)。结论罗格列酮减轻胰岛素抵抗、提高排卵率效果优于二甲双胍,适用于胰岛素抵抗较严重PCOS患者;二甲双胍降低体质量效果明显,适用于肥胖、胰岛素抵抗不严重PCOS患者。
Objective To compare the clinical effects of rosiglitazone and metformin in the treatment of ovulation disorders in patients with insulin resistance and polycystic ovarian syndrome (PCOS). Methods Fifty-six patients with PCOS insulin resistance were randomly divided into control group and observation group with 28 cases in each group. The control group was given metformin 500 mg once daily for 3 times daily. The observation group was given rosiglitazone 4 mg once daily, Oral; 2 groups were continuous medication for 3 months. Fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), serum testosterone, luteinizing hormone (LH) / follicle stimulating hormone Follicle-stimulating hormone (FSH), body mass index and ovulation rate. Results There was no significant difference in fasting blood glucose and FSH levels between the two groups before and after treatment (P> 0.05). The levels of FINS and HOMA-IR, serum testosterone, LH and LH / FSH in both groups were significantly lower than those before treatment (P <0.05), and the ovulation rate was significantly higher than that before treatment (P <0.05). The FINS, HOMA-IR and ovulation rates in the observation group were significantly different from those in the control group (P <0.05) The body mass index decreased before treatment (P <0.05). The body mass index of the observation group before and after treatment showed no significant difference (P> 0.05). Conclusions Rosiglitazone is superior to metformin in decreasing insulin resistance and increasing ovulation rate, which is more suitable for patients with severe PCOS. Insulin resistance is notable for metformin. It is suitable for patients with obesity and insulin resistance without serious PCOS.