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 二甲双胍联合螺内酯治疗多囊卵巢综合征的疗效观察

  

  1. 1.张家港市中医院 内分泌科,江苏 张家港 215600;2.苏州大学附属第一医院 内分泌科,江苏 苏州 215006
  • 出版日期:2016-10-05 发布日期:2016-10-11
  • 通讯作者: 通信作者:施毕旻,Email: shibimin@163.com

Combination treatment with metformin and spironolactone in patients with polycystic ovary syndrome

  1. 1.Department of Endocrinology, Zhangjiagang Hospital of Traditional Chinese Medicine,
    Zhangjiagang 215600, China;2.Department of Endocrinology,the Medical College affiliated
    to Soochow University,Suzhou 215006, China
  • Online:2016-10-05 Published:2016-10-11
  • Contact: Corresponding author: Shi Bimin, Email: shibimin@163.com

摘要: 目的本研究旨在观察对多囊卵巢综合征(PCOS)患者应用二甲双胍联合螺内酯治疗的疗效,包括患者体内代谢、内分泌相关指标改变。方法60例PCOS患者,随机分为A、B两组(各30例)。A组口服二甲双胍1 000 mg/d,B组口服二甲双胍1 000 mg/d联合螺内酯40 mg/d,随访3个月,比较各项指标水平差异。结果治疗后两组体质量、体质量指数(BMI)均降低,且差异有统计学意义(P<0.05),B组腰臀比(WHR)以及多毛评分较治疗前均显著降低(P<0.05)。两组内分泌激素中黄体生成素(LH)、睾酮(T)值较治疗前均下降(P<0.05),促卵泡生成素(FSH)较治疗前轻度变化,但差异无统计学意义(P>0.05)。A组经治疗后空腹胰岛素较前显著下降(P<0.05),血糖水平则无改变(P>0.05);B组治疗后血糖和胰岛素均较治疗前显著降低(P<0.01,P<0.05)。脂代谢方面,A组治疗后甘油三酯及低密度脂蛋白水平较治疗前显著降低(P<0.05),B组治疗后甘油三酯(P<0.05)、低密度脂蛋白胆固醇(P<0.01)、总胆固醇(P<0.05)水平均较治疗均前显著降低。结论较二甲双胍单独应用,螺内酯和二甲双胍联合治疗具有更加显著的临床效果。

关键词: 多囊卵巢综合征, 二甲双胍, 螺内酯

Abstract: ObjectiveTo investigate the effect of combination therapy with metformin and spironolactone in patients with polycystic ovary syndrome, including metabolism, endocrinerelated impacts, and subsequent ovulation rates.  MethodsA total of 60 patients with polycystic ovary syndrome were included in this study. All patients were randomly divided into A and B groups (30 cases each). Group A was treated with metformin 1 000 mg  everyday while group B was treated with metformin 1 000 mg combined with spironolactone 40 mg for 3 months. Then related indices were compared before and after treatment  between two groups. ResultsAfter 3 months of treatment, body mass and BMI were decreased in both groups and were significantly lower than those before treatment (P<0.05); The waisthip ratio(WHR)  and FerrimanGallwey score were significantly lower after treatment in group B than in group A (P<0.05).  After treatment, the levels of LH and T were decreased and were significantly lower than those before treatment (P<0.05), however, the level of FSH was slightly changed (P>0.05). After treatment, the level of insulin was significantly decreased in group A (P<0.05), however, the level of glucose was no obvious difference(P>0.05); in group B, the levels of insulin and glucose were significantly decreased (P<0.01 and P<0.05, respectively). After treatment, the levels of TG and LDLC were significantly decreased in group A (P<0.05)  and the levels of TG, LDLC and TC were significantly decreased in group B (P<0.05,P<0.01 and P<0.05, respectively).ConclusionIn comparison with metformin alone, the combination therapy may be more effective for PCOS patients.

Key words: polycystic ovary syndrome, metformin, spironolactone