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目的探讨复方醋酸环丙孕酮及二甲双胍治疗多囊卵巢综合征(PCOS)临床效果及对内分泌、脂代谢影响,为临床治疗提供参考。方法选择2012年1月~2014年1月湖州市妇幼保健院收治的240例PCOS患者,根据治疗所用药物分为二甲双胍组、复方醋酸环丙孕酮组和联合组,每组80例。对比治疗后排卵率、内分泌指标、脂代谢指标等。结果各组患者妊娠率对比差异无统计学意义(P>0.05),联合组排卵率高于二甲双胍组和复方醋酸环丙孕酮组(P<0.05);联合组HDL-C升高明显高于复方醋酸环丙孕酮组(P<0.05),两组间其余指标对比差异无统计学意义(P>0.05);联合组T、LH、SHBG升高显著高于二甲双胍组,二甲双胍组IR、FI下降明显低于联合组(P<0.05),联合组Apo A升高,二甲双胍组下降(P<0.05);二甲双胍组不良反应发生率为22.50%,复方醋酸环丙孕酮组不良反应发生率为18.75%,联合组不良反应发生率为31.25%,联合组明显高于复方醋酸环丙孕酮组及二甲双胍组(P<0.05)。结论复方醋酸环丙孕酮联合二甲双胍治疗多囊卵巢综合征临床效果较好,高脂血症改善效果优于单纯使用复方醋酸环丙孕酮,高雄激素血症改善优于单纯使用二甲双胍。
Objective To investigate the clinical effects of compound cyproterone acetate and metformin in the treatment of polycystic ovary syndrome (PCOS) and its effect on endocrine and lipid metabolism and provide a reference for clinical treatment. Methods From January 2012 to January 2014, 240 PCOS patients admitted to Huzhou Maternal and Child Health Hospital were divided into metformin group, cyproterone acetate combination group and combination group according to the drugs used in the treatment, 80 cases in each group. Ovulation rate after treatment, endocrine indicators, lipid metabolism indicators. Results There was no significant difference in pregnancy rates between the two groups (P> 0.05). The ovulation rate in combination group was higher than that in metformin and cyproterone acetate combination groups (P <0.05). HDL-C in combination group was significantly higher than that in combination group (P <0.05), and there was no significant difference between the two groups (P> 0.05). The levels of T, LH and SHBG in the combination group were significantly higher than those in the metformin group and metformin group (P <0.05). The Apo A concentration in combination group was lower than that in metformin group (P <0.05). The incidence of adverse reactions in metformin group was 22.50%. The incidence of adverse reactions in combination CSP group was 18.75%. The incidence of adverse reactions in the combination group was 31.25%. The combined group was significantly higher than the compound cyproterone acetate group and the metformin group (P <0.05). Conclusions The compound cyproterone acetate combined with metformin in the treatment of polycystic ovary syndrome clinical effect is better, the improvement of hyperlipidemia is better than the simple use of compound cyproterone acetate, hyperandrogenism better than metformin alone.