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目的研究二甲双胍联合孕激素治疗子宫内膜不典型增生合并胰岛素抵抗的临床疗效。方法选取2015年1月-2016年12月在甘肃省妇幼保健院接受诊治的100例子宫内膜不典型增生合并胰岛素抵抗患者作为研究对象,按照随机数表法分为组对照组和研究组,每组各50例。对照组患者给予醋酸甲地孕酮分散片治疗,研究组患者给予醋酸甲地孕酮分散片联合二甲双胍治疗。治疗6个月后,比较两组患者用药前后卵巢内分泌功能、近期疗效和不良反应发生率的差异。结果治疗前,两组患者卵巢内分泌功能指标比较,差异无统计学意义(P>0.05);治疗后,两组患者的卵巢内分泌功能指标水平均低于用药前,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05);两组患者用药不良反应发生率比较,差异无统计学意义(P>0.05)。结论二甲双胍联合孕激素治疗子宫内膜不典型增生合并胰岛素抵抗效果显著,能有效调节患者卵巢内分泌功能,控制疾病进展。
Objective To study the clinical efficacy of metformin combined with progestin in the treatment of endometrial dysplasia and insulin resistance. Methods From January 2015 to December 2016, 100 cases of endometrial dysplasia with insulin resistance were enrolled in the Gansu Provincial Maternal and Child Health Hospital and divided into two groups according to the random number table: group control group and study group, Each group of 50 cases. Patients in the control group were treated with megestrol acetate dispersible tablets, and patients in the study group were treated with megestrol acetate dispersible tablets and metformin. After 6 months of treatment, the differences in the endocrine function, the recent curative effect and the incidence of adverse reactions between the two groups before and after treatment were compared. Results Before treatment, there was no significant difference in ovarian endocrine function between the two groups (P> 0.05). After treatment, the ovarian endocrine function indexes in both groups were lower than those before treatment, and the study group was lower than the control group, The difference was statistically significant (P <0.05). The total effective rate of the study group was higher than that of the control group, the difference was statistically significant (P <0.05). There was no significant difference between the two groups in the incidence of adverse drug reactions (P> 0.05). Conclusion Metformin combined with progesterone treatment of endometrial dysplasia with insulin resistance significantly, can effectively regulate ovarian endocrine function in patients with disease control.