摘要
目的探讨二甲双胍联合屈螺酮炔雌醇片及生活方式干预在肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)合并糖尿病前期(prediabetes mellitus,preDM)患者中的应用效果。方法选取2021年1月至2022年12月于瑞金市妇幼保健院妇科门诊就诊的60例肥胖型PCOS合并preDM期患者作为研究对象,根据治疗方法不同分为观察组与对照组,各30例。对照组予以生活方式干预和口服屈螺酮炔雌醇片治疗。观察组在对照组的治疗基础上予以盐酸二甲双胍片治疗。比较两组治疗前后临床症状指标、肥胖指标、卵巢体积、血清性激素、血糖、血脂水平及药物不良反应发生情况。结果治疗后,观察组痤疮和多毛发生率、体重指数、腰臀比及睾酮、黄体生成素、空腹血糖、75 g糖负荷试验后2 h餐后血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇水平均明显低于对照组,卵巢体积明显小于对照组,月经周期恢复率、卵泡刺激素、高密度脂蛋白胆固醇水平均高于对照组,差异有统计学意义(P<0.05);两组雌激素水平及不良反应发生率比较差异无统计学意义。结论二甲双胍联合屈螺酮炔雌醇片及生活方式干预肥胖型PCOS合并preDM患者效果显著,可有效改善患者痤疮、多毛症状及肥胖状态,减小卵巢体积,调控性激素及糖脂水平,安全性较高,值得临床推广应用。
Objective To investigate the application effect of metformin combined with drospirenone and ethinylestradiol tablets and lifestyle intervention in obese patients with polycystic ovary syndrome(PCOS)and prediabetes mellitus(preDM).Methods A total of 60 obese patients with PCOS and preDM who visited the department of Gynecology and Obstetrics at Ruijin Maternal and Child Health Care Hospital from January 2021 to December 2022 were selected as the study subjects,and they were divided into the observation group and the control group according to different treatment methods,with 30 cases in each group.The control group was given lifestyle intervention and treatment with oral drospirenone and ethinylestradiol tablets,the observation group was treated with metformin hydrochloride tablets on the basis of the treatment in the control group.The clinical symptom indicators,obesity indicators,ovarian volume,serum sex hormones,blood glucose and blood lipid levels before and after treatment,and adverse drug reactions were compared between the two groups.Results After treatment,the incidences of acne and hirsutism,body mass index,waist-hip ratio,testosterone,luteinizing hormone,fasting blood glucose,postprandial 2 h blood glucose after 75 g glucose loading test,triglycerides,total cholesterol and low-density lipoprotein cholesterol levels in the observation group were significantly lower than those in the control group,and the ovarian volume was significantly smaller than that in the control group,the recovery rate of the menstrual cycle,the level of follicle-stimulating hormone and high-density lipoprotein cholesterol were higher than those in the control group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in estrogen levels and the incidence of adverse reactions between the two groups.Conclusion Metformin combined with drospirenone and ethinylestradiol tablets and lifestyle intervention is markedly effective for obese patients with PCOS and preDM,it can effectively improve acne,hirsutism symptoms and obese condition,reduce ovarian volume,and regulate the levels of sex hormones,glucose and lipids,with relatively high safety,it is worthy of clinical promotion and application.
作者
谢慧芳
刘琪
朱学超
陈媛
XIE Huifang;LIU Qi;ZHU Xuechao;CHEN Yuan(Department of Gynecology and Obstetrics,Ruijin Maternal and Child Health Care Hospital,Ruijin,Jiangxi,342500,China)
出处
《当代医学》
2024年第33期20-25,共6页
Contemporary Medicine
基金
赣州市科技计划项目(GZ2022ZSF663)。
关键词
二甲双胍
屈螺酮炔雌醇片
生活方式干预
肥胖型多囊卵巢综合征
糖尿病前期
Metformin
Drospirenone and ethinylestradiol tablets
Lifestyle intervention
Obesity with polycystic ovary syndrome
Prediabetes
