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目的:探讨痰脂消颗粒联合二甲双胍改善肥胖型多囊卵巢综合征(PCOS)胰岛素抵抗的临床疗效。方法:选取2013年6月—2015年12月福建省妇幼保健院收治的PCOS胰岛素抵抗患者60例,按照随机数字表法分为两组,对照组30例患者给予二甲双胍口服(500 mg/次,3次/d)以及对症支持治疗,治疗组30例患者在对照组治疗的基础上加服痰脂消颗粒进行治疗。疗程均为3个月。观察并记录两组患者治疗前后的身高、体质量、腰围、中医症状积分、月经及妊娠情况以判定中医临床疗效;同时检测卵泡刺激素(FSH)、黄体生成素(LH)、催乳素(PRL),雌二醇(E_2)、睾酮(T)、甘油三酯(TG)、胆固醇(CHOL)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、糖耐量及糖负荷后的胰岛素释放试验,计算体质量指数、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、糖耐量曲线下面积及胰岛素曲线下面积。结果:治疗组患者的临床显效率为82.8%,明显高于对照组的56%(P<0.05)。两组患者的BMI、腰围、LH、LH/FSH、T、HOMA-IR、CHOL、LDL、糖耐量曲线下面积及胰岛素曲线下面积均明显降低,与治疗前比较差异显著(P<0.05)。治疗组患者上述各指标降低程度较对照组更为明显(P<0.05)。结论:痰脂消颗粒联合二甲双胍治疗肥胖型PCOS临床效果良好,能显著改善胰岛素抵抗以及内分泌代谢紊乱,值得临床推广使用。
Objective: To investigate the clinical effects of Tanzhixie granule combined with metformin in improving insulin resistance of obese patients with polycystic ovary syndrome (PCOS). Methods: Sixty patients with PCOS in Fujian MCH from June 2013 to December 2015 were selected and divided into two groups according to the random number table. In the control group, 30 patients were given metformin orally (500 mg once daily, 3 times / d) and symptomatic and supportive treatment. The treatment group 30 patients in the control group based on the treatment of plus Tan Zhi Xiao particles for treatment. Treatment are 3 months. Observed and recorded the clinical efficacy of Chinese medicine before and after treatment in two groups of patients with height, weight, waist circumference, symptom scores, menstruation and pregnancy to determine the clinical efficacy of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL E_2, T, TG, CHOL, LDL, HDL, glucose tolerance and insulin after glucose loading The release test was performed to calculate body mass index, homeostasis model assessment of insulin resistance index (HOMA-IR), area under the glucose tolerance curve, and area under the insulin curve. Results: The clinical effective rate of the treatment group was 82.8%, which was significantly higher than 56% of the control group (P <0.05). The area under the curve of glucose tolerance and the area under the curves of insulin, BMI, waist circumference, LH, LH / FSH, T, HOMA-IR, CHOL and LDL in both groups were significantly lower than those before treatment (P <0.05). The reduction of each index in the treatment group was more obvious than that in the control group (P <0.05). Conclusion: Tanzhixiao particles combined with metformin in the treatment of obese patients with PCOS good clinical results, can significantly improve insulin resistance and endocrine and metabolic disorders, worthy of clinical promotion and use.