目的 探討二甲雙胍聯(lián)合炔雌醇環(huán)丙孕酮片治療多囊卵巢綜合征的臨床療效。方法 選擇2010年1月—2014年1月安陽(yáng)市第三人民醫(yī)院收治的多囊卵巢綜合征患者100例，隨機(jī)分為治療組（50例）和對(duì)照組（50例）。對(duì)照組患者自月經(jīng)第5天開(kāi)始口服炔雌醇環(huán)丙孕酮片，每晚1片，連服21 d，待撤退性出血第5天開(kāi)始下一療程治療。治療組在對(duì)照組治療基礎(chǔ)上，進(jìn)餐前30 min口服鹽酸二甲雙胍片，1片/次，3次/d。兩組均連續(xù)治療3個(gè)療程。治療后，對(duì)兩組的臨床療效進(jìn)行評(píng)價(jià)，同時(shí)對(duì)兩組患者的性激素水平、胰島素抵抗指數(shù)（HOMA-IR）、胰島素分泌指數(shù)（HOMA-β）、排卵率、妊娠率進(jìn)行比較。結(jié)果 治療組和對(duì)照組總有效率分別為96.0%、78.0%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的促黃體生成素（LH）、促卵泡生成素（FSH）、睪酮（T）水平均較治療前顯著降低，雌激素（E₂）較治療前顯著升高，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組患者的性激素水平改善程度明顯優(yōu)于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者HOMA-IR、HOMA-β均較治療前顯著降低，治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療后治療組這兩個(gè)指數(shù)均低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療組排卵率和妊娠率均顯著高于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 二甲雙胍聯(lián)合炔雌醇環(huán)丙孕酮片對(duì)多囊卵巢綜合征有較好的臨床療效，可改善患者的性激素水平，提高患者的妊娠率，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of metformin combined with Ethinylestradiol and Cyproterone Acetate Tablets in treatment of polycystic ovary syndrome. Methods Patients with polycystic ovary syndrome (100 cases) in the People’s No. 3 Hospital of Anyang from January, 2010 to January, 2014 were randomly divided into control (50 cases) and treatment (50 cases) groups. Patients in the control group were po administered with Ethinylestradiol and Cyproterone Acetate Tablets from day 5 of menstruation, 1 piece every night for 21 d, and the next course of treatment began 5 d after withdrawal bleeding. Patients in the treatment group were po administered with Metformin Hydrochloride Tablets 30 min before meals, 1 piece/time, three times daily. The patients in the two groups were treated continuously for three periods of treatment. After treatment, the treatment efficacy was evaluated, while the sex hormone levels, HOMA IR, HOMA-β, ovulation rate, and pregnancy rate in two groups were compared.Results The efficacies in the treatment and control groups were 96.0% and 78.0%, respectively, and there were differences between the two groups (P < 0.05). After treatment, the levels of LH, FSH, and T in two groups were significantly reduced, E₂ was significantly elevated, and there was significant difference compared with those before treatment in the same group (P < 0.05). And sex hormone levels in the treatment group were improved better than those in the control group, and there was significant difference between two groups (P < 0.05). After treatment, HOMA IR and HOMA-β in two groups were significantly reduced, and the difference was statistically significant before and after treatment (P < 0.05). The two indexes in the treatment group were lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Metformin combined with Ethinylestradiol and Cyproterone Acetate Tablets has good clinical effect in treatment of polycystic ovary syndrome, and can improve the sex hormone levels and pregnancy rate, which is worthy of clinical application.

國(guó)家自然科學(xué)基金資助項(xiàng)目（81000234）