目的 研究吡格列酮聯(lián)合炔雌醇環(huán)丙孕酮治療多囊卵巢綜合征的療效。方法 選擇2014年1月—2017年12月東莞市人民醫(yī)院治療的63例多囊卵巢綜合癥患者作為研究對象，用抽簽法隨機將患者分為對照組（32例）和觀察組（31例）。對照組在月經(jīng)的第5天開始于睡前口服炔雌醇環(huán)丙孕酮片，1片/d，連服21 d。觀察組在對照組治療的基礎(chǔ)上口服鹽酸吡格列酮片，1片/d。兩組共持續(xù)服用3個月經(jīng)周期。觀察患者的臨床療效，比較兩組治療前后的性激素和糖脂代謝指標水平，以及卵巢體積和體質(zhì)量指數(shù)。結(jié)果 治療后，觀察組的總有效率為90.32%，明顯高于對照組的71.87%，兩組總有效率比較差異具有統(tǒng)計學(xué)意義（P<0.05）。兩組治療后的促卵泡刺激素（FSH）、睪酮（T）和促黃體生成素（LH）水平均明顯降低（P<0.05），觀察組性激素水平明顯低于對照組（P<0.05）。治療后，觀察組總膽固醇（TC）、空腹血糖（FBG）和三酰甘油（TG）水平明顯降低，高密度脂蛋白（HDL）水平明顯升高（P<0.05）；且觀察組血糖和血脂水平顯著優(yōu)于對照組（P<0.05）。兩組治療后的卵巢體積和體質(zhì)量指數(shù)明顯降低（P<0.05），且觀察組明顯低于對照組（P<0.05）。結(jié)論 吡格列酮聯(lián)合炔雌醇環(huán)丙孕酮可以有效調(diào)節(jié)多囊卵巢綜合癥患者的性激素、血糖和血脂水平，具有一定的臨床推廣應(yīng)用價值。

Objective To study the effect of pioglitazone combined with ethinylestradiol and cyproterone acetate in treatment of polycystic ovary syndrome. Methods A total of 63 patients with polycystic ovary syndrome in Dongguan People's Hospital from January 2014 to December 2017 were selected as study subjects, and randomly divided into control group (32 cases) and observation group (31 cases). Patients in the control group were po administered with Ethinylestradiol and Cyproterone Acetate Tablets before going to bed on the 5th day of menstruation for 21 days, 1 tablets daily. Patients in the observation group were po administered with Pioglitazone Hydrochloride Tablets on the basis of control group, 1 tablets daily. Both groups took the drug continuously for 3 menstrual cycles. The clinical efficacy of the patients was observed, and the levels of sex hormone and lipid metabolism, ovarian volume and BMI before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 90.32%, which was significantly higher than 71.87% of the control group, and the difference between two groups was statistically significant (P<0.05). After treatment, the levels of FSH, T, and LH in both groups were significantly decreased (P<0.05), and the sex hormone levels in the observation group were significantly lower than those in the control group (P<0.05). After treatment, TC, FBG, and TG levels in the observation group were significantly decreased, but HDL level was increased (P<0.05), and the lipid metabolism indexes in the observation group were significantly better than those in the control group (P<0.05). After treatment, ovarian volume and BMI were significantly reduced in two groups (P<0.05), and the indexes in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Pioglitazone combined with ethinylestradiol and cyproterone acetate can effectively regulate the levels of sex hormones, blood glucose, and blood lipids in patients with polycystic ovary syndrome, which has certain clinical application value.

R984

國家衛(wèi)生計生委醫(yī)藥衛(wèi)生科技發(fā)展研究中心科研項目（W2016CWGD05）；廣東省醫(yī)學(xué)科學(xué)技術(shù)研究基金項目（C2017034）