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目的:探讨炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征(PCOS)伴胰岛素抵抗的临床效果。方法:选择2017年5月至2019年5月台州市第一人民医院收治的PCOS伴胰岛素抵抗患者90例进行研究。根据随机数字表法将患者分为对照组、治疗组各45例。对照组采用炔雌醇环丙孕酮治疗，观察组采用炔雌醇环丙孕酮联合二甲双胍治疗。比较两组临床疗效，治疗前后雌二醇(En 2)、睾酮(T)、促黄体生成素(LH)、促卵泡雌激素(FSH)水平以及胰岛素抵抗指数(HOMA-IR)、空腹血浆葡萄糖(FPG)、体质量指数(BMI)、空腹胰岛素(FINS)水平，并对两组的排卵、妊娠、月经恢复情况及不良反应进行分析。n 结果:治疗组总有效率(97.77%)明显高于对照组的总有效率(77.77%)，差异有统计学意义(χn 2＝8.389，n P＝0.003)。治疗前，治疗组En 2、T、LH、FSH与对照组差异均无统计学意义(均n P>0.05)。治疗后，治疗组En 2[(112.90±18.90)pmol/L]、T[(1.30±0.78)nmol/L]、LH[(8.00±1.50)U/L]、FSH[(1.20±0.39)U/L]，均显著低于对照组[En 2(128.90±19.95)pmol/L、T(2.19±1.00)nmol/L、LH(11.65±1.60)U/L、FSH(1.89±0.50)U/L]，差异均有统计学意义(n t＝3.905、4.707、10.871、7.299，均n P0.05)。治疗后，治疗组患者HOMA-IR(2.19±0.50)、FPG[(4.30±1.19)mmol/L]、BMI[(22.40±1.89)kg/mn 2]、FINS[(15.98±5.00)mU/L]，均显著低于对照组[HOMA-IR(3.90±0.58)、FPG(6.09±1.20)mmol/L、BMI(24.69±4.60)kg/mn 2、FINS(19.00±6.89)mU/L]，差异均有统计学意义(n t＝14.979、7.105、3.089、2.379，均n P<0.05)。治疗组患者的排卵、妊娠以及月经恢复情况均明显高于对照组，差异均有统计学意义(χn 2＝4.121、4.285、10.000，均n P0.05). After treatment, the levels of En 2[(112.90±18.90)pmol/L], T[(1.30±0.78)nmol/L], LH[(8.00±1.50)U/L]and FSH[(1.20±0.39)U/L] in the treatment group were significantly lower than those in the control group[En 2(128.90±19.95) pmol/L, T(2.19±1.00) nmol/L, LH(11.65±1.60)U/L and FSH(1.89±0.50)U/L], the differences were statistically significant(n t=3.905, 4.707, 10.871, 7.299, all n P0.05). After treatment, the levels of HOMA-IR (2.19±0.50), FPG[(4.30±1.19)mmol/L], BMI[(22.40±1.89)kg/mn 2], FINS[(15.98±5.00)mU/L] in the treatment group were significantly lower than those in the control group[HOMA-IR(3.90±0.58), FPG (6.09±1.20) mmol/L, BMI (24.69±4.60)kg/mn 2, FINS (19.00±6.89)mU/L], the differences were statistically significant(n t=14.979, 7.105, 3.089, 2.379, all n P<0.05). The ovulation, pregnancy and menstrual recovery in the treatment group were significantly higher than those in the control group (χn 2=4.121, 4.285, 10.000, all n P<0.05). The incidence of adverse reactions in the treatment group (13.33%) was significantly lower than that in the control group (37.77%), the difference was statistically significant between the two groups (χn 2=7.066, n P=0.007).n Conclusion:Ethinylestradiol cycloproterone combined with metformin in the treatment of PCOS with insulin resistance has significant clinical efficacy, can alleviate the endocrine metabolic disorders and insulin resistance, it is worthy of clinical application and promotion.