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目的观察应用二甲双胍、罗格列酮和两者联合治疗对存在胰岛素抵抗(IR)的多囊卵巢综合征(PCOS)患者促排卵的效果。方法选择IR的PCOS患者90例随机分为A、B、C三组,分别口服二甲双胍(28例)、罗格列酮(30例)和罗格列酮联合二甲双胍(32例)。三组用药时间均为3个月,比较用药前后胰岛素抵抗指数(HOMA-IR)和排卵情况。结果 A、B、C组HOMA-IR分别由(3.67±1.06)、(3.63±0.71)(、3.62±0.68)下降为(2.20±0.46)、(2.18±0.44)、(1.81±0.34);C组明显低于A、B两组(P<0.01)。C组治疗后排卵率为84.3%,明显高于A组的35.8%和B组的36.7%(P<0.01)。结论罗格列酮联合二甲双胍能有效改善全身、尤其卵巢局部的IR;在并未应用促排卵药物的情况下,同样能达到相当高的促排卵率。
Objective To observe the effect of metformin and rosiglitazone and their combination therapy on ovulation induction in patients with polycystic ovary syndrome (PCOS) with insulin resistance (IR). Methods Ninety PCOS patients with IR were randomly divided into three groups: metformin (28 cases), rosiglitazone (30 cases) and rosiglitazone combined with metformin (32 cases). The three groups were treated for 3 months, before and after treatment compared insulin resistance index (HOMA-IR) and ovulation. Results HOMA-IR in group A, B and C decreased from (3.67 ± 1.06) and (3.63 ± 0.71) (3.62 ± 0.68) to (2.20 ± 0.46) and (2.18 ± 0.44) and Group was significantly lower than A, B two groups (P <0.01). The ovulation rate in group C after treatment was 84.3%, which was significantly higher than 35.8% in group A and 36.7% in group B (P <0.01). Conclusion Rosiglitazone combined with metformin can effectively improve the body, especially the ovarian local IR; in the absence of ovulation induction drugs, the same can achieve a very high rate of ovulation induction.