目的 探讨二甲双胍联合炔雌醇环丙孕酮片治疗多囊卵巢综合征的临床疗效。方法 选择2010年1月—2014年1月安阳市第三人民医院收治的多囊卵巢综合征患者100例，随机分为治疗组（50例）和对照组（50例）。对照组患者自月经第5天开始口服炔雌醇环丙孕酮片，每晚1片，连服21 d，待撤退性出血第5天开始下一疗程治疗。治疗组在对照组治疗基础上，进餐前30 min口服盐酸二甲双胍片，1片/次，3次/d。两组均连续治疗3个疗程。治疗后，对两组的临床疗效进行评价，同时对两组患者的性激素水平、胰岛素抵抗指数（HOMA-IR）、胰岛素分泌指数（HOMA-β）、排卵率、妊娠率进行比较。结果 治疗组和对照组总有效率分别为96.0%、78.0%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者的促黄体生成素（LH）、促卵泡生成素（FSH）、睾酮（T）水平均较治疗前显著降低，雌激素（E₂）较治疗前显著升高，同组治疗前后差异有统计学意义（P<0.05）；且治疗后治疗组患者的性激素水平改善程度明显优于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者HOMA-IR、HOMA-β均较治疗前显著降低，治疗前后比较差异有统计学意义（P<0.05），且治疗后治疗组这两个指数均低于对照组，两组比较差异有统计学意义（P<0.05）。治疗组排卵率和妊娠率均显著高于对照组，两组比较差异有统计学意义（P<0.05）。结论 二甲双胍联合炔雌醇环丙孕酮片对多囊卵巢综合征有较好的临床疗效，可改善患者的性激素水平，提高患者的妊娠率，值得临床推广应用。

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.

国家自然科学基金资助项目（81000234）