目的 研究吡格列酮联合炔雌醇环丙孕酮治疗多囊卵巢综合征的疗效。方法 选择2014年1月—2017年12月东莞市人民医院治疗的63例多囊卵巢综合症患者作为研究对象，用抽签法随机将患者分为对照组（32例）和观察组（31例）。对照组在月经的第5天开始于睡前口服炔雌醇环丙孕酮片，1片/d，连服21 d。观察组在对照组治疗的基础上口服盐酸吡格列酮片，1片/d。两组共持续服用3个月经周期。观察患者的临床疗效，比较两组治疗前后的性激素和糖脂代谢指标水平，以及卵巢体积和体质量指数。结果 治疗后，观察组的总有效率为90.32%，明显高于对照组的71.87%，两组总有效率比较差异具有统计学意义（P<0.05）。两组治疗后的促卵泡刺激素（FSH）、睾酮（T）和促黄体生成素（LH）水平均明显降低（P<0.05），观察组性激素水平明显低于对照组（P<0.05）。治疗后，观察组总胆固醇（TC）、空腹血糖（FBG）和三酰甘油（TG）水平明显降低，高密度脂蛋白（HDL）水平明显升高（P<0.05）；且观察组血糖和血脂水平显著优于对照组（P<0.05）。两组治疗后的卵巢体积和体质量指数明显降低（P<0.05），且观察组明显低于对照组（P<0.05）。结论 吡格列酮联合炔雌醇环丙孕酮可以有效调节多囊卵巢综合症患者的性激素、血糖和血脂水平，具有一定的临床推广应用价值。

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

国家卫生计生委医药卫生科技发展研究中心科研项目（W2016CWGD05）；广东省医学科学技术研究基金项目（C2017034）