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投稿时间：2019-12-19 网络发布日期：2020-09-20
投稿时间：2019-12-19 网络发布日期：2020-09-20
中文摘要: 目的 探讨盐酸小檗碱(黄连素)治疗多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)患者的临床疗效及对血浆颗粒蛋白前体(PGRN)水平的影响。方法 选择2017年1月至2018年6月100例于广东省妇幼保健院妇科及妇保科就诊的胰岛素抵抗型PCOS(PCOS-IR)患者作为研究对象,根据随机数字表法将患者分为黄连素组(35例)、二甲双胍组(35例)及对照组(30例),对照组患者于月经周期或撤药性出血第2~5天开始口服炔雌醇环丙孕酮,黄连素组患者在对照组的基础上加服黄连素,二甲双胍组患者在对照组的基础上加服二甲双胍,21 d为1个疗程,三组均治疗3个疗程。比较三组治疗前后血浆PGRN、胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FINS)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH、睾酮(T)、体质指数(BMI)等指标水平。通过电话随访1年,记录三组排卵率及妊娠率。结果 (1)BMI水平:三组治疗后与治疗前比较均明显下降(P<0.05)。(2)血浆PGRN水平:二甲双胍组及黄连素组治疗后较治疗前降低(P<0.05),对照组治疗前后无变化(P>0.05),黄连素组治疗后低于二甲双胍组(P<0.05)。(3)HOMA-IR、FINS和血糖水平:黄连素组和二甲双胍组HOMA-IR、FINS治疗后均明显降低(P<0.05),黄连素组HOMA-IR低于二甲双胍组(P<0.05);三组治疗前后血糖水平比较差异无统计学意义(P>0.05)。(4)TG、TC、LDL-C水平:黄连素组和二甲双胍组治疗后低于对照组(P<0.05)。(5)LH、LH/FSH、T水平:黄连素组和二甲双胍组均低于对照组,黄连素组低于二甲双胍组(P<0.05)。(6)随访1年结果:黄连素组、二甲双胍组和对照组排卵率为94.29%、88.57%和63.33%(P<0.01),妊娠率为74.29%、65.71%、36.67%(P<0.01),三组间差异有统计学意义。结论 黄连素治疗PCOS-IR的疗效显著,可明显改善患者血浆PGRN水平,提高排卵率和妊娠率。
Abstract:Objective To investigate the clinical efficacy of berberine hydrochloride (BBH) in the treatment of polycystic ovary syndrome (PCOS) with insulin resistance (IR) and its effect on the level of plasma progranulin (PGRN). Methods From January 2017 to June 2018, 100 patients with insulin resistant PCOS (PCOS-IR) were selected as the research objects.According to the random number table method, the patients were divided into BBH group (35 cases), metformin group (35 cases) and control group (30 cases).The patients in the control group took ethinylestradiol-cyproterone from the second to fifth day of menstrual cycle or withdrawal bleeding.The BBH group was given BBH on the basis of the control group, and the metformin group was given metformin on the basis of the control group.Twenty-one days was a course of treatment, all the three groups were treated for three courses.The levels of PGRN in plasma and HOMA-IR, FINS, FPG, 2hPG, TG, TC, HDL-C, LDL-C, LH, FSH, LH/FSH, testosterone (T) and BMI were compared before and after treatment.The ovulation rates and pregnancy rates of the three groups were recorded. Results BMI levels of the three groups were significantly decreased compared with before treatment (P<0.05).The level of plasma PGRN in metformin group and BBH group was lower than that before treatment (P<0.05), while there was no change in control group before and after treatment (P>0.05).After treatment, the level of PGRN in BBH group was lower than that in metformin group (P<0.05).HOMA-IR and FINS in BBH group and metformin group were significantly lower than those in metformin group (P<0.05), and HOMA-IR in BBH group was lower than that in metformin group (P<0.05);there was no significant difference in blood glucose levels among the three groups before and after treatment (P>0.05).The levels of TG, TC and LDL-C in BBH group and metformin group were lower than those in control group (P<0.05).The levels of LH, LH/FSH and T in BBH group and metformin group were lower than those in control group, while those in BBH group were lower than those in metformin group (P<0.05).One year after follow-up, the ovulation rates of BBH group, metformin group and control group were 94.29%, 88.57% and 63.33%(P<0.01), and the pregnancy rates were 74.29%, 65.71% and 36.67%(P<0.01).Conclusion BBH has a significant effect on PCOS-IR, which can significantly improve the plasma PGRN level, and increase ovulation rate and pregnancy rate.
文章编号： 中图分类号： 文献标志码：A
基金项目:广东省中医药局课题(20191037)
| Author Name | Affiliation |
| LYU Xiao, CHEN Ye, WENG Hui-nan, XIA Jian-hong | Women′s Health Care Department, Guangdong Maternal and Child Health Hospital, Guangzhou, Guangdong 511442, China |
引用文本：
吕霄,陈烨,翁慧男,夏建红.盐酸小檗碱对多囊卵巢综合征伴胰岛素抵抗的疗效及对血浆颗粒蛋白前体水平的影响[J].中国临床研究,2020,33(9):1167-1171.
吕霄,陈烨,翁慧男,夏建红.盐酸小檗碱对多囊卵巢综合征伴胰岛素抵抗的疗效及对血浆颗粒蛋白前体水平的影响[J].中国临床研究,2020,33(9):1167-1171.