| BackgroundPolycystic ovary syndrome(PCOS)is the most common endocrine disorder among women of reproductive age and an important cause of nonovulatory infertility.Insulin resistance(IR)is the central link in the development of PCOS.IR is associated with hyperandrogenemia and ovulation disorders,and significantly increases the risk of long-term complications such as type 2 diabetes,cardiovascular and cerebrovascular diseases,and metabolic syndrome.In recent years,metformin and pioglitazone have been gradually used in the treatment of PCOS with IR,but the relevant research data are few.Therefore,this study explored the application value of pioglitazone combined with metformin sustained-release tablets in the treatment of PCOS with IR,and provided a reference for clinical treatment.ObjectiveTo compare the efficacy and safety of metformin sustained release tablets and pioglitazone and metformin sustained release tablets alone in the treatment of patients with PCOS and IR.To determine the clinical value of the combination regimen of pioglitazone and metformin sustained-release tablets in the treatment of PCOS with IR.Methods1.Retrospective analysis was conducted to select the patients diagnosed as PCOS with IR in the Department of Gynecology and Obstetrics of Anyang District Hospital of Puyang City from January 2018 to June 2020,and 150 patients meeting the inclusion criteria were selected as the research subjects.They were divided into control group(group A)and study group(group B).2.Control group(group A)included 73 patients treated with metformin sustained-release tablets alone,while study group(group B)included 77 patients treated with pioglitazone and metformin sustained-release tablets.3.Control the level of luteinizing hormone LH,follicle stimulating hormone FSH,LH/FSH,testosterone before and after 6 months of treatment T),body mass index,waist hip ratio WHR,fasting plasma glucose FPG,fasting insulin fasting fasting fasting fasting fasting fasting fasting insulin Ins),Homeostasis model insulin resistance index HOMA-IR,total cholesterol TC,triglycerides TG),high density lipoprotein HDL-C,low density lipoprotein LDL-C,follicle quality,ovulation status and medication safety.4.To comprehensively evaluate the clinical value and significance of the combination regimen of pioglitazone and metformin sustained release tablets in the treatment of PCOS with IR,and draw a conclusion.Results1.After six months of treatment,BMI,LH,LH/FSH,T,FPG,FINS,HOMA-IR,TC,TG and LDL-C in both groups were significantly decreased,the number of follicles decreased,the maximum diameter of follicles increased,the thickness of follicles decreased,the volume of ovulation decreased,and the ovulation rate increased,all of which were statistically significant.(P> 0.05).2.After treatment,there was no significant change in HDL-C and WHR in group A(P > 0.05).After treatment,WHR and HDL-C in group B were significantly decreased and increased,both of which were statistically significant(P <0.05).There was no significant change before and after FSH treatment in both groups(P> 0.05).3.After treatment,WHR,LH,LH/FSH,T,FPG,FINS,HOMA-IR,HDL-C,follicle number,follicle maximum diameter,follicle membrane thickness,ovarian volume and ovulation rate in group B had more significant changes than that in group A(P < 0.05).However,there were no significant differences in BMI,FSH,TC,TG and LDL-C between the two groups after treatment(P> 0.05).4.The adverse reaction rate of group B was not significantly higher than that of group A(P> 0.05),which was not statistically significant.ConclusionPioglitazone and metformin zyban joint scheme in improving the body quality,PCOS patients with IR with IR,high androgen levels,lipid metabolic disorder and egg quality of clinical effect is better than metformin zyban alone,especially in the aspect of lower WHR,increase HDL-C make up for the deficiency of the metformin zyban single-agent scheme,clinical safety and reliable,Worth popularizing. |
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