2018 年第 9 期 第 13 卷

肌肉肌醇联合D手性肌醇治疗胰岛素抵抗多囊卵巢综合征患者的临床效果

Clinical effect of myo-inositol combined with D-chiro-inositol on insulin resistant polycystic ovary syndrome

作者：杜静吴日然林秀峰柯玩娜杜彦

英文作者：

单位：528403广东省中山市博爱医院生殖中心

英文单位：

关键词：多囊卵巢综合征；胰岛素抵抗；肌肉肌醇；D手性肌醇

英文关键词：

• 摘要：

• 【摘要】目的    探讨肌肉肌醇联合D手性肌醇(DCI)治疗胰岛素抵抗（IR）多囊卵巢综合征(PCOS)患者的临床效果。方法    选取2016年6月至2017年6月广东省中山市博爱医院收治的96例IR PCOS患者，按照随机数字表法分为3组，每组32例。安慰剂组口服叶酸治疗，二甲双胍组口服二甲双胍治疗，肌肉肌醇联合DCI组口服肌肉肌醇和DCI混合物胶囊治疗，均治疗6个月。比较3组患者治疗前后性激素水平、血糖水平、胰岛素水平、IR指标、血脂以及月经恢复情况、排卵率和妊娠率。结果    安慰剂组患者治疗前后性激素水平、血糖水平、胰岛素水平、IR指标以及血脂水平差异均无统计学意义（均P＞0.05）。二甲双胍组和肌肉肌醇联合DCI组治疗后雄烯二酮及硫酸脱氢表雄酮水平与治疗前比较差异均无统计学意义（均P>0.05）；而卵泡刺激素、性激素结合球蛋白（SHBG）水平较治疗前升高，黄体生成素（LH）、雌二醇、泌乳素、睾酮、空腹血糖、空腹胰岛素、稳态模型评估的胰岛素抵抗指数（HOMA-IR）、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平较治疗前降低，且肌肉肌醇联合DCI组LH、雌二醇、睾酮、空腹血糖、空腹胰岛素、HOMA-IR低于，SHBG水平高于二甲双胍组，差异均有统计学意义（均P＜0.05）。肌肉肌醇联合DCI组患者月经恢复率、排卵率以及妊娠率均明显高于二甲双胍组和安慰剂组［93.8%（30/32）比56.3%（18/32）、3.1%（1/32）；71.9%（23/32）比37.5%（12/32）、3.1%（1/32）；50.0%（16/32）比15.6%（5/32）、0.0%（0/32）］，差异均有统计学意义（均P＜0.05）。结论    肌肉肌醇联合DCI治疗可明显改善IR PCOS患者性激素、血糖、血脂代谢以及IR情况，并能提高患者排卵率以及妊娠率。

• 【Abstract】Objective    To explore the clinical effect of myo-inositol(MI) combined with D-chiro-inositol(DCI) on insulin resistance（IR） polycystic ovary syndrome(PCOS). Methods    Ninety-six women with IR PCOS admitted in Boai Hospital of Zhongshan from June 2016 to June 2017 were randomly divided into 3 groups, with 32 cases in each group. The placebo group took folic acid; the metformin group took metformin; the MI＋DCI group took MI and DCI mixture capsule; all patients were treated for 6 months. Levels of sex hormones, blood glucose, insulin, IR index and blood lipid were analyzed before and after treatment. Menstrual recovery rate, ovulation rate and pregnancy rate were analyzed. Results    There were no significant differences of sex hormones, blood glucose, insulin, IR index and blood lipid before and after treatment in the placebo group(P>0.05). In the metformin group and MI＋DCI group, levels of androstenedione and dehydroepiandrosterone sulfate after treatment showed no significant differences compared to those before treatment(P>0.05); levels of follicle stimulating hormone and sex hormone binding globulin(SHBG) after treatment were significantly higher than those before treatment; levels of luteinizing hormone(LH), estradiol, prolactin, testosterone, fasting blood glucose, fasting insulin, homeostasis model assessment-insulin resistance(HOMA-IR), total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol after treatment were significantly lower than those before treatment(P<0.05). After treatment, levels of LH, estradiol, testosterone, fasting blood glucose, fasting insulin and HOMA-IR in the MI＋DCI group were significantly lower and SHBG was significantly higher than those in the metformin group(P<0.05). Menstrual recovery rate, ovulation rate and pregnancy rate in the MI＋DCI group were significantly higher than those in the metformin group and placebo group［93.8%（30/32） vs 56.3%（18/32）, 3.1%（1/32）; 71.9%（23/32） vs 37.5%（12/32）, 3.1%（1/32）; 50.0%（16/32） vs 15.6%（5/32）, 0.0%（0/32）］(P<0.05). Conclusion    MI combined with DCI treating IR PCOS patients can effectively regulate sex hormones, blood glucose and blood lipid metabolism, relive IR and improve ovulation rate and pregnancy rate.