2023 年第 2 期 第 18 卷

补阳活血汤联合二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗效果评估

Effect of Buyanghuoxue decoction combined with metformin on the treatment of polycystic ovary syndrome complicated with insulin resistance

作者：朱秀娟赵秀萍

英文作者：Zhu Xiujuan Zhao Xiuping

单位：北京中医药大学第三附属医院妇科，北京100020

英文单位：Department of Gynaecology the Third Affiliated Hospital of Beijing University of Chinese Medicine Beijing 100020 China

关键词：多囊卵巢综合征；胰岛素抵抗；二甲双胍；补阳活血汤

英文关键词：Polycysticovarysyndrome;Insulinresistance;Metformin;Buyanghuoxuedecoction

• 摘要：

• 目的 探究补阳活血汤联合二甲双胍治疗多囊卵巢综合征（PCOS）合并胰岛素抵抗(IR)患者的效果。方法 前瞻性选取2019年6月至2020年6月北京中医药大学第三附属医院收治的PCOS合并IR患者90例为研究对象，按随机数字表法分为对照组和观察组，各45例。对照组口服二甲双胍片治疗；观察组采用补阳活血汤联合二甲双胍片治疗。比较2组患者临床疗效，治疗前后空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、补体C1q/肿瘤坏死因子相关蛋白3(CTRP3)、CTRP9水平。结果 观察组治疗有效率明显高于对照组［93.3%(42/45)比77.8%(35/45)］，差异有统计学意义（P＜0.05）。治疗后2组患者空腹血糖、HOMA-IR及观察组空腹胰岛素水平均低于治疗前，且观察组患者空腹胰岛素及HOMA-IR水平均低于对照组［（92±9）mIU/L比（103±15）mIU/L、（2.9±0.4）比（3.2±0.6）］，差异均有统计学意义（均P＜0.05）。治疗后2组患者三酰甘油、LDL-C水平均低于治疗前，HDL-C水平明显高于治疗前，且观察组患者三酰甘油、LDL-C水平均低于对照组，HDL-C水平高于对照组［（4.1±0.7）mmol/L比（4.8±0.8）mmol/L、（2.5±0.9）mmol/L比（3.0±0.8）mmol/L、（1.8±0.6）mmol/L比（1.6±0.7）mmol/L］，差异均有统计学意义(均P＜0.05)。治疗后对照组CTRP9、观察组CTRP3和CTRP9水平均高于治疗前，且观察组CTRP3和CTRP9水平均高于对照组［（378±87）μg/L比（283±59）μg/L、（435±89）μg/L比（318±72）μg/L］，差异均有统计学意义(均P＜0.05)。结论 补阳活血汤联合二甲双胍可通过改善糖脂代谢和胰岛功能来治疗PCOS合并IR患者，疗效较好。

• Objective To explore the effect of Buyanghuoxue decoction combined with metformin on the treatment of polycystic ovary syndrome (PCOS) with insulin resistance (IR). Methods  Totally 90 PCOS patients complicated with IR were prospectively selected from the Third Affiliated Hospital of Beijing University of Chinese Medicine from June 2019 to June 2020. They were divided into the control group and the observation group according to the random number table method, with 45 cases in each group. The control group was treated with metformin tablets and the observation group was treated with Buyanghuoxue decoction combined with metformin tablets. The clinical effects, the levels of fasting plasma glucose, fasting insulin, insulin resistance index (HOMA-IR), triacylglycerol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), complement C1q/tumor necrosis factor related protein 3 (CTRP3), and CTRP9 before and after treatment were compared between the two groups. Results  The effective rate of the observation group was significantly higher than that of the control group［93.3%(42/45) vs 77.8%(35/45)］(P＜0.05). After treatment, levels of fasting plasma glucose, HOMA-IR of both groups and the level of fasting insulin of the observation group were lower than those before treatment, and levels of fasting insulin and HOMA-IR in the observation group were lower than those in the control group［（92±9）mIU/L vs （103±15）mIU/L, （2.9±0.4） vs （3.2±0.6）］(all P＜0.05). After treatment, the levels of triacylglycerol and LDL-C of two groups were lower than those before treatment, and the level of HDL-C of two groups was higher than that before treatment; levels of triacylglycerol and LDL-C of the observation group were lower than those of the control group, and the level of HDL-C was higher than that of the control group［（4.1±0.7）mmol/L vs （4.8±0.8）mmol/L, （2.5±0.9）mmol/L vs （3.0±0.8）mmol/L, （1.8±0.6）mmol/L vs （1.6±0.7）mmol/L］(all P＜0.05). After treatment, levels of CTRP9 of the control group, CTRP3 and CTRP9 of the observation group were higher than those before treatment, and levels of CTRP3 and CTRP9 of the observation group were higher than those of the control group［（378±87）μg/L vs （283±59）μg/L, （435±89）μg/L vs （318±72）μg/L］(all P＜0.05). Conclusion  Buyanghuoxue decoction combined with metformin can improve the glycolipid metabolism and islet function of PCOS patients complicated with IR, with good efficacy.