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目的对比观察食物交换份法引导下的个体化饮食干预与二甲双胍药物治疗多囊卵巢综合征(PCOS)的临床疗效。方法将2013年6月-2015年12月在广州市妇女儿童医疗中心妇科内分泌就诊的75例合并胰岛素抵抗的PCOS患者随机分为食物交换份法引导下的饮食干预组(37例)和口服二甲双胍治疗组(38例)。对两组患者调控治疗3个月,比较干预前后排卵、体重、性激素及代谢指标改善情况。结果 64例患者完成全程3个月的观察治疗,其中饮食干预组31例、二甲双胍治疗组33例。干预前两组患者各项指标比较差异无统计学意义(P>0.05);干预后饮食干预组7例、二甲双胍组8例恢复排卵;治疗前、后两组患者体重(WT)、体重指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)及总胆固醇(TC)等指标比较差异有统计学意义(均P<0.05),黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、高密度脂蛋白胆固醇(HDL-C)等指标变化差异无统计学意义(P>0.05);饮食干预组对WT、BMI的控制作用与二甲双胍组比较差异有统计学意义(P<0.05)。结论采用食物交换份法引导下的个体化饮食干预与二甲双胍药物治疗对PCOS患者均有恢复排卵作用,对多项代谢指标的改善疗效相当,饮食干预组对WT、BMI的控制效果更好,副作用小,疗效确切,适合长期使用。
Objective To compare the clinical efficacy of individualized dietary intervention and metformin-treated polycystic ovary syndrome (PCOS) under the guidance of the Food Exchanges Act. Methods Seventy-five patients with PCOS who were treated with gynecologic endocrinology at Guangzhou Women and Children’s Medical Center from June 2013 to December 2015 were randomly divided into dietary intervention group (n = 37) and oral metformin Treatment group (38 cases). Control and treatment of two groups of patients for 3 months, compared before and after intervention ovulation, body weight, sex hormones and metabolic parameters improved. Results 64 patients completed the whole 3 months of observation and treatment, including diet intervention group, 31 cases, metformin treatment group, 33 cases. Before intervention, there was no significant difference in each index between the two groups (P> 0.05); after the intervention, diet intervention group (7 cases) and metformin group (8 cases) regained ovulation. Before and after treatment, the body weight, body mass index BMI, WHR, FPG, FINS, HOMA-IR and TC were all significantly different (all P <0.05) , LH, FSH, T and HDL-C had no significant difference (P> 0.05), and there was no significant difference in the indexes of WT, The control effect of BMI was significantly different from that of metformin group (P <0.05). Conclusion Individualized dietary intervention and metformin-based drug treatment guided by food-exchange method can restore ovulation in all patients with PCOS, and has similar curative effect on multiple metabolic indexes. The diet intervention group has better control effect on WT and BMI, and side effects Small, effective, suitable for long-term use.