炔雌醇环丙孕酮片联合生活方式干预治疗肥胖型多囊卵巢综合征的疗【第一】严红莲(1975-)，女，副主任医师，主要从事生殖内分泌临床与研究工作。?性医学?DOI:10.3969/j.issn.1672-1993.2014.07.013【摘要】目的:探讨炔雌醇环丙孕酮片（达英-35）联合生活方式调整对肥胖型多囊卵巢综合征生殖内分泌和脂代谢的影响。方法:选取2011年7月至2013年7月来我院就诊的肥胖型多囊卵巢综合征不孕患者105例，随机分为观察组（53例）和对照组（52例）。对照组采用达英-35进行治疗，观察组在对照组基础上联合生活方式调整治疗。观察治疗前后患者体重、体重指数（BMI）及腰围指数（WHR），检测生殖激素、卵巢及子宫内膜变化，及观察月经恢复率、排卵率以及妊娠率。结果:观察组体重、BMI治疗后明显低于治疗前及对照组治疗后（P＜0??05），WHR则无显著性差异。观察组治疗后的LH、T、LH/FSH、FINS、TG各指标与治疗前及对照组治疗后比较，差异有统计学意义（P＜0??05）。观察组左、右卵巢体积治疗后明显低于治疗前及对照组治疗后（P＜0??05）。观察组的月经恢复率、排卵率以及妊娠率均明显高于对照组（P＜0??05）。结论:达英-35联合生活方式调整可改善肥胖型多囊卵巢综合征患者的生殖内分泌及脂代谢的水平，改善左、右卵巢体积及月经恢复率、排卵率以及妊娠率。【关键词】达英-35；生活方式调整；肥胖型多囊卵巢综合征；生殖内分泌；脂代谢EffectofDiane-35combinedwith?lifestyleinterventioninthetreatmentofobesity-relatedpolycysticovariansyndromeYANHonglian1,LinBing1,ShaoXiaohong2,XingYanjun2.1.DepartmentofReproduction,MaternalandChildHealthHospitalinShundeDistrict,Foshan528300,China;2.DepartmentofGynaecology,MaternalandChildHealthHospitalinShundeDistrict,Foshan528300,China【Abstract】Objectives:ToexploretheeffectofDiane-35combinedwithlifestyleinterventiononthereproductiveendocrineandlipidmetabolismofobesity-relatedpolycysticovariansyndrome(PCOS).Methods:105infertilitypatientswithobesity-relatedPCOSvisitedourhospitalfromJuly2011toJuly2013wererandomlydividedintoobservationgroupandcontrolgroup,eachof52patients.PatientsinthecontrolgroupweretreatedwithDiane-35whileobservationgroupreceivedadditionallifestyleintervention.Bodyweight,bodymassindex(BMI)andwaistcircumferenceindex(WHR)beforeandaftertreatmentwereobserved;changesinreproductivehormoneandovarianandendometriumweredetected,andrecoveryrateofmenstruation,ovulationrateandpregnancyratewereobserved.Results:ThebodyweightandBMIoftheobservationgroupaftertreatmentwereobviouslylowerthanthosebeforetreatmentandthecontrolgroupaftertreatment(P<0.05),whileWHRwasofnosignificantdifference.AsforindexessuchasLH,T,LH/FSH,FINSandTG,thedifferencebetweenobservationgroupaftertreatmentandthecontrolgroupaftertreatmentorobservationgroupbeforetreatmentwasofsignificantdifferences(P<0.05).Theleft,rightovarianvolumeoftheobservationgroupaftertreatmentwereobviouslysmallerthanthosebeforetreatmentandthecontrolgroupaftertreatment(P<0.05).Therecoveryrateofmenstruation,ovulationrateandpregnancyrateoftheobservationgroupweresignificantlyhigherthanthecontrolgroup(P<0.05).Conclusion:Diane-35combinedwithlifestyleinterventioncanimprovethereproductiveendocrineandlipidmetabolismofpatientswithobesity-relatedPCOS;improveleftandrightovarianvolumeandrecoveryrateofmenstruation,ovulationrateandpregnancyrate.【Keywords】Diane-35;Lifestyleintervention;Obesity-relatedpolycysticovariansyndrome;Reproductiveendocrine;Lipidmetabolism【】R711.75【文献标志码】A多囊卵巢综合征（polycysticovariansyndrome，PCOS）临床症候复杂，其病因及发病机制不明。目前认为PCOS主要与肾上腺功能异常、下丘脑-垂体功能障碍/[1,2/]、胰...