本文選題：二甲雙胍　切入點(diǎn)：多囊卵巢綜合征　出處：《皖南醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:檢驗(yàn)二甲雙胍對(duì)PCOS患者的治療效果,以及血清AMH在治療過(guò)程中的變化;檢驗(yàn)二甲雙胍在PCOS患者無(wú)胰島素抵抗情況下血清AMH及各項(xiàng)指標(biāo)的影響,幫助更多的了解二甲雙胍治療PCOS的作用效果,進(jìn)一步觀察多囊卵巢綜合征內(nèi)分泌代謝情況,為臨床治療提供更可靠的依據(jù)。方法:選取皖南醫(yī)學(xué)院弋磯山醫(yī)院生殖中心門診就診的多囊卵巢綜合征患者,將他們隨機(jī)分成A、B兩組,二甲雙胍治療組(A組)及空白對(duì)照組(B組)。在實(shí)驗(yàn)前在患者月經(jīng)第三天檢測(cè)患者血清AMH值及相關(guān)代謝指標(biāo)并記錄,隨后進(jìn)行相關(guān)治療及對(duì)照,三個(gè)月后的月經(jīng)第三天復(fù)測(cè)血清AMH值及相關(guān)代謝指標(biāo)。同時(shí)將A組與B組按照有無(wú)胰島素抵抗分為A1、A2組及B1、B2組。最后將各組數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,得出相關(guān)結(jié)論。結(jié)果:1.實(shí)驗(yàn)組(A組)PCOS患者經(jīng)二甲雙胍治療后,AMH值明顯下降,平均下降幅度超過(guò)2ng/ml,并有統(tǒng)計(jì)學(xué)意義(t=8.290,P0.05);同時(shí)BMI(t=5.562,P0.05)及T(t=7.248,P0.05)也明顯下降,并有統(tǒng)計(jì)學(xué)意義;而FSH(t=0.750,P0.05)及LH(t=,0.613,P0.05)有輕微波動(dòng),但差異無(wú)統(tǒng)計(jì)學(xué)意義。2.對(duì)照組(B組)治療前后AMH有輕微下降,但是差異無(wú)統(tǒng)計(jì)學(xué)意義(t=1.736,P0.05);同時(shí)各項(xiàng)指標(biāo)BMI(t=0.567,P0.05)、FSH(t=-0.444,P0.05)、LH(t=0.827,P0.05)、T(t=0.633,P0.05)均有輕微波動(dòng),但無(wú)統(tǒng)計(jì)學(xué)差異差異。3.實(shí)驗(yàn)組中有胰島素抵抗組(A1組)PCOS患者經(jīng)二甲雙胍治療后,AMH值明顯下降,平均下降幅度超過(guò)2ng/ml,并有統(tǒng)計(jì)學(xué)意義(t=5.913,P0.05);同時(shí)BMI(t=3.936,P0.05)及T(t=7.177,P0.05)也明顯下降,并有統(tǒng)計(jì)學(xué)意義;而FSH(t=0.651,P0.05)及LH(t=0.500,P0.05)并無(wú)統(tǒng)計(jì)學(xué)差異。4.實(shí)驗(yàn)組中無(wú)胰島素抵抗組(A2組)PCOS患者經(jīng)二甲雙胍治療后,AMH值明顯下降,平均下降幅度超過(guò)2ng/ml,并有統(tǒng)計(jì)學(xué)意義(t=5.917,P0.05);同時(shí)BMI(t=3.976,P0.05)及T(t=3.198,P0.05)也明顯下降,并有統(tǒng)計(jì)學(xué)意義;而FSH(t=-0.589,P0.05)及LH(t=0.377,P0.05)并無(wú)統(tǒng)計(jì)學(xué)差異。5.實(shí)驗(yàn)組(A組)同對(duì)照組(B組)比較,實(shí)驗(yàn)組(A組)PCOS患者經(jīng)二甲雙胍治療前后AMH值、BMI、LH、T值的改變幅度更大,AMH(t=-5.189,P0.05)、BMI(t=-3.582,P0.05)、T值(t=-3.046,P0.05)的改變趨勢(shì)為減小,而LH(t=5.849,P0.05)值的改變趨勢(shì)為增大,并有統(tǒng)計(jì)學(xué)意義(P0.05),而FSH(t=-1.809,P0.05)值的改變趨勢(shì)為減少,但無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。6.實(shí)驗(yàn)組中有胰島素抵抗組(A1組)同對(duì)照組中有胰島素抵抗組(B1組)比較,實(shí)驗(yàn)組中有胰島素抵抗組(A1組)PCOS患者經(jīng)二甲雙胍治療前后AMH值、BMI、LH、T值的改變幅度更大,AMH(t=-2.136,P0.05)、BMI(t=-2.983,P0.05)、T值(t=-2.071,P0.05)的改變趨勢(shì)為減小,而LH(t=3.209,P0.05)值的改變趨勢(shì)為增大,并有統(tǒng)計(jì)學(xué)意義(P0.05),而FSH(t=-1.206,P0.05)值的改變趨勢(shì)為減少,但無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。7.實(shí)驗(yàn)組中無(wú)胰島素抵抗組(A2組)同對(duì)照組中無(wú)胰島素抵抗組(B2組)比較,實(shí)驗(yàn)組中無(wú)胰島素抵抗組(A2組)PCOS患者經(jīng)二甲雙胍治療前后AMH值、BMI、LH、T值的改變幅度更大,AMH(t=-4.009,P0.05)、BMI(t=-2.571,P0.05)、T值(t=-3.416,P0.05)的改變趨勢(shì)為減小,而LH(t=3.140,P0.05)值的改變趨勢(shì)為增大,并有統(tǒng)計(jì)學(xué)意義(P0.05),而FSH(t=-0.885,P0.05)值的改變趨勢(shì)為減少,但無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.二甲雙胍可影響PCOS患者血清AMH值,并使之降低;2.二甲雙胍不僅可以降低有胰島素抵抗的PCOS患者血清AMH值,同時(shí)可降低無(wú)胰島素抵抗的PCOS患者血AMH值,擴(kuò)大了二甲雙胍的應(yīng)用范圍,增加了PCOS的治療途徑。3.二甲雙胍影響PCOS患者血AMH值的變化可能與患者本身BMI、T有關(guān),而與FSH無(wú)關(guān),而與LH是否有關(guān),仍待進(jìn)一步論證。4.PCOS患者AMH與BMI有一定的關(guān)系,同時(shí)與T也有一定的關(guān)系,但仍需大樣本試驗(yàn)論證。
[Abstract]:Objective: to test the effect of metformin treatment on PCOS patients, and the changes of serum AMH in the treatment process; test metformin without insulin resistance of serum AMH and other indexes in patients with PCOS, help to learn more about PCOS and the effect of metformin in treatment of polycystic ovary syndrome, further observation of endocrine metabolism, provide more reliable the basis for clinical treatment. Methods: selected outpatients with polycystic ovary reproductive center of Wangnan Medical College yijishan hospital syndrome patients, they were randomly divided into A, B two group, metformin treatment group (A group) and control group (group B). Before the experiment of serum AMH in patients with menstruation third days and the related metabolic indexes and recorded, followed by treatment and control, the third day period of three months after the re measurement of serum AMH level and metabolism index. At the same time A group and B group according to the 鏈夋棤鑳板矝绱犳姷鎶楀垎涓篈1,A2緇勫強(qiáng)B1,B2緇，

本文編號(hào)：1605316