何君婷　　汤吉梅　　张业

[关键词] 2型糖尿病;卵巢综合征;利拉鲁肽;降浊合剂

[中图分类号] R711.75          [文献标识码] B          [文章编号] 1673-9701（2021）14-0142-05

Clinical effect of Jiangzhuo Mixture combined with liraglutide in the treatment of type 2 diabetes with polycystic ovary syndrome

HE Junting1   TANG Jimei2   ZHANG Ye1

1.Department of Endocrinology， Ningbo Hospital of Traditional Chinese Medicine， Ningbo   315000， China; 2.Department of Endocrinology， Shangyu People′s Hospital of Shaoxing City in Zhejiang Province， Shaoxing   312300， China

[Abstract] Objective To observe the clinical efficacy of Jiangzhuo Mixture combined with liraglutide in the treatment of type 2 diabetes with polycystic ovary syndrome. Methods A total of 62 patients with type 2 diabetes and polycystic ovary syndrome who were treated at Shangyu People′s Hospital in Shaoxing City from March 2018 to March 2020 were selected and divided into the control group and the observation group by using a random number table， with 31 cases in each group. The control group was treated with liraglutide， and the observation group was treated with Jiangzhuo Mixture on the basis of the control group. Twelve weeks was a course of treatment. The patient′s general condition， blood biochemistry， sex hormone levels， menstruation， and ovulation were measured before and after treatment between the two groups. Results （1）After treatment， the waist circumference， BMI， FPG， 2 h PG， HbA1c， FINS， HOMA-IR， TG， LH， and T levels between the two groups were reduced more significantly than that before treatment（P<0.05）， and the levels of BMI， HbAlc， FINS， HOMA-IR， TG， and LH in the observation group were significantly lower than those in the control group（P<0.05）. （2）The change rate of the menstrual cycle regularity in the observation group was significantly higher than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion Jiangzhuo Mixture combined with liraglutide in the treatment of T2DM with PCOS can effectively improve the clinical symptoms， regulate the patient′s blood glucose， blood lipid， and sex hormone levels， and improve the menstrual cycle.

[Key words] Type 2 diabetes; Ovarian syndrome; Liraglutide; Jiangzhuo Mixture

多囊卵巢綜合征（Polycystic ovary syndrome，PCOS）是一种具有生殖、代谢、心理特征的常见生殖内分泌代谢性疾病[1]。以雄激素过多伴无（低）排卵、多毛和月经不调为特征的临床综合征[2]。胰岛素抵抗（Insulin resistance，IR）是其发病的重要机制，据统计，50%～70%的PCOS患者合并有IR[3]，而肥胖加剧IR。IR使卵巢白质增厚影响卵泡的发育，阻碍排卵继发不孕[4]。同时IR也可导致糖尿病的发生和血脂紊乱。有资料显示，PCOS患者糖耐量受损（Impaired glucose tolerance，IGT）在美国发生率为23%～35%，2型糖尿病（Type 2 diabetes，T2DM）患病率为4%～10%[5]，70%的PCOS 患者存在血脂紊乱[6]，主要为总胆固醇（Total cholesterol，TC）、三酰甘油（Triglycerides，TG）、低密度脂蛋白胆固醇（Low-density lipoprotein， LDL-C）升高及高密度脂蛋白胆固醇（High density lipoprotein，HDL-C）下降[7]。目前常规治疗改善PCOS 患者的肥胖、月经不规律等效果仍不理想，寻找能够显著减轻体重、改善胰岛素抵抗、恢复月经周期的治疗方法至关重要[8]。利拉鲁肽是一种人胰高糖素样肽-1 受体激动剂（Glucagon-like peptide-1 receptor agonist，GLP-1RA），于2011 年中国批准用于治疗成人2 型糖尿病。有研究发现，GLP-1RA可以显著改善2 型糖尿病患者肥胖和胰岛素抵抗，且起效快、治疗时间短[9-11]。目前国内外已有学者逐渐关注利拉鲁肽是否也能成为治疗PCOS 的利器[12]。同时我院中医药在代谢性疾病方面研究也逐渐深入，本研究对我院就诊的T2DM合并PCOS 患者采用利拉鲁肽联合降浊合剂治疗，观察对血糖、血脂、性激素及排卵功能的影响，拟为T2DM合并PCOS 的临床中西医治疗提供参考，现报道如下。

1 资料与方法

1.1一般资料

选取2018年3月至2020年3月于绍兴市上虞人民医院就诊的2型糖尿病合并多囊卵巢综合征已婚妇女62例，应用随机数字表分为对照组和观察组，每组各31例。……