A Meta Analysis Of The Effect Of Metformin And Diane-35in Treatment Of Polycystic Ovary Syndrome

Background and object:Polycystic ovary syndrome is the most common endocrine disorders in female, whichis characterized by a long-term anovulation, hyperandrogenism, insulin resistance andcompensatory hyperinsulinemia, the symptom of this disease is complex and diverse. Thedisease not only effect fertility function, and increase female functional uterine bleeding,endometrial cancer due to the sex hormone disorder, moreover, it is also associated with ametabolic disturbance characterized by hypertension, dyslipidemia and insulin resistancethat carries an increased risk of type2diabetes in later life. Polycystic ovary syndrome iscommon in fertile woman, it is important for diagnosis timely and effective treatment. Inrecent years, It is universally accepted that the effects of Diane-35in combination withmetformin on the clinical, and the situation of fertility become more and more attentionafter treatment. The purpose of this study is to assess and analyze effectiveness of treatingPCOS using Diane-35in combination with metformin by meta-analysis of evidence-basedmedicine approach in order to provide medical evidence for clinical rational drug use.Methods:We searched MEDLINE, PubMed, CNKI, Articles Chinese database, Chinesebiomedical literature database and Chinese science and technology journal full-text databasepool for articles published up to November2013. There was divided into three groups:metformin group, Diane-35group and Diane-35in combination with metformin group.According to include and exclude standards, there was eventually21study,1268cases ofpatients selected about Diane-35and Diane-35in combination with metformin in treatmentof PCOS, including Diane-35combined with metformin group:650cases, Diane35treatment group:618cases. There was5study,202cases of patients selected about Diane-35and metformin in treatment of PCOS, including Diane35treatment group:100cases, metformin group:102cases. Using the Review manager5.1software to accomplishmeta-analysisResults:(1) Compared Diane-35group with metformin group of the treatment of polycysticovary syndrome: A total of five randomized controlled clinical study included202cases ofpatients after screening. Diane-35is better than metformin in improving of T (P <0.05), LH(P <0.05),FSH (P <0.05), LH/FSH (P <0.05). Metformin is superior in improving BMI(P=0.04),TC(P <0.05),HDL(P=0.01).there is no significant difference between the two groupsin improving WHR (P=0.14), TG (P=0.15), LDL (P=0.06).(2) Compared Diane-35combined with metformin group with Diane-35group of thetreatment of polycystic ovary syndrome: A total of21randomized controlled clinical studyincluded1268cases of patients cases of patients after screening. Diane-35combined withmetformin is more effective than Diane-35in improving BMI(P<0.05), T (P<0.05), FSH (P<0.05), TG (P<0.05), LDL (P<0.05), FIN (P<0.05), FBG (P<0.05), HDL (P<0.05). There isno significant difference between the two terms in improving LH (P=0.68), LH/FSH(P=0.21), FSH(P=0.31),SHBG (P=0.06).Conclusion:Diane-35is better than metformin in improving hyperandrogenism, metformin is moreeffective in the treatment of hyperinsulinemia and insulin resistance, and metformin canreduce the level of free testosterone to enhance the therapeutic effect of Diane-35, at thesame time, metformin can compensate the deficiencies of insulin sensitivity with oralDiane-35. Therefore, the effect of combination treatment is more obvious.