Comparison Of The Efficacy Of Pioglitazone Metformin Tablets And Metformin Hydrochloride Tablets In Patients With Polycystic Ovary Syndrome With Insulin Resistance

Background and Objective:Polycystic ovary syndrome(PCOS)has been a common endocrine disease that plagues women for a long time,and its clinical manifestations are mainly thin menstruation,amenorrhea,hairy,acne,seborrheic alopecia,and ultrasound-prone ovaries Cystic changes and abnormal sex hormone levels.In women of childbearing age,the incidence of PCOS is as high as 5%-10%,and the main reason for patients to see a doctor is their menstrual disorders and infertility.The incidence of anovulatory infertility in PCOS patients is as high as 30% ～ 60%.In addition,there are many long-term complications brought by PCOS,not only local lesions such as endometrial disease,but the most serious is endometrial cancer;more importantly,such as diabetes,hypertension,dyslipidemia and cardiovascular disease Such as systemic diseases,these pose a serious threat to women’s health.And recent studies have shown that the etiology of this endocrine disease involves multiple factors such as heredity,environment,and development.According to previous traditional concepts,the main endocrine characteristics of PCOS are hyperandrogenemia and persistent thin ovulation or anovulation.However,since Burghen et al.Proposed that most PCOS patients have insulin resistance in 1980,the problem of metabolic disorders caused by PCOS is increasing.The more attention is paid to it.Although many mechanisms of the pathophysiology of PCOS are still unclear,many recent studies have suggested that hyperandrogenemia and insulin resistance play a vital role in PCOS,and there is a correlation between the them,that is,hyperandrogenemia can aggravate insulin resistance,and insulin resistance in turn can aggravate hyperandrogenemia.Therefore,in the diagnosis and treatment of PCOS patients with insulin resistance and hyperandrogenemia as the main manifestations,it is important to explore the relationship between the three,and drugs that increase insulin sensitivity have gradually become the first-line drugs for PCOS treatment.At present,the higher clinical application rates are biguanide and thiazolidinediones.These two drugs interfere from different channels and increase the body’s sensitivity to insulin.Their representative drugs are metformin and pioglitazone.But biguanides and thiazolidinediones have their own advantages in improving insulin resistance.This study analyzed the clinical efficacy of patients with PCOS and insulin resistance who did not improve their insulin resistance significantly after metformin alone,and then switched to pioglitazone metformin tablets.The clinical data before and after treatment for a certain period of time were detailedly recorded,analyzed,and statistically processed to compare the effects of glucose metabolism levels,sex hormone levels,and body mass index,and then to explore pioglitazone metformin tablets for PCOS patients with insulin resistance Effect of treatment.Methods:Patients with polycystic ovary syndrome with insulin resistance who attended the gynecology department of the First Affiliated Hospital of Zhengzhou University from March 2018 to December 2019 were collected and screened for taking metformin hydrochloride tablets for more than 3 months.Insulin resistance did not improve significantly.80 patients were switched to pioglitazone metformin tablets,and the patients were observed for three consecutive months.Comparative analysis of fasting blood glucose(FBG),fasting insulin(FINS),fasting insulin resistance index(HOMA-IR = FBG × FIN / 22.5),and oral glucose tolerance test(OGTT)The blood glucose(1h BG,2h BG)and insulin(1h INS,2h INS)levels of the next 1 hour and 2 hours were supplemented by investigating their effects on sex hormone levels and body mass index(BMI).Results:(1)After 3 months of treatment with pioglitazone metformin tablets,the insulin levels,HOMA-IR,and 2h BG in each phase of the patient were significantly lower than before treatment,and the differences were statistically significant(P <0.05);In other words,there was no statistically significant difference between patients before and after treatment(P> 0.05).(2)After treatment with pioglitazone metformin tablets,the patient’s BMI decreased significantly compared with that before treatment,and the difference was statistically significant(P <0.05).(3)After treatment with pioglitazone metformin,the patients’ testosterone(TESEO),estradiol(E2),were significantly lower than before treatment,and the differences were statistically significant(P <0.05).Conclusions:(1)In this study,combined use of pioglitazone metformin can significantly improve insulin resistance in patients with polycystic ovary syndrome with insulin resistance.(2)The combined application of pioglitazone and metformin can effectively reduce testosterone levels.(3)In the treatment of patients with polycystic ovary syndrome and insulin resistance who are not sensitive to metformin alone,pioglitazone metformin tablets may be a better choice.