目的 探讨桂枝茯苓胶囊联合二甲双胍对多囊卵巢综合征（polycystic ovary syndrome，PCOS）合并胰岛素抵抗患者的临床疗效。方法 选取浙江中医药大学附属江南医院2021 年 7 月至2024 年 5 月收治的 PCOS 合并胰岛素抵抗患者 108 例，按照随机数字表法分为研究组和对照组，每组54 例。对照组采用二甲双胍治疗，研究组在此基础上联合桂枝茯苓胶囊。比较两组临床疗效、治疗前后雌激素、性激素水平及妊娠相关指标。结果 （1）研究组月经紊乱改善率、临床症状改善率、性激素水平恢复正常率均显著高于对照组[分别为97.67%（42/43）vs.80.95%（34/42）、92.59%（50/54）vs. 77.78%（42/54）、94.44%（51/54）vs. 79.63%（43/54），均P<0.05]。（2）治疗后研究组患者孕酮、睾酮、雌二醇恢复正常范围率明显高于对照组患者[分别为83.33%（45/54）vs. 55.56%（30/54）、88.89%（48/54） vs. 53.70%（29/54）、85.19%（46/54）vs. 59.26%（32/54）， P<0.05]。（3）研究组月经恢复率、排卵率及妊娠率均显著高于对照组[分别为98.15%（53/54）vs. 62.96%（34/54）、81.48%（44/54）vs.51.85%（28/54）、48.15%（26/54）vs.14.81%（8/54）（P<0.05）。结论 桂枝茯苓胶囊联合二甲双胍治疗PCOS合并胰岛素抵抗患者可进一步提升疗效，调节雌孕激素分泌及提升妊娠率。

Objective To study the clinical efficacy of Guizhi Fuling capsules combined with metformin in patients with polycystic ovary syndrome （PCOS） and insulin resistance. Methods A total of 108 patients with PCOS and insulin resistance admitted to Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from July 2021 to May 2024 were selected and divided into study group and control group according to the random number table method，with 54 cases in each group. The control group was treated with metformin，and the study group was combined with Guizhi Poria capsule on this basis. The clinical efficacy， estrogen and sex hormone levels and pregnancy-related indicators before and after treatment were compared between the two groups. Results （1） The improvement rate of menstrual disorders，clinical symptoms，and return to normal sex hormone levels in the study group were significantly higher than those in the control group [97.67% （42/43） vs. 80.95% （34/42），92.59% （50/54） vs. 77.78% （42/54），94.44% （51/54） vs. 79.63% （43/54），all P<0.05]. （2） After treatment，the normal range rate of progesterone，testosterone and estradiol in the study group was significantly higher than that in the control group [83.33% （45/54） vs. 55.56% （30/54），88.89% （48/54） vs. 53.70% （29/54），85.19% （46/54） vs. 59.26% （32/54），P<0.05]. （3） The menstrual recovery rate，ovulation rate and pregnancy rate of the study group were significantly higher than those of the control group [98.15% （53/54） vs. 62.96% （34/54），81.48% （44/54） vs. 51.85% （28/54），48.15% （26/54） vs. 14.81% （8/54） （P<0.05）. Conclusion Guizhi Fuling capsule combined with metformin in the treatment of PCOS and insulin resistance can further improve the efficacy， regulate estrogen secretion and increase pregnancy rate.