二甲双胍联合促排卵药治疗多囊卵巢综合征的疗效观察

Effects of Metformin on Clomiphene-Induced Ovulation in the Polycystic Ovary Syndrome

目的 :观察二甲双胍联合克罗米酚 (CC)治疗多囊卵巢综合征 (PCOS)合并不孕患者的疗效。方法 :选择 4 0例 PCOS患者 ,随机分成 A组和 B组。 A组 :2 0例从月经周期第 1～ 3天开始服药二甲双胍 ,3次 / d,每次 5 0 0 mg,于第 2个月经周期第 5天加服 CC10 0 mg/ d× 5治疗 1个周期。 B组 :于月经周期第 5天服 CC10 0 mg/ d× 5 ,促排卵治疗 1个周期。测定所有患者的性激素、空腹血糖 (FG)及空腹胰岛素 (Fins)。结果 :服二甲双胍后 ,血 L H、T及 Fins的水平明显下降(P<0 .0 5 )。 A组妊娠 9例 ,妊娠率为 4 5 % ,B组妊娠 3例 ,妊娠率 15 % ,两组妊娠率有显著性差异 (P<0 .0 5 )。结论 :二甲双胍治疗 PCOS不仅能降低血 L H、T及 Fins,同时能提高 CC治疗 PCOS的妊娠率。

Objective:To observe the effects of metformin plus clomiphene in the treatment of patients with polycystic ovary syndrome(PCOS).Methods:Forty PCOS patients with infertility were randomly divided into two groups,patients in group A (n=20) were given metformin,1 500 mg daily for one cycle from 1～3 day in menstral cycle,after one cycle,plus clomiphene citrate 100mg/day×5 for induction of ovulation,patients in group B were induced ovulation with CC alone for 1 cycle. The levels of serum FSH,LH,T glucose and insulin were measured in all patients.Results:In group A,the levels of serum LH.T and Fins were significantly decreased when compared with those of pre-treatment Levels (P<0.05). 9 of the 20 patients (45 percent) became pregrancy. In group B,3 of the 20 patiens (15 percent) became pregnancy.The pregnant rates between two groups showed significantly differences (45% vs 15%,P<0.05).Conclusions:Metformin therapy not only decreases high LH and insulin resistance but also improves pregnant rates combined with clomiphene to the patients with PCOS.