妈富隆联合二甲双胍治疗多囊卵巢综合征伴不孕的临床观察

Clinical Observation of Marvelon Combined with Metformin in Infertile Patients with Polycystic Ovary Syndrome

目的:探讨去氧孕烯炔雌醇(妈富隆)联合1.1-二甲基双胍盐酸盐(二甲双胍)治疗多囊卵巢综合征(PCOS)伴不孕的效果。方法:PCOS伴不孕者82例随机分为实验组(口服妈富隆1片/d,连服21 d,同时予二甲双胍500 mg/次,每日3次,并于治疗前、后检测性激素水平,测量腰/臀比值(WHR)、体重指数(BMI),3个周期后予N,N-二乙-基2-(4-(1,2-二苯基-2-氯乙烯基)苯氧基)乙胺(克罗米芬)促排卵)和对照组(调整生活方式,完成相关检查后予克罗米芬促排卵)。结果:实验组治疗前、后临床症状(P<0.01或P<0.05)和性激素水平(P<0.01)明显改善,WHR、BMI下降(P<0.05)。与对照组比,实验组周期排卵率和临床妊娠率显著提高(P<0.05或P<0.01)。结论:PCOS伴不孕者促排卵前予妈富隆和二甲双胍治疗3个周期可显著改善高雄激素血症和胰岛素抵抗,有效提高促排卵率及临床妊娠率。

Objective： To evaluate the therapeutic effects of marvelon combined with metformin in infertile patients with polycystic ovary syndrome（PCOS）. Methods： Eighty-two infertile patients with PCOS were randomly divided into test group（taking marvelon（one tablet a day for 21 days）plus mefformin（at dosage of 500 mg, three times a day）, detecting the levels of sex hormone before and after therapy, measuring waist hip ratio（WHR）and body mass index（BMI））and control group（adjusting the lifeway and completing some tests）. The ovulation induction treated by clomiphene was conducted between two groups. Results： The clinical symptoms（ P 〈 0.01 or P 〈 0.05）and the levels of sex hormone（ P 〈 0.01）in the test group were improved obviously, WHR and BMI were decreased. Compared with the control group, the cycle ovulation and clinical pregnancy rates in the test group were increased obviouly（ P 〈 0.05 or P 〈 0.01 ）. Conclusion： Marvelon with mefformin before inducing ovulation can effectively improve hyperandrogenism and insulin resistance in infertile patients with PCOS, and further enhance the induced ovulation and clinical pregnancy rates.