五积散联合枸椽酸氯米芬治疗多囊卵巢综合征合并不孕症的临床观察

Clinical Observations on Treating Polycystic Ovarian Syndrome(PCOS) with Sterility with Wu Ji San and Clomifene Citrate

目的观察五积散配合小剂量枸椽酸氯米芬治疗多囊卵巢综合征（PCOS）合并不孕症的疗效。方法将80例P-COS患者随机分为治疗组（五积散加枸椽酸氯米芬）和对照组（枸椽酸氯米芬）,给予1~3月治疗后,主要观察血清睾酮（T）,促卵泡激素（FSH）,促黄体生成素（LH）,空腹胰岛素（FINS）,餐后2 h胰岛素（INS）及卵泡发育、子宫内膜厚度的变化,同时观察卵巢过度刺激的发生、排卵率和妊娠率。结果治疗组痊愈18例,有效14例,总有效率80.00%;对照组痊愈10例,有效14例,总有效率60.00%,2组比较,P〈0.05。治疗组注射绒毛膜促性腺激素（HCG）日子宫内膜明显厚于对照组（P〈0.01）。对照组发生2例卵巢过度刺激综合征（OHSS）,治疗组未有发生。治疗组治疗前后胰岛素抵抗和血清睾酮有显著性差异（P〈0.05）,对照组无统计学差异（P〉0.05）,2组比较,P〈0.05。结论五积散联合枸椽酸氯米芬能减轻枸椽酸氯米芬副作用并增加其敏感性,对提高妊娠率有较好的疗效。

OBJECTIVE The purpose of this research is to observe the curative effect of Wu Ji San and small dose Clomifene Citrate on PCOS with sterility.METHOD 80 PCOS patients were divided randomly into treatment group（Clomifene Citrate） and control group（Wu Ji San and Clomifene Citrate）.After 1 to 3 months treatment,the changes of the following items would be observed：testosterone（T）,Follicular Stimulating Hormone（FSH）,luteinizing hormone（LH）,fasting insulin（FINS）,Insulin（INS） 2 hours after meal,follicular development,the changes of endometrium thickness.Additionally,the occurrence of ovarian hyperstimulation,Ovulation rate and pregnancy rate were detected.RESULT In the treatment group,18 cases were cured,14 cases got better,the overall response rate was 80.00%;while in the control group,18 cases cured and 14 got better,the overall response rate was 60.00%,comparing the treatment group with the control group,P0.05.By injecting HCG,the endometrium thickness of the treatment group is apparently thicker than that of the control group（P0.01）.2 cases of ovarian hyperstimulation occurred in the control group,none in the treatment group.In the treatment group,the Insulin resistance and serum testosterone experienced a dramatic change before and after treatment（P0.05）.There was no statistical difference in the control group（P0.05）.CONCLUSION Wu Ji San,together with Clomifene Citrate,is able to reduce the side effect of Clomifene Citrate and increase its sensitivity,thus effectively increasing pregnancy rate.