炔雌醇环丙孕酮片、二甲双胍缓释片联合克罗米芬治疗多囊卵巢综合征不孕患者的临床疗效

Clinical efficacies of ethinylestradiol and cyproterone acetate tablet,metformin extentab combined with clomiphene in treatment of polycystic ovary syndrome

目的:观察炔雌醇环丙孕酮片与二甲双胍缓释片联合克罗米芬治疗多囊卵巢综合征(PCOS)不孕患者的疗效。方法:把60例PCOS患者随机分为两组。观察组(32例)用炔雌醇环丙孕酮片、二甲双胍联合克罗米芬治疗,对照组(28例)用炔雌醇环丙孕酮片联合克罗米芬治疗治疗。两组患者均在治疗3个周期后行促排卵治疗;观察治疗前后体重指数、空腹胰岛素水平、性激素的变化情况及促排卵情况、妊娠情况和早孕流产情况。结果:两组患者经治疗后黄体生成素(LH)、促卵泡素(FSH)、睾酮(T)及空腹胰岛素(FINS)水平均有明显下降;观察组LH/FSH、T、FINS、BMI均低于对照组,差异有统计学意义(P<0.05)。观察组的排卵率(87.50%)和妊娠率(66.71%)都远远高于对照组的(66.71%)(29.76%),差异有统计学意义P<0.05。而早孕流产率差异无统计学意义(P>0.05)。结论:炔雌醇环丙孕酮片与二甲双胍缓释片联合克罗米芬治疗P-COS不孕患者的疗效优于炔雌醇环丙孕酮片和克罗米芬合用。

Objective：To observe the therapeutic effects of ethinylestradiol and cyproterone acetate tablet,metformin extentab combined with clomiphene in treatment of polycystic ovary syndrome（PCOS）.Methods：60 patients with PCOS were divided into two groups randomly.32 patients in observation group were treated with ethinylestradiol and cyproterone acetate tablet,metformin extentab combined with clomiphene,while 28 patients in control group were treated with ethinylestradiol and cyproterone acetate tablet,clomiphene.After treated for 3 courses,the patients in the two groups received controlled ovarian hyperstimulation（COH） treatment;body mass indexes（BMI）,fasting insulin levels,the changes of sex hormones,COH outcomes,pregnancy outcomes and abortion rate during the first trimester of pregnancy before and after treatment in the two groups were observed.Results：After treatment,the levels of uteinizing hormone（LH）,follicle stimulating hormone（FSH）,testosterone（T） and fasting insulin in the two groups decreased significanly;LH/FSH,T,fasting insulin and BMI in observation group were significantly lower than those in control group（P0.05）.The ovulation rate and pregnancy rate in observation group were 87.50% and 66.71%,respectively,which were significantly higher than those in control group（66.71%,29.76%）（P0.05）.But there was no significant difference in abortion rate during the first trimester of pregnancy between the two groups（P0.05）.Conclusion：The clinical efficacy of ethinylestradiol and cyproterone acetate tablet,metformin extentab combined with clomiphene is superior to that of ethinylestradiol and cyproterone acetate tablet,clomiphene.