二甲双胍联合炔雌醇丙孕酮治疗胰岛素抵抗性多囊卵巢综合征所致不孕症的疗效观察

Metformin is Joint Female Alcohol Progesterone Insulin Resistance Polycystic Ovarian Syndrome Treatment of Infertility Caused by Clinical Observation

目的:探讨应用二甲双胍联合炔雌醇丙孕酮(达英-35)治疗胰岛素抵抗性多囊卵巢综合征所致不孕症的临床疗效。方法:将124例胰岛素抵抗性多囊卵巢综合征的不孕患者随机分为两组(治疗组和观察组),A组为月经第5 d或黄体酮撤退性出血第5 d开始,直接应用克罗米芬(CC)、尿促性素(HMG)、绒毛膜促性腺激素(HCG)促排卵治疗3周期,B组三餐后30 min给予二甲双胍500 mg,3次/d,同时自月经第2 d给予炔雌醇丙孕酮1片/晚,21 d,共3个周期,然后再用A组促排卵治疗3周期。观察两组患者治疗前后体重指数(BIM)、空腹血糖(FPG)、空腹胰岛素水平(FINS)、黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇(E2)、睾酮(T)、泌乳素(PRL),并将2组促排卵后排卵率、妊娠率及流产率加以比较。结果:治疗组在口服二甲双胍联合炔雌醇丙孕酮3个月后BIM、FGP、FINS、FSH、LH、T、LH/FSH均较治疗前明显降低(P<0.05),且较观察组的排卵率、妊娠率升高,流产率降低。结论:对于胰岛素抵抗性多囊卵巢综合征所导致不孕的促排卵治疗前,应用二甲双胍联合炔雌醇丙孕酮能有效降低雄激素,改善胰岛素抵抗,提高妊娠率,降低流产率。

Objective：Discusses application metformin is joint female alcohol c progesterone（diane-35） treatment insulin resistance（IR） polycystic ovarian syndrome（PCOS） of the clinical curative effect of infertility.Methods： 124 cases of insulin resistance（IR） polycystic ovarian syndrome（PCOS） infertility patients were randomly divided into two groups（the treatment group and the observation group）,A group of menstrual 5 days or palace progestin retreat hemorrhages 5 days start,the direct application Clomiphene（CC）/Menotrophin（HMG）/chorionic gonadotropin（HCG） promote ovulation treatment 3 cycles,three and A half hours after the group B give metformin 500 mg,three times per day,and at the same time period since the second day is to give female alcohol c progesterone 1 piece/late,21 days,of three cycles,and then use A group of promoting ovulation treatment 3 cycle.Observe both groups of patients before and after treatment body mass index（BIM）,fasting blood sugar（FGP）,fasting insulin levels（FINS）,luteinizing hormone（LH）,erythropoietin follicle-stimulating hormone（FSH）,estradiol（E2）,testoster-one（T）,prolactin（PRL）,and will promote ovulation 2 groups after ovulation rate,pregnancy rate and abortion rate compared.Results：The treatment group in oral metformin is joint female alcohol c progesterone after 3 months,FGP,FINS,BIM,FSH and LH,T,LH/FSH than that of before treatment significantly（P0.05）,and more the observation group of ovulation rate,the pregnancy rate increases,the abortion rate to decrease.Conclusion： In insulin resistance to sexual polycystic ovarian syndrome to promote ovulation before treatment of infertility,application metformin is joint female alcohol c progesterone can effectively reduce the androgen,improve insulin resistance,increase pregnancy rate,reduce the abortion rate.