摘要
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.
出处
《内蒙古医学杂志》
2012年第10期1166-1169,共4页
Inner Mongolia Medical Journal