雷洛昔芬与克罗米芬治疗多囊卵巢综合征的疗效对比

Comparison between Raloxifene and Clomiphene for Treating Polycystic Ovary Syndrome

目的：比较雷洛昔芬与克罗米芬治疗多囊卵巢综合征（PCOS）的临床疗效及对排卵的促进作用。方法将86例患者随机分为A组和B组，各43例。A组和B组分别于月经第5天给予雷洛昔芬和克罗米芬治疗。月经第12天通过B超检查监测卵泡及子宫内膜情况，当卵泡直径超过18 mm、子宫内膜厚度超过7 mm时，肌肉注射人绒毛膜促性腺激素（HCG）5000～10000 U诱发排卵。结果 HCG注射日A组患者子宫内膜厚度明显高于B组（ P﹤0.05）；与B组相比，A组雌二醇（E2）、促黄体生成素（LH）均有明显改善（ P﹤0.05）；HCG注射48 h后，A组排卵率明显高于B组（ P﹤0.05）；两组患者成熟卵泡数量、卵泡成熟时间相当（ P﹥0.05）；两组患者不良反应发生率均较低，差异无统计学意义（ P﹥0.05）。结论雷洛昔芬能改善PCOS患者的性激素指标，对子宫内膜不良反应较小，具有较好的促排卵作用，且临床不良反应较少，安全性较高，值得进一步研究。

Objective To compare the clinical efficacy and safety of raloxifene and clomiphene in treating polycystic ovary syndrome （ PCOS ） . Methods Totally 86 patients were randomly divided into group A and the group B,43 cases in each group. The group B were given clomiphene,and the group A was given raloxifene on the 5th day of menstruation. On the 12th day of menstruation,the con-dition of follicular and endometrial were checked by B-ultrasound;when the follicle diameter ﹥ 18 mm,and the endometrial thickness ﹥ 7 mm, the intramuscular injection of human chorionic gonadotropin（HCG） 5 000～10 000 U was applied to induce ovulation. Results The endometrial thickness of group A on the HCG injection day was higher than the group B（ P ﹤ 0. 05）;the E2 and LH levels of group A improved better than group B（ P ﹤ 0. 05）;after 48 h of HCG injection,the ovulation rate of group A was significantly higher than group B（ P ﹤ 0. 05）;the number of mature follicles,follicle considerable time of the two groups had no statistically significant dif-ference（ P ﹥ 0. 05）;the occurrence rate of adverse reactions in the two groups had no statistical differences（ P ﹥ 0. 05）. Conclusion Raloxifene can improve hormone index of PCOS patients with fewer adverse reactions on the endometrium,it is safe and has a good role in promoting ovulation,and deserves to be further studied.