炔雌醇环丙孕酮片联合坤泰胶囊对多囊卵巢综合征患者内分泌和排卵的影响

Effect of Ethinylestradiol and Cyproterone Acetate Tablets Joint Kuntai Capsule on Endocrine and Ovulation of Patients with Polycystic Ovary Syndrome

目的探讨炔雌醇环丙孕酮片联合坤泰胶囊对多囊卵巢综合征(PCOS)患者内分泌和排卵的影响。方法选取自2013年1月至2014年1月成都医学院第一附属医院收治的诊断为多囊卵巢综合征患者80例,按随机数表法将其随机分为对照组和观察组,各40例。对照组采用炔雌醇环丙孕酮片单独治疗,每晚口服1片炔雌醇环丙孕酮片,连续口服21 d后停药;观察组采用炔雌醇环丙孕酮片联合坤泰胶囊治疗,每次口服坤泰胶囊4粒,每日3次,连续治疗3个周期。两组患者均连续用药治疗3个月,检测并比较两组患者治疗前后的生殖内分泌指标情况,记录两组患者治疗后的成熟卵泡数、诱排日子宫内膜厚度、人绒毛膜促性腺激素(HCG)、雌二醇(E2)值、宫颈黏液评分及排卵率、妊娠率情况,并进行比较。结果治疗后两组患者的黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH、E2、睾酮等性激素水平均较治疗前显著降低(P<0.05);观察组治疗后的FSH、瘦素水平显著低于对照组[(3.4±1.0)U/L比(5.4±2.2)U/L,(17±4)μg/L比(26±7)μg/L],SHBG水平为显著高于对照组[(62±13)nmol/L比(32±11)nmol/L](P<0.01)。观察组患者治疗后的成熟卵泡数、诱排日子宫内膜厚度、HCG日E2值及宫颈黏液评分均显著高于对照组[(4.4±1.3)个比(3.3±1.2)个;(10±4)mm比(7±3)mm;(1348±184)ng/L比(893±175)ng/L;(12.4±2.3)分比(7.0±2.7)分],差异有统计学意义(P<0.01);观察组患者治疗后的排卵率、妊娠率显著高于对照组[92.5%(37/40)比70.0%(28/40),60.0%(24/40)比25.0%(10/40)],差异有统计学意义(P<0.05)。结论炔雌醇环丙孕酮片联合坤泰胶囊治疗PCOS的效果较单独炔雌醇环丙孕酮片治疗更为显著,能明显改善患者的内分泌紊乱,促排卵作用好,可作为一种较为理想的PCOS治疗方案。

Objective To investigate the effect of ethinylestradiol and cyproterone acetate tablets joint kuntai capsule on endocrine and ovulation in patients with polycystic ovary syndrome（ PCOS）. Methods From Jan. 2013 to Jan. 2014,80 patients with PCOS from the First Affiliated Hospital of Chengdu Medical College were included in the study,according to the random number table method they were divided into control group and observation group,40 cases in each group. The control group was treated with ethinylestradiol and cyproterone acetate tablets monotherapy,one tablet every night for 21 d; the observation group was treated with ethinylestradiol and cyproterone acetate tablets joint kuntai capsule treatment,4 kuntai capsules every time,3 times a day,for three cycles. All patients were medicated for 3 months,and the reproductive endocrinology indicators before and after treatment were tested and compared,recording the number of mature follicles,endometrial thickness,human chorionic gonadotropin（ HCG）,estradiol（ E2）,cervical mucus score,ovulation rate,and pregnancy rate of the two groups for comparison. Results Compared with before treatment,luteinizing hormone（ LH）,follicle stimulating hormone（ FSH）,LH / FSH,E2,testosterone and other sex hormone levels were significantly decreased after treatment（ P〈0. 05）; the FSH,leptin levels were significantly lower than the control group[（ 3. 4 ± 1. 0） U / L vs（ 5. 4 ± 2. 2） U / L,（ 17 ± 4） μg / L vs（ 26 ±7） μg / L],SHBG levels significantly higher than the control group[（ 62 ± 13） nmol / L vs（ 32 ± 11） nmol / L]（ P〈0. 01）. Mature follicles endometrial thickness,HCG day E2 value and cervical mucus scores of the observation group were significantly higher than the control group [（ 4. 4 ± 1. 3） vs（ 3. 3 ± 1. 2）;（ 10 ±4） mm vs（ 7 ± 3） mm;（ 1348 ± 184） ng / L vs（ 893 ± 175） ng / L;（ 12. 4 ± 2. 3） vs（ 7. 0 ± 2. 7） ],the differences were statistically significant（ P〈0. 01）; ovulation rate and pregnancy rate of the observation group were significantly higher than the control group [92. 5%（ 37 /40） vs 70. 0%（ 28 /40）,60. 0%（ 24 /40） vs 25. 0%（ 10 /40） ],the differences were statistically significant（ P〈0. 05）. Conclusion Ethinylestradiol and cyproterone acetate tablets joint kuntai capsule treatment of PCOS is better than ethinylestradiol and cyproterone acetate tablets monotherapy,which can improve endocrine disorders and promoteovulation,thus can be used as an ideal PCOS treatment.