二甲双胍联合克罗米芬治疗多囊卵巢综合征并不孕症的临床疗效及其对患者内分泌的影响

Clinical effects of metformin combined with clomiphene on infertility of patients with polycystic ovary syndrome and its influence on endocrine

目的观察二甲双胍联合克罗米芬治疗多囊卵巢综合征(PCOS)并不孕症的临床疗效及其对内分泌的影响。方法选取PCOS合并不孕的患者60例作为研究对象,按随机数字表法分为观察组与对照组,每组30例患者。观察组患者采用二甲双胍联合克罗米芬进行治疗,对照组患者采用克罗米芬进行治疗。观察比较两组患者治疗前后体质量、体质量指数(BMI)及腰臀比(WHR);内分泌指标:血清中的促卵泡刺激素(FSH)、黄体生成素(LH)、垂体泌乳素(PRL)、睾酮(T)、雌二醇(E2)、空腹胰岛素(FIN)、空腹血糖(FPG)水平及胰岛素抵抗指数(HOMA-IR)变化情况;治疗后排卵率、妊娠率、早孕流产率及子宫内膜厚度。结果 (1)两组患者治疗后体质量、BMI及子宫内膜厚度与治疗前比较均显著下降(P<0.05);腰臀比与治疗前比较有所下降,但差异无统计学意义(P>0.05)。(2)内分泌指标:与治疗前相比:观察组患者血清中LH、PRL、T、E2、FIN、FPG水平及HOMA-IR均显著改善,差异有统计学意义(P<0.05);对照组患者血清中LH、PRL、T、E2水平显著改善(P<0.05),FIN、FPG水平及HOMA-IR差异无统计学意义(P>0.05);两组患者FSH水平与治疗前比较差异无统计学意义(P>0.05);治疗后与对照组相比,观察组患者LH、PRL、T、FIN水平显著降低、E2水平显著升高(P<0.05)。(3)治疗后观察组患者妊娠率、排卵率均显著优于对照组(P<0.05);两组患者早孕流产率比较差异无统计学意义(P>0.05)。结论二甲双胍联合克罗米芬治疗PCOS导致不孕症,能够有效改善患者的临床症状体征以及内分泌情况,提高患者妊娠率,疗效显著,值得进行临床推广。

Objective To observe the clinical effects of metformin combined with clomiphene on infertility of patients with polycystic ovary syndrome and its influence on endocrine.Methods 60 patients with polycystic ovary syndrome admitted in our hospital were randomly divided into the observation group and control group,with 30 cases in each one.The patients in the observation group were undertaken metformin combined with clomiphene,the control group were received clomiphene only.(1) Weight,BMI,WHR scores were recorded before and after the treatment;(2) The level of FSH,LH,PRL,T,E2,FIN,FPG and HOMA-IR were observed before and after the treatment;(3) The ovulation rate,pregnancy rate,early pregnancy abortion rate and endometrial thickness were observed after the treatment.Results(1) After the treatment,the weight,BMI and endometrial thickness of the two groups were significantly better(P < 0.05).There was no significantly difference in WHR for the two groups(P > 0.05);(2) Before the treatment,there was no significantly difference in the level of FSH,LH,PRL,T,E2,FIN,FPG and HOMA-IR for the two groups(P > 0.05).After the treatment,the level of FSH,LH,PRL,T,E2,FIN,FPG and HOMA-IR of the observation group were significantly better(P < 0.05).The level of FSH,LH,PRL,T,E2 of the control group were significantly better(P < 0.05) and there was no significantly difference in the level of FIN,FPG and HOMA-IR for the control groups(P > 0.05).There was no significantly difference in the level of FSH for the two groups before the treatment(P > 0.05).Compared with the control group,the level of LH,PRL,T and FIN of the observation group were significantly lower and the level of E2 was significantly higher after the treatment(P < 0.05).(3) The ovulation rate,pregnancy rate was much higher than that in the observation group(P < 0.05) and there was no significantly difference in the early pregnancy abortion rate for the two groups(P > 0.05).Conclusions Metformin combined with clomiphene on infertility of patients with polycystic ovary syndrome can effectively relieve clinical symptoms improve endocrine,pregnancy rate and significant clinical efficacy worthy of promotion.