炔雌醇环丙孕酮联合二甲双胍对多囊卵巢综合征不孕症患者激素水平的影响

Effect of ethinylestradiol and cyproterone acetate tablets combined with metformin on hormone levels of patients with sterility caused by polycystic ovary syndrome

目的探讨炔雌醇环丙孕酮联合二甲双胍对多囊卵巢综合征不孕症患者激素水平的影响。方法选取多囊卵巢综合征不孕症患者76例,根据随机数表法将所有患者分为2组,每组38例。对照组使用促进排卵的方式治疗,观察组患者给予口服炔雌醇环丙孕酮片联合盐酸二甲双胍肠溶胶囊,再使用促进排卵的方式治疗。比较2组患者治疗前后性激素水平、胰岛素抵抗指数(HOME-IR)、空腹血糖(FBG)、空腹胰岛素(FINS)及排卵、妊娠情况,并记录卵巢过度刺激综合征(OHSS)及不良反应发生率。结果治疗后,2组患者性激素各项指标均较治疗前显著改善,且观察组改善情况较对照组显著(P<0.05);治疗后,2组患者FPG、FINS及HOMA-IR均较治疗前降低,且观察组降低程度显著大于对照组(P<0.05);观察组患者排卵率、妊娠率、OHSS发生率均显著优于对照组(P<0.05);2组患者不良反应发生率无显著差异(P>0.05)。结论炔雌醇环丙孕酮联合二甲双胍在治疗多囊卵巢综合征不孕症效果显著,可有效改善性激素水平及胰岛素抵抗状态,提高患者的排卵率及妊娠率。

Objective To investigate the effect of ethinylestradiol and cyproterone acetate tablets combined with metformin on hormone levels of patients with sterility caused by polycystic ovary syndrome.Methods Totally 76 infertile patients with polycystic ovary syndrome were selected and randomly divided into two groups,38 cases in each group.The control group was treated with ovulation promotion therapy,while the observation group was given ethinylestradiol and cyproterone acetate tablets and metformin hydrochloride enteric-coated capsules and ovulation promotion.The levels of sex hormones,insulin resistance index(HOME-IR),fasting blood glucose(FBG),fasting insulin(FINS),ovulation and pregnancy were compared between the two groups before and after treatment,and the incidence of ovarian hyperstimulation syndrome(OHSS)and the incidence rate of adverse reactions were recorded.Results After treatment,hormone indicators in both groups were significantly better than those before treatment,and the indicators in observation group were significantly better than the control group(P<0.05).After treatment,FPG,FINS and HOMA-IR were significantly lower than those before treatment in both groups,and the indexes in observation group were significantly lower than the control group(P<0.05).In the observation group,ovulation rate,pregnancy[CM(40*2]rate and incidence rate of OHSS were significantly better than the control group(P<0.05).There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05).Conclusion Ethinylestradiol and cyproterone acetate tablets combined with metformin is effective in the treatment of patients with sterility caused by polycystic ovary syndrome,which can effectively improve the level of sex hormone and insulin resistance,and increase the ovulation rate and pregnancy rate.