地塞米松联合氯米芬治疗多囊卵巢综合征的疗效及对血清性激素水平的影响

Efficacy of Dexamethasone Combined With Clomiphene in Treatment of Polycystic Ovarian Syndrome and its Effect on Serum Gonadal Hormone Level

目的:探讨地塞米松联合氯米芬治疗多囊卵巢综合征的疗效及对血清性激素水平的影响.方法:回顾性选取2015年1月至2018年6月沈阳市红十字会医院收治的多囊卵巢综合征患者130例,按照治疗方案不同分为观察组68例和对照组62例.两组患者于月经第3-7日给予氯米芬治疗;观察组患者在此基础上于月经第3-12日给予地塞米松治疗,连服1周.所有患者均进行6个月经周期的治疗,若中途出现妊娠反应,立即停药.比较两组患者治疗前后的血清性激素水平、治疗后排卵和妊娠情况及不良反应发生情况的差异.结果:治疗后,两组患者孕酮、雌二醇、睾酮及黄体生成素水平明显优于治疗前,且观察组患者上述指标水平明显优于对照组;观察组患者的排卵率、妊娠率分别为79.41%(54/68)、75.00%(51/68),明显高于对照组的56.45%(35/62)、46.77%(29/62),上述差异均有统计学意义(P<0.05).观察组、对照组患者不良反应发生率分别为4.41%(3/68)、4.84%(3/62),差异无统计学意义(P>0.05).结论:地塞米松联合氯米芬治疗多囊卵巢综合征,能有效调节患者的血清性激素水平,提高排卵率和妊娠率,安全性好.

OBJECTIVE: To probe into the efficacy of dexamethasone combined with clomiphene in treatment of polycystic ovarian syndrome and its effect on serum gonadal hormone level. METHODS: 130 patients with polycystic ovarian syndrome admitted into Shenyang Red Cross Hospital from Jan. 2015 to Jun. 2018 were retrospectively selected and divided into observation group(68 cases) and control group(62 cases) according to different therapeutic regimens. Both groups were treated with clomiphene during the 3 rd to 7 th day of menstruation;on this basis, the observation group was given dexamethasone on the 3 rd to 12 th day of menstruation for 1 week. All patients were treated for 6 menstrual cycles, and medication withdrawal was given when pregnancy reaction occurred. Differences in serum gonadal hormone levels, incidences of ovulation, pregnance and adverse drug reactions between two groups were compared. RESULTS: After treatment, the progesterone, estradiol levels, the testosterone and luteinizing hormone levels of both groups were significantly better than those of before treatment, and those of the observation group were significantly better than the control group;the rates of ovulation and pregnancy of observation group were respectively 79.41%(54/68) and 75.00%(51/68), which were significantly higher than those of the control group(56.45%, 35/62;46.77%, 29/62), with statistically significant differences(P<0.05);the incidences of adverse drug reactions of observation group and control group were respectively 4.41%(3/68)and 4.84%(2/62), the difference had no statistical significance(P>0.05). CONCLUSIONS: The combination of dexamethasone and clomiphene in treatment of polycystic ovarian syndrome can effectively regulate serum gonadal hormone level, improve the rates of ovulation and pregnancy, with high safety.