醋酸曲普瑞林注射液联合炔雌醇环丙孕酮片治疗PCOS不孕症的效果及对相关激素水平的影响

Effect of Triptorelin acetate injection combined with Cyproterone acetate plus Ethinylestradiol tablet on infertility with polycystic ovary syndrome and its effect on related hormone levels

目的探讨醋酸曲普瑞林注射液联合炔雌醇环丙孕酮片治疗多囊卵巢综合征(PCOS)不孕症的效果及对血清睾酮、促甲状腺素水平的影响。方法选取2015年3月至2017年3月湖北省武汉市中西医结合医院诊治的多囊卵巢综合征不孕症患者110例作为研究对象。按随机数字表法分为观察组和对照组,各55例。对照组予醋酸曲普瑞林注射液治疗,观察组予炔雌醇环丙孕酮片与醋酸曲普瑞林联合治疗,比较两组患者的治疗效果及雌激素、睾酮、促甲状腺激素等的水平及超氧化物歧化酶活性。结果观察组的总有效率为96.4%,对照组为80.0%,观察组高于对照组,差异具有统计学意义(P<0.05);在本研究中治疗前两组患者的睾酮、促卵泡激素、黄体生成素、超氧化物歧化酶、促甲状腺素的水平差异无统计学意义(P>0.05),治疗后促卵泡激素水平、超氧化物歧化酶活性均升高,且观察组升高较对照组更多,睾酮、黄体生成素、促甲状腺素水平均下降,且观察组下降更多,差异均具有统计学意义(P<0.05);观察组的累积排卵率为87.27%,累积妊娠率为72.73%,对照组分别为76.27%、45.45%,观察组高于对照组,差异具有统计学意义(P<0.05);观察组的痤疮、月经稀发、多毛症状少于对照组,差异具有统计学意义(P<0.05),两组患者在治疗过程中均未发生不良反应。结论醋酸曲普瑞林注射液联合炔雌醇环丙孕酮片治疗多囊卵巢综合征不孕症的效果较好,可有效提高排卵率、妊娠率,有效调节血性激素、促甲状腺素等激素的水平,增加超氧化物歧化酶活性,在临床上可广泛使用。

Objective To investigate the effect of Triptorelin acetate injection combined with Cyproterone acetate plus Ethinylestradiol tablet in treating infertility with polycystic ovary syndrome(PCOS) and its effect on related hormone levels. Methods From March 2015 to March 2017, 110 infertile patients with PCOS were randomly selected in Wuhan Integrated Hospital of Traditional Chinese and Western Medicine, and were divided into observation group and control group according to the random number table method, each with 55 cases. The control group was treated with Triptorelin acetate injection, and the observation group was treated with Triptorelin acetate injection and Cyproterone acetate plus Ethinylestradiol tablet. The therapeutic effects and the levels of testosterone, follicle-stimulating hormone(FSH), thyroid-stimulating hormone(TSH), luteinizing hormone(LH), and superoxide dismutase(SOD) in the two groups were observed. Results The total effective rate was 96.4 % in the observation group and 80.0 % in the control group, with statistically significant differences(P<0.05). There was no statistically significant difference in the levels of testosterone, FSH, SOD and TSH between the two groups before treatment(P>0.05). After treatment, the level of FSH and SOD activity were increased in both groups, and the levels of testosterone, LH, and TSH were significantly reduced, both more significant in the observation group than that in the control group, with statistically significant differences(P<0.05). The cumulative ovulation rate and cumulative pregnancy rate in the observation group(87.27 %, 72.73 %) were significantly higher than those in the control group(76.27 %, 45.45 %), with statistically significant differences(P<0.05). The incidences of acne, menstrual thinness, and polyhair symptoms in the observation group were significantly smaller than those in the control group, with statistically significant differences(P<0.05). There was no adverse reaction in the two groups. Conclusions Triptorelin acetate injection combined with Cyproterone acetate plus Ethinylestradiol tablet is effective in treating infertility with PCOS, which can effectively increase the rate of ovulation and pregnancy, regulate effectively the levels of gonadal hormones and TSH, and increase the activity of SOD, hereby worthy of wide application in clinical practice.