二甲双胍联合来曲唑对多囊卵巢综合征并不孕症患者的临床疗效

Clinical efficacy of metformin combined with letrozole in the treatment of polycystic ovary syndrome with infertility

目的探讨二甲双胍联合来曲唑对多囊卵巢综合征(PCOS)并不孕症患者的临床疗效以及对内分泌的影响。方法对门诊收治的180例PCOS合并不孕症患者,用随机数字表法,将患者分为对照组和观察组,每组90例。对照组患者给予来曲唑。观察组患者给予来曲唑联合二甲双胍。两组患者均连续治疗3个月经周期。记录患者治疗前后体质指数(BMI)、血清黄体生成素(LH)、促卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)、空腹血糖(FPG)、空腹胰岛素(FIN)和胰岛素抵抗指数(HOMA-IR)、排卵情况、妊娠情况以及不良反应,并评价疗效。结果经过治疗后,观察组患者BMI,FPG,FINS,HOMA-IR水平均低于对照组,差异有显著性(P<0.05);观察组LH,E2和T水平低于对照组,差异有显著性(P<0.05);观察组排卵率、妊娠率和总有效率均高于对照组,差异有显著性(P<0.05)。结论采用二甲双胍联合来曲唑治疗PCOS并不孕症,能显著改善患者症状和内分泌情况,提高妊娠率,降低不良反应。

Objective To investigate the clinical efficacy and endocrine effects of metformin combined with letrozole in the treatment of polycystic ovary syndrome(PCOS) with infertility.Methods One hundred and eighty PCOS patients with infertility were randomly divided into control group and observation group by radom number table method,90 cases in each group.The control group was given letrozole while the observation group was given letrozole and metformin.Both groups were treated 3 menstrual cycles.Body mass index(BMI),serum luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E2),testosterone(T),fasting plasma glucose(FPG),fasting insulin(FIN) and insulin resistance index(HOMA-IR),ovulation,pregnancy and adverse reactions were recorded before and after treatment.Results After treatment,BMI,FPG,FIN,HOMA-IR levels in the observation group were significantly lower(P<0.05)than the control group;The levels of LH,E2 and T in the observation group were lower than the control group,which has significant difference(P<0.05);The ovulation rate,pregnancy rate and total effective rate in the observation group were significantly higher than the control group(P<0.05).Conclusion Metformin combined with letrozole in the treatment of PCOS with infertility can significantly alleviates the symptoms and endocrine conditions of patients,increase the pregnancy rate and reduce adverse reactions.