炔雌醇环丙孕酮片联合营养干预对多囊卵巢综合征的疗效及对患者AMH水平和排卵率的影响分析

Effect of ethinylestradiol cyproterone combined with nutritional intervention on polycystic ovary syndrome.

目的探讨炔雌醇环丙孕酮片联合营养干预在多囊卵巢综合征(PCOS)治疗中的临床应用价值及对患者抗苗勒管激素(AMH)和排卵率的影响。方法前瞻性选取2018年6月至2020年3月广西柳州市中医医院妇科收治的PCOS患者110例,采用随机数字表法分为实验组(n=55)和对照组(n=55)。2组均给予炔雌醇环丙孕酮片及基础治疗,实验组同时给予营养干预治疗。比较2组患者治疗前和治疗3个月后血清AMH、雄激素(T)、性激素结合清蛋白(SHBG)、促黄体生成素(LH)、促卵泡生成素(FSH)水平,卵巢体积,窦卵泡数目,排卵率及1年后妊娠率。结果治疗前,2组患者的血清AMH、T、SHBG、LH、FSH水平比较,差异无统计学意义(P>0.05);治疗3个月后,2组AMH、T、LH水平均较治疗前明显降低(P<0.05),SHBG水平较治疗前明显升高(P<0.05),FSH水平无明显变化(P>0.05),且实验组改善效果优于对照组(P<0.05)。治疗前,2组患者的卵巢体积及窦卵泡数目比较,差异无统计学意义(P>0.05);治疗3个月后,2组的卵巢体积及窦卵泡数目均较治疗前明显降低(P<0.05),且实验组明显低于对照组(P<0.05)。实验组患者的排卵率、1年后妊娠率均明显高于对照组,差异有统计学意义(P<0.05)。结论在炔雌醇环丙孕酮片治疗的基础上实施营养干预,可更有效调节PCOS患者激素水平,促进排卵,提高妊娠率。

Objective To investigate the clinical application value of ethinylestradiol cyprogesterone combined with nutritional intervention in the treatment of polycystic ovary syndrome(PCOS)and its effect on AMH and ovulation rate.Methods A total of 110 PCOS patients admitted to the department of Gynecology of Liuzhou Hospital of Traditional Chinese Medicine from June 2018 to March 2020 were prospectively selected and randomly divided into the experimental group(n=55)and the control group(n=55).Both groups were given ethinylestradiol cyprogesterone tablets and basic treatment,while the experimental group was given nutritional intervention treatment.Serum AMH,androgen(T),sex hormone binding albumin(SHBG),luteinizing hormone(LH),follicle-stimulating hormone(FSH)levels,ovarian volume,number of sinus follicles before and after three months treatment,ovulation rate and pregnancy rate after 1 year were compared between the two groups.Results Before treatment,serum levels of AMH,T,SHBG,LH and FSH were not significantly different between the two groups(P>0.05).After three months treatment,the levels of AMH,T and LH in both groups were significantly lower than those before treatment(P<0.05),the level of SHBG was significantly higher than that before treatment(P<0.05),and the level of FSH was not significantly changed(P>0.05).Moreover,the improvement effect of the experimental group was better than that of the control group(P<0.05).Before treatment,there was no significant difference in ovarian volume or number of sinus follicles between the two groups(P>0.05).After three months treatment,the ovarian volume and the number of sinus follicles in both groups were significantly lower than before treatment(P<0.05),and the experimental group was significantly lower than the control group(P<0.05).The ovulation rate and pregnancy rate after 1 year in the experimental group were significantly higher than those in the control group(P<0.05).Conclusion Nutrition intervention on the basis of ethinylestradiol cyprogesterone can more effectively regulate the hormone level of PCOS patients,promote ovulation and improve the pregnancy rate.