二甲双胍联合克罗米芬治疗多囊卵巢综合征并不孕症的临床效果及对胰岛功能的影响

Clinical effect of metformin combined with clomiphene in the treatment of polycystic ovary syndrome complicated with infertility and its influence on islet function

目的探讨二甲双胍联合克罗米芬治疗多囊卵巢综合征(PCOS)合并不孕症的临床效果及对胰岛功能的影响。方法选择2018年1月至2019年12月于我院就诊的80例PCOS合并不孕症患者为研究对象,按照随机数字表法将其分为对照组和观察组,各40例。对照组给予克罗米芬治疗,观察组给予克罗米芬+二甲双胍治疗,比较两组的治疗效果、排卵率、子宫内膜厚度、性激素指标、血脂指标、胰岛功能指标及生活质量。结果观察组的治疗总有效率、排卵率高于对照组(P<0.05)。治疗后,两组的子宫内膜厚度减小,雌二醇水平升高,促黄体生成素、促卵泡激素水平降低,且观察组优于对照组(P<0.05)。治疗后,两组的TC、TG、LDL-C、空腹胰岛素水平及胰岛素抵抗指数均显著降低,且观察组低于对照组(P<0.05)。治疗后,两组的生活质量各项评分均升高,且观察组高于对照组(P<0.05)。结论二甲双胍与克罗米芬联合治疗PCOS合并不孕症的效果显著,可有效减轻机体胰岛素抵抗,改善性激素分泌状况,降低血脂水平,促进排卵,提升患者的生活质量。

Objective To investigate the clinical effect of metformin combined with clomiphene in the treatment of polycystic ovary syndrome(PCOS)complicated with infertility and its influence on islet function.Methods A total of 80 PCOS patients complicated with infertility admitted in our hospital from January 2018 to December 2019 were selected as the research objects and divided into control group and observation group according to the random number table method,with 40 cases in each group.The control group was treated with clomiphene,and the observation group was treated with clomiphene+metformin.The treatment effect,ovulation rate,endometrial thickness,sex hormone indexes,blood lipid indexes,islet function indexes and quality of life were compared between the two groups.Results The total effective rate of treatment and ovulation rate in the observation group were higher than those in the control group(P<0.05).After treatment,the endometrial thickness decreased,the level of estradiol increased,the levels of luteinizing hormone and follicle stimulating hormone decreased in both groups,and those in the observation group were better than the control group(P<0.05).After treatment,the levels of TC,TG,LDL-C,fasting insulin and insulin resistance index in both groups significantly decreased,and those in the observation group were lower than the control group(P<0.05).After treatment,the quality of life scores in both groups improved,and those in the observation group were higher than the control group(P<0.05).Conclusion Metformin combined with clomiphene in the treatment of PCOS complicated with infertility has a significant effect,which can effectively reduce insulin resistance,improve the secretion of sex hormones,reduce the level of blood lipids,promote ovulation,and improve the quality of life of patients.