不同预处理联合促排卵治疗肥胖型多囊卵巢综合征的临床研究

Clinical study of different pretreatments combined with ovulation promotion in the treatment of obese polycystic ovary syndrome

目的探究不同预处理联合促排卵治疗肥胖型多囊卵巢综合征(PCOS)的应用价值。方法选取2019年1月至2021年5月我院122例肥胖型PCOS患者,随机数字表法分组,各61例。2组均采取促排卵治疗(达英-35、奥利司他胶囊、克罗米芬),二甲双胍组采取二甲双胍,肌醇组采取肌醇,连续治疗3个周期。统计2组促排卵效果、妊娠结局、不良反应及预处理前、预处理后体质量指数(BMI)、脂代谢指标、性激素水平、氧化损伤指标。结果预处理后2组BMI、HOMA-IR、LH、FSH低于预处理前(P<0.05),预处理后肌醇组TC、TG低于二甲双胍组(P<0.05);预处理后肌醇组MDA、8-iso-PGF2α水平低于二甲双胍组,TAS水平高于二甲双胍组(P<0.05);2组排卵率、优势卵泡个数、妊娠率、流产率及异位妊娠率比较,差异无统计学意义(P>0.05);肌醇组不良反应发生率1.64%低于二甲双胍组(14.75%,P<0.05)。结论肌醇、二甲双胍联合促排卵治疗肥胖型PCOS效果相当,前者可有效纠正脂代谢紊乱、减轻氧化应激、减少不良反应发生。

Objective To explore the application value of different pretreatments combined with ovulation stimulation in the treatment of obese polycystic ovary syndrome(polycystic ovarian syndrome,PCOS).Methods A total of 122 obese patients with PCOS in our hospital from January 2019 to May 2021 were selected and randomly divided into groups,61 cases in each group.Both groups were treated with ovulation induction therapy(Diane-35,orlistat capsules,Clomifene Citrate Capsules),metformin group was treated with metformin,and inositol group was treated with inositol for 3 consecutive cycles.The effects of ovulation induction,pregnancy outcomes,adverse reactions,and body mass index(body mass index,BMI),lipid metabolism indexes,sex hormone levels,and oxidative damage indexes before and after pretreatment were counted in the two groups.Results The BMI,HOMA-IR,LH,and FSH of the two groups after pretreatment were lower than those before pretreatment(P<0.05),and the TC and TG in the inositol group after pretreatment were lower than those in the metformin group(P<0.05).After pretreatment,the levels of MDA and 8-iso-PGF2αin the inositol group were lower than those in the metformin group,and the levels of TAS were higher than those in the metformin group(P<0.05).The ovulation rate,number of dominant follicles,pregnancy rate,abortion rate and There was no significant difference in the rate of ectopic pregnancy(P>0.05).The incidence of adverse reactions in the inositol group was 1.64%lower than that in the metformin group(14.75%,P<0.05).Conclusion Inositol and metformin combined with ovulation induction have similar effects in the treatment of obese PCOS.The former can effectively correct lipid metabolism disorders,reduce oxidative stress,and reduce adverse reactions.