枸橼酸氯米芬联合HCG治疗对PCOS患者AMH水平和排卵率的影响

Effect of clomiphene citrate capsule combined with HCG treatment on AMH levels and ovulation rate in patients with PCOS

目的探讨枸橼酸氯米芬联合人绒毛膜促性腺激素(HCG)治疗多囊卵巢综合征(PCOS)疗效及对患者抗缪勒氏管激素(AMH)水平和排卵率的影响。方法选取PCOS患者100例随机等分为对照组和联合组,对照组口服枸橼酸氯米芬胶囊,联合组在此基础上增加HCG干预。比较两组AMH、性激素结合球蛋白(SHBG)、胰岛素抵抗程度、性激素、排卵指标、妊娠指标和安全有效性。结果治疗后两组胰岛素、胰岛素抵抗指数、AMH、黄体生成素、卵泡刺激素不同程度降低,且联合组低于对照组(P<0.05)。治疗后两组SHBG、胰岛素分泌指数、孕酮、雌二醇不同程度升高,且联合组高于对照组(P<0.05)。治疗后联合组排卵率、妊娠率、治疗有效率均高于对照组(P<0.05)。两组不良反应比较差异无显著性(P>0.05)。结论枸橼酸氯米芬联合HCG治疗PCOS,可降低患者血清AMH调节性激素水平,改善卵巢功能,具有临床应用价值。

Aim To explore the efficacy of clomiphene citrate combined with human chorionic gonadotropin(HCG)in the treatment of polycystic ovary syndrome(PCOS)and its effect on the anti-mullerian tube hormone(AMH)level and ovulation rate in patients.Methods 100 cases of PCOS patients were selected and randomly divided into control group and combination group,50 cases in each group.The control group was treated with clomiphene citrate capsule orally,and the observation group was additively treated with HCG intervention.The levels of anti-Muller's tube hormone(AMH),sex hormone binding globulin(SHBG),insulin resistance,serum sex hormone levels,ovulation and pregnancy indexes and safety and efficacy were compared between the two groups.Results After treatment,insulin,insulin resistance index,AMH,luteizing hormone and follicle stimulating were reduced to varying degrees,and the combination group was lower than the control group(P<0.05).After treatment,SHBG,insulin secretion index,progesterone and estradiol increased to different degrees,and the combination group was higher than the control group(P<0.05).The ovulation rate,pregnancy rate and treatment response rate of the combination group were higher than that of the control group(P<0.05).There was no significant difference of adverse reaction between the two groups(P>0.05).Conclusion Clomiphene citrate combined with HCG for PCOS can reduce the serum regulating hormone level of AMH and improve ovarian function,which has clinical application value.