戊酸雌二醇片联合二甲双胍治疗多囊卵巢综合征不孕症的临床效果

Clinical Effects of Estradiol Valerate Tablets Combined with Metformin in the Treatment of Infertility in Polycystic Ovary Syndrome

目的:探究戊酸雌二醇片联合二甲双胍治疗多囊卵巢综合征(PCOS)的临床效果。方法:选择2020年1月—2021年12月淄博市中心医院收治的多囊卵巢综合征患者80例,应用随机数字表法将其分为对照组(戊酸雌二醇片)及观察组(戊酸雌二醇片+二甲双胍),各40例,对比两组临床指标(卵泡排出时间、优势卵泡数量、子宫内膜厚度、妊娠率)、治疗总有效率、性激素[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_(2))]水平、胰岛素样生长因子结合蛋白-1(IGFBP-1)、白细胞介素-18(IL-18)、白细胞介素-10(IL-10)、内皮素(ET)、晚期氧化蛋白产物(AOPP)、谷胱甘肽过氧化物酶(GSH-Px)、γ干扰素诱导蛋白-10(IP-10)、热休克蛋白90(HSP90)。结果:观察组卵泡排出时间、优势卵泡数量、子宫内膜厚度、妊娠率均优于对照组,差异均有统计学意义(P<0.05)。对照组治疗总有效率低于观察组,差异有统计学意义(P<0.05)。治疗前,两组LH、FSH、E_(2)差异均无统计学意义(P>0.05);治疗后,两组LH、FSH均降低,E_(2)均升高,观察组均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组IGFBP-1、IL-18、IL-10、ET差异均无统计学意义(P>0.05);治疗后,两组IL-18、ET均降低、IGFBP-1、IL-10均升高,观察组均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组AOPP、GSH-Px、IP-10、HSP90差异均无统计学意义(P>0.05);治疗后,两组AOPP、IP-10、HSP90均降低,GSH-Px升高,观察组均优于对照组,差异均有统计学意义(P<0.05)。结论:PCOS不孕患者采用戊酸雌二醇片联合二甲双胍治疗,效果显著,可改善患者性激素水平,减轻炎症反应、应激损伤,调节IP-10、HSP90水平,提高妊娠率。

Objective:To investigate the clinical effect of Estradiol Valerate Tablets combined with Metformin in the treatment of polycystic ovary syndrome(PCOS).Method:A total of 80 patients with PCOS admitted to Zibo Central Hospital from January 2020 to December 2021 were selected and divided into 40 cases each in the control group(Estradiol Valerate Tablets)and the observation group(Estradiol Valerate Tablets+Metformin)by applying the random number table method,and the two groups were compared in terms of clinical indicators(follicular discharge time,number of dominant follicles,endometrial thickness,pregnancy rate),total treatment efficiency,sex hormone[luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E_(2))]levels,insulin-like growth factor-binding protein-1(IGFBP-1),interleukin-18(IL-18),interleukin-10(IL-10),endothelin(ET),advanced oxidative protein products(AOPP),glutathione peroxidase(GSH-Px),interferonγ-inducible protein-10(IP-10),and heat shock protein 90(HSP90).Result:The follicular discharge time,the number of dominant follicles,the endometrial thickness,and the pregnancy rate of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the control group was lower than that in the observation group,the difference was statistically significant(P<0.05).Before treatment,the differences in LH,FSH and E_(2) between the two groups were not statistically significant(P>0.05);after treatment,LH and FSH decreased and E_(2) increased in both groups,and the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Before treatment,the differences of IGFBP-1,IL-18,IL-10 and ET between the two groups were not statistically significant(P>0.05);after treatment,IL-18 and ET were reduced and IGFBP-1 and IL-10 were elevated in both groups,and the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Before treatment,the differences of AOPP,GSH-Px,IP-10 and HSP90 between the two groups were not statistically significant(P>0.05);after treatment,AOPP,IP-10 and HSP90 were reduced and GSH-Px was elevated in both groups,and the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The treatment of PCOS infertile patients with Estradiol Valerate Tablets combined with Metformin is effective,which can improve the patients'sex hormone level,reduce inflammatory response and stress injury,regulate IP-10 and HSP90 levels,and improve the pregnancy rate.