雌二醇片/雌二醇地屈孕酮片复合包装治疗卵巢功能下降及卵巢早衰患者的临床效果观察

Observation on the clinical effect of complex packing estradiol tablets/estradiol and dydrogesterone tablets in patients with diminished ovarian reserve and premature ovarian failure

目的分析对卵巢功能下降及卵巢早衰患者开展雌二醇片/雌二醇地屈孕酮片复合包装治疗的临床价值。方法取300例卵巢功能下降及卵巢早衰患者为此次试验研究对象,按照治疗方案不同作分组处理,分为对照组(n=150)、研究组(n=150)。对照组行激素替代治疗,研究组行雌二醇片/雌二醇地屈孕酮片复合包装治疗。比较两组患者的治疗效果、不良反应发生率、治疗前后性激素指标[雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)、孕酮(P)]、卵巢彩超检查结果指标(卵巢直径、子宫内膜厚度、窦卵泡数)、卵巢动脉血流指标[卵巢间质动脉的收缩期峰值流速(PSV)、阻力指数(RI)、搏动指数(PI)]。结果研究组治疗总有效率90.67%高于对照组的80.67%,差异明显(P<0.05)。两组不良反应发生率对比,差异不显著(P>0.05)。治疗后,两组患者LH、FSH较治疗前下降,P、E_(2)较治疗前升高,且研究组LH(15.21±1.34)IU/L、FSH(21.18±1.52)IU/L低于对照组的(18.42±1.31)、(26.01±1.45)IU/L,P(35.73±4.11)nmol/L、E_(2)(62.35±3.54)pmol/L高于对照组的(27.56±4.24)nmol/L、(51.24±4.05)pmol/L,差异显著(P<0.05)。较治疗前,治疗后两组患者的卵巢直径增大、子宫内膜厚度增厚、窦卵泡数增多,且研究组卵巢直径(20.43±1.87)mm大于对照组的(18.21±1.75)mm、子宫内膜厚度(7.54±0.62)mm厚于对照组的(5.12±0.52)mm、窦卵泡数(2.71±0.21)个多于对照组的(1.82±0.13)个,差异显著(P<0.05)。治疗后,两组患者PSV较治疗前升高,RI、PI较治疗前下降,且研究组PSV(18.24±1.89)cm/s高于对照组的(16.23±2.24)cm/s,RI(0.66±0.11)、PI(1.48±0.29)低于对照组的(0.71±0.14)、(1.64±0.23),差异显著(P<0.05)。结论对卵巢功能下降及卵巢早衰患者开展雌二醇片/雌二醇地屈孕酮片复合包装治疗,治疗总有效率更高,同时可改善患者的性激素、卵巢动脉血流以及卵巢状况。

Objective To analyze the clinical value of complex packing estradiol tablets/estradiol and dydrogesterone tablets in patients with diminished ovarian reserve and premature ovarian failure.Methods 300 patients with diminished ovarian reserve and premature ovarian failure were studied and divided into a control group(n=150)and a study group(n=150)according to different therapeutic schemes.The patients in the control group were treated with hormone replacement therapy,and those in the study group were treated with complex packing estradiol tablets/estradiol and dydrogesterone tablets.Patients in both groups were compared in terms of the therapeutic effect,the incidence of adverse reaction,the indexes of sex hormone[estradiol(E_(2)),luteinizing hormone(LH),follicle stimulating hormone(FSH),progesterone(P)],the results of ovarian color ultrasound(ovarian diameter,endometrial thickness,number of antral follicle)and the indexes of ovarian artery blood flow[peak systolic velocity(PSV),resistance index(RI),pulsation index(PI)of ovarian interstitial artery]before and after treatment.Results The total effective rate of the study group was 90.67%,which was higher than 80.67%of the control group,and the difference was significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,LH and FSH decreased and P and E_(2)increased in both groups compared with those before treatment;the study group had LH of(15.21±1.34)IU/L and FSH of(21.18±1.52)IU/L,which were lower than(18.42±1.31)and(26.01±1.45)IU/L in the control group;the study group had P of(35.73±4.11)nmol/L and E_(2)of(62.35±3.54)pmol/L,which were higher than(27.56±4.24)nmol/L and(51.24±4.05)pmol/L in the control group;the difference was significant(P<0.05).After treatment,the ovarian diameter increased,endometrial thickness thickened,and the number of antral follicles increased in both groups;in the study group,the ovarian diameter of(20.43±1.87)mm was greater than(18.21±1.75)mm in the control group,the endometrial thickness of(7.54±0.62)mm was thicker than(5.12±0.52)mm in the control group,and the number of antral follicles of(2.71±0.21)was more than(1.82±0.13)in the control group.The difference was significant(P<0.05).After treatment,PSV in both groups was higher than than before treatment,and RI and PI were lower than those before treatment;the study group had higher PSV of(18.24±1.89)cm/s than(16.23±2.24)cm/s in the control group;the study group had RI of(0.66±0.11)and PI of(1.48±0.29),which were lower than(0.71±0.14)and(1.64±0.23)in the control group;the difference was significant(P<0.05).Conclusion Complex packing estradiol tablets/estradiol and dydrogesterone tablets for diminished ovarian reserve and premature ovarian failure is more effective,at the same time can improve the patient's sex hormones,ovarian artery blood flow and ovarian status.