A novel herbal combination ameliorates ovarian dysfunction and regulates altered biochemical parameters in rats with letrozole-induced polycystic ovary syndrome

Objective:To investigate the potential activity of novel herbal combination and novel herbal formulation(syrup)in female Sprague Dawley rats with letrozole-induced polycystic ovary syndrome(PCOS).Methods:Forty-two rats were randomly divided into seven groups with six rats in each group.Group 1 received 0.5%carboxy methylcellulose orally for 37 days and served as the normal control group.Group 2 was orally administered with letrozole of 1 mg/kg for 21 days and served as the PCOS induction group without treatment.Group 3 to 7 were administered with letrozole of 1 mg/kg for 21 days orally to induce PCOS,and then respectively received clomiphene citrate at 1 mg/kg,100 and 200 mg/kg of novel herbal combination,200 mg/kg of novel herbal formulation(syrup),and 400 mg/kg of marketed formulation of Pushyanuga churna,once daily for 15 days.Effects of the novel herbal combination and its syrup formulation were evaluated on the hormonal profile,the levels of antioxidants,the lipid profile and on the ovarian morphology,using letrozole-induced PCOS model in rats.Results:Letrozole caused alterations in hormonal levels and lipid levels similar to PCOS and ovarian histology showed presence of ovarian cysts confirming the induction of PCOS in rats.On treatment with the novel herbal combination and its syrup formulation in PCOS-induced rats,the altered hormonal and lipid profiles showed significant recovery to normal levels.Ovarian histology confirmed the restoration of folliculogenesis in the PCOS-induced rats.The treatment with the syrup formulation of novel herbal combination was found to be more effective than novel herbal combination and showed better recovery in various parameters evaluated.The results of the study,however,suggested that treatment with novel herbal combination and its syrup formulation provided minimal protection against oxidative stress caused due to the induction of PCOS.Conclusions:The integrated approach for management of PCOS is to counterbalance the limitations associated with modern therapy.Both the novel herbal combination and the syrup formulation of novel herbal combination show efficacy in the management of PCOS in rats and restore folliculogenesis in the ovary.The syrup formulation of novel herbal combination is most effective in the management of PCOS and shows potential to be developed as an adjuvant therapeutic agent.

Preliminary study of letrozole use for improving spermatogenesis in non-obstructive azoospermia patients with normal serum FSH

We investigated whether letrozole （2.5 mg day-1） improves sperm count in non-obstructive azoospermia （NOA） patients. Four men were included in this study, and they had folliculo-stimulating hormone and other hormone levels within the normal range and no varicoceles or chromosomal aberrations. These four patients were administered letrozole for 3 months. Sperm count, testicular volume, gonadotropin, testosterone （T） and estradiol （E2） blood levels were assessed before, during and 1 week after the suspension of treatment. All patients showed spermatozoa in their ejaculate, increased gonadotropin and T levels and lower E2 levels （P〈0.05 in all cases）, when letrozole was administered. This suggests that letrozole treatment might improve sperm count in an NOA sub-population; however, more studies, including the proper controls, are needed to confirm its efficacy.

Stability-indicating liquid chromatographic method for the determination of Letrozole in pharmaceutical formulations

A stability-indicating high-performance liquid chromatographic method was developed and validated for the determination of Letrozole in tablet dosage forms. Reversed-phase chromatography was performed on Shimadzu Model LC-Class-Vp with Lichrocart/Lichrosphere 100 C-18 (250 mm 4.6 mm, 5 mm particle size) column with methanol: tetra butyl ammonium hydrogen sulfate (80:20V/V) as mobile phase at a flow rate of 1 mL/min with UV detection at 240 nm. Linearity was observed in the concentration range of 0.5-150 mg/mL (R 2 0.9998) with regression equation y 102582xt43185. The limit of quantitation (LOQ) and limit of detection (LOD) were found to be 0.043 and 0.012 mg/mL respectively. The forced degradation studies were performed by using HCl, NaOH, H 2 O 2 , thermal and UV radiation. Letrozole is more sensitive towards alkaline conditions and very much resistant towards acidic, oxidative and photolytic degradations. The method was validated as per ICH guidelines. The RSD for intra-day (0.78-0.97) and inter-day (0.86-0.96) precision were found to be lesser than 1%. The percentage recovery was in good agreement with the labeled amount in the pharmaceutical formulations and the method is simple, specific, precise and accurate for the determination of Letrozole in pharmaceutical formulations.

Randomized controlled trial of Letrozole versus Clomiphene citrate for induction of ovulation in polycystic ovarian syndrome (PCOS): A Malaysian experience

Background: The purpose of this study was to compare the effectiveness of Letrozole versus Clomiphene citrate for ovulation induction in polycystic ovarian syndrome (PCOS) with infertility. Methods: This was a prospective randomized trial involving 150 women with PCOS attending the Infertility Clinic at three hospitals in Malaysia. During the initial visit, anthropometric measurements and baseline investigations were performed. Patients were randomized to 5.0 mg Letrozole daily (75 patients) or 100 mg Clomiphene citrate daily (75 patients) from the fifth until the ninth day of menstruation. Serial transvaginal scans were performed to see the dominant follicles, endometrial thickness and number of follicles. Transvaginal scans were performed serially to look for evidence of ovulation. Results: The subjects were homogenously distributed. The difference between Letrozole and Clomiphene citrate for ovulation rate was 59 (78.7%) versus 40 (53.3%). Patients taking Letrozole exhibited a mean endometrial thickness (ET) at mid cycle of menses (Day 11-D14) of9.2 mm(SD ± 2.3) versus8.4 mm(SD ± 2.2) for patients taking Clomiphene citrate, and these differences were statistically significant

Crystal Engineering of Co(Ⅱ) Metal-organic Frameworks Based on the Hydrolysis Product of Letrozole and Coligands

The cyanide groups of letrozole(1-[bis(4-cyanophenyl)methyl]-1,2,4-triazole) were hydrolyzed into the carboxylic groups under alkaline conditions. Then the hydrolysis product(1-[bis(4-carboxylphenyl)methyl]-1,2,4-triazole, H2ltzda) reacted with Co(NO3)2·6H2O in the presence of different bipyridl-typed ligands under hydrothermal conditions. As a result, two new Co(Ⅱ) MOFs were obtained, formulated as [Co2(ltzda)2(bpp)2]n(1) and {[Co2(ltzda)2(bpy)]·4H2O}n(2)(bpp = 1,3-di(4-pyridyl)propane, bpy = 4,4’-bipyridine). Two MOFs have been characterized by single-crystal X-ray diffraction, thermogravimetric analysis and magnetic measure. 1 displays a 2D metal-organic framework containing wave layers and 2 shows a pillared-layer structure existing in a 2-fold interpenetrated mode.

Simultaneous Letrozole and Clomiphene Citrate versus Letrozole Alone in Clomiphene Citrate Resistant Polycystic Ovary Syndrome: A Randomised Controlled Trial

Background: Polycystic ovary syndrome (PCOS) is a common cause of anovulatory infertility. The therapeutic strategies for clomiphene citrate (CC)- resistant patients include the addition of corticosteroids, extended duration of clomiphene, gonadotrophin therapy, laparoscopic ovarian drilling, in vitro fertilization or the use of aromatase inhibitors recently. Letrozole decreases estrogen levels in the body, so it releases the hypothalamus and/or pituitary gland from the negative feedback of estrogen. This increases levels of gonadotrophins, which stimulates follicular growth. Objectives: To evaluate the role of letrozole alone and simultaneous use of letrozole and clomiphene citrate (CC) for ovulation induction in patients with clomiphene citrate-resistant PCOS (CCR-PCOS). Patients and Methods: This open-label randomised controlled study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt during the period from February 2018 to June 2019. The study included 60 CCR-PCOS patients who were randomly allocated by independent personnel into two arms: group A (letrozole alone) or B (letrozole + CC). In either group, monitoring the mean follicular diameter and endometrial thickness in the days 10, 12, and 14 of the cycle by transvaginal ultrasound and Measurement of serum Progesterone (ng/ml) 7 days after the expected time of ovulation. Results: We investigated various clinical and sonographic factors that may predict the outcome of the method of induction of ovulation in CCR-PCOS with no significant affection for the results. There was a non-significant difference between the studied groups regarding ovulation and pregnancy per cycle or per patient. Conclusion: Letrozole alone or simultaneous use of letrozole and CC offers a good second-line option for induction of ovulation in CCR-PCOS patients. However, the combination of CC and letrozole did not add any benefit over the use of letrozole alone regards ovulation rate, follicular volume, endometrial thickness, pregnancy rate and live birth rate.

Short-term Femara (letrozole) treatment and suppression of Ki67 expression in postmenopausal endometrial carcinoma

Objective: To determine if short-term treatment with Femara (letrozole) induces measurable reduction in tumor Ki67 expression in postmenopausal women with FIGO grade 1 and 2 endometrial carcinoma. Methods: In this non-randomized prospective study, 12 patients were given Femara (letrozole) 2.5 mg daily for approximately 3 weeks prior to planned hysterectomy for FIGO grade 1 or 2 endometrial carcinoma. A group of 12 demographically similar patients were enrolled as no-treatment controls. Ki67 expression in tumor cells was quantitated by immunohistochemistry with mechanical scanning within the initial endometrial biopsy and compared to that in the hysterectomy specimen for each patient in the treatment and control groups. Results: The treatment and control groups were similar in age, tumor grade and FIGO stage. When “aromatase inhibitor responsiveness” was defined as proportionate decline in Ki67% stained tumor cells of at least 70% between the pre-treatment endometrial biopsy and post-treatment hysterectomy specimens, 5 of 12 patients were found to be “responsive” in the treatment group with none of the controls fulfilling these criteria. Conclusion: Femara (letrozole) 2.5 mg daily for approximately 3 weeks induced a significant reduction in tumor cell Ki67 expression among 5 of 12 (41%) postmenopausal women with FIGO grade 1 or 2 endometrial carcinoma. We postulate that Ki67 may be a useful marker during aromatase inhibitor medical treatment of patients with endometrial cancer who are not candidates for surgical treatment.

SPE-UPLC-MS/MS assay for determination of letrozole in human plasma and its application to bioequivalence study in healthy postmenopausal Indian women

A rapid and sensitive ultra performance liquid chromatography-tandem mass spectrometry（UPLC-MS/MS） method is described for determination of letrozole in human plasma.Following solid phase extraction（SPE） of letrozole and letrozole-d4 on Orochem DVB-LP cartridges,chromatography was performed on Acquity UPLC BEH C_（18）（50 mm × 2.1 mm.1.7 μm） column using methanol-0.1%formic acid in water（85：15,v/v） as the mobile phase.Detection was carried out on a triple quadrupole mass spectrometer with an electrospray source,operated under positive ionization mode.Quantitation of letrozole and letrozole-d4 was done using multiple reaction monitoring（MRM） following the transitions at m/z286.2→217.0 and m/z 290.2→221.0,respectively.The calibration plots were linear through the concentration range of 0.10-100 ng/mL（r^2 ≥ 0.9990） using 100 μL human plasma.The extraction recovery of letrozole ranged from 94.3%to 96.2%and the intra-batch and inter-batch precision was ≤ 5.2%.The method was successfully applied to a bioequivalence study of letrozole after oral administration of2.5 mg tablet formulation to 16 healthy postmenopausal Indian women.The assay reproducibility was also established through incurred sample reanalysis（ISR） of 74 subject samples.

Combined effects of Gymnema sylvestre and Pergularia daemia on letrozole-induced polycystic ovarian syndrome in rats

Objective:To investigate the combined therapeutic potential of Gymnema(G.)sylvestre and Pergularia(P.)daemia on letrozole-induced polycystic ovarian syndrome(PCOS)in rats.Methods:Thirty six healthy female Wistar rats with regular estrus cycles were randomly divided into six groups each of 6.GroupⅠreceived 1 mL of 0.5%carboxyl methyl cellulose orally and served as the vehicle control group,while groupsⅡtoⅥwere treated with letrozole(1 mg/kg body weight p.o.)for 21 days to induce PCOS.After induction of PCOS,groupⅡserved as the PCOS control group,without treatment;groupⅢreceived metformin(20 mg/kg body weight p.o.)as the standard group,and groupsⅣtoⅥreceived G.sylvestre(100 mg/kg body weight p.o.),P.daemia(300 mg/kg body weight p.o.),and the combination of G.sylvestre and P.daemia,respectively,for 28 days.Vaginal smears were collected from all rats daily throughout the study to determine the phases of the estrus cycle.After completing the treatment schedule,oral glucose tolerance test,serum lipid profile and reproductive hormonal analysis were carried out.Subsequently,the rats were sacrificed to collect ovary and uterus for histopathological examination.Results:The PCOS control rats showed a significant irregularity in the estrus cycle,hyperglycemia,and the altered serum lipid profile such as the increased low and very low density lipoprotein,triglyceride,and decreased high density lipoproteins.In addition,the PCOS control rats showed a significant increase in serum luteinizing hormone,testosterone,and estrogen,and decrease in follicle stimulating hormone and progesterone.These changes were significantly revoked in all the treatment groups.The test drugs also significantly reduced the gained ovary weight(P<0.001),and histopathology of the ovary showed almost normal ovary.Among the treatment groups,the group of combination treatment of G.sylvestre and P.daemia showed superior ameliorative results in PCOS parameters.Conclusions:Combination of G.sylvestre and P.daemia presents potent synergistic activity against hyperandrogenism,hyperinsulinemia,anovulation and follicular cysts in letrozole-induced PCOS rats.

Protective and therapeutic effect of protocatechuic acid in assessment of letrozole- induced polycystic ovary syndrome in rats

Objective:To investigate the potential activity of protocatechuic acid in female Wistar rats with letrozole-induced polycystic ovary syndrome(PCOS).Methods:Thirty rats were divided into five groups of six each.Group 1 received 0.5%carboxy methyl cellulose orally and served as the normal control group;group 2 was treated orally with 1 mg/kg of letrozole daily for 21 days and served as the PCOS induced group;group 3 was orally administered with letrozole of 1 mg/kg for 21 days and further administered with standard drug of clomiphene citrate at a dose of 1 mg/kg body weight in 0.5%carboxy methyl cellulose per oral and served as the standard group;groups 4 and 5 were administered with letrozole of 1 mg/kg for 21 days and further treated with protocatechuic acid orally at low dose of 5 mg/kg body weight and high dose of 15 mg/kg body weight respectively for 15 days.At the end of the study period,rats were subjected for the estimation of invasive blood pressure and heart rate,biochemical estimations and antioxidant assay.In addition,ovarian histomorphology was examined.Results:The PCOS was confirmed in the letrozole induced rats with increased concentration of androgen,abnormal lipid levels,glucose,glycosylated haemoglobin and also depletion of antioxidants.After protocatechuic acid treatment,the increased levels of testosterone due to induction of PCOS were restored to normal levels.Additionally,there was a consistent decrease in luteinizing hormone and follicle stimulating hormone levels in the treatment groups,followed by decrease in the number of cysts after treatment with protocatechuic acid.Histopathological observations showed a remarkable recovery of the ovarian tissue and the presence of normalized structure of antral follicle.Protocatechuic acid treatment restored all the parameters to normalcy and abolished cysts formation in ovaries of female rats.Conclusions:Protocatechuic acid shows potential protective effects in letrozole-induced PCOS rats.The protective effect is comparable to that of clomiphene citrate and thus shows its potential in the treatment of PCOS.

Letrozole versus Gonadotropin in Unexplained Infertile Couples Failed to Conceive with Clomiphene Citrate

Background:?Unexplained infertility represents about 15% - 20% of infertile couples. Usually, these cases need assistance. Clomiphene citrate is the most used drug for this problem but sometimes pregnancy failed to achieve it, so other options for assistance are gonadotrophin or letrezole. The objective of our study was to compare the pregnancy rate for letrezole and gonadotropin inunexplained infertile women’s who failed to conceive with clomiphene citrate. Methods: This prospective quasi-randomized trial was carried out in cytogenetic unite at obstetrics and gynecology department, Zagazig University Hospital. 140 infertile females were included, induction of ovulation by letrozole for half of them and by gonadotrophin for the other half. Results: There was statistically highly significant decrease in duration of stimulation, E2 levels and endometrial thickness at day of HCG in letrezole group, no significant difference between two groups as regard number of follicles and pregnancy rate per cycle, while the cumulative pregnancy rate and the cost of stimulation are significantly higher in gonadotrophin group. Conclusion: In patient with unexplained infertility who failed to conceive with clomiphene citrate, gonadotrophins have a higher pregnancy rate than letrezole. However, pregnancy rate was high enough with lower cost with letrezole to be acceptable and justified its use in this group of patients.

Best time for progesterone supplementation in aid ovulation induction cycles by letrozole

Objective:To explore the best time for progesterone supplementation in AID ovulation induction cycles by Letrozole.Methods: The data analysed in this study were collected from 509 patients who were performed AID (Artificial Insemination by Donor) administrated letrozole (LE) between 2014.8-2015.7. All patients were randomly divided into 4 groups by the time of progesterone administrated, including experimental group and the control group. The experimental group was divided into group 1-72 h after ovulation, group 2-48 h after ovulation, group 3-24 h after ovulation and control group—without administrated LE. The gestation and live birth rate were evaluated by monitoring vaginal ultrasound and HCG blood value 14 d after AID.Results: The pregnancy rate with administrated progesterone added 72 h after ovulation was 31.9%, which was significantly higher than those of other groups, the same situation as groups added progesterone was significantly higher than the control group. However, there was no significant difference in the numbers of abortions among the four groups. The LBR of group 4 was significantly lower than that of group 1.Conclutions: Progesterone administrated 72 h after ovulation can promoted the gestation rate, but did not affect the rate of miscarrage .

Letrozole可改善体外受精的结果

据西班牙研究人员报道，对卵巢过度刺激反应较差的患者利用芳香酶抑制剂letrozole进行辅助治疗可增加体外受精（IVF）的成功率。

Letrozole可更有效地降低乳腺癌的复发风险

据近期出版的《新英格兰医学杂志》（NEJM）刊登的IBSCG研究结果显示，letrozole与它莫西芬相比可更有效地降低乳腺癌幸存者复发的风险。研究证实letrozole有助于阻止乳腺癌向身体其他部位的扩散，复发高危女性可从letrozole中获益。

来曲唑片在男性患者中超说明书用药点评及循证评价

目的:调查我院男性患者使用来曲唑片超说明书用药现状并进行循证评价,促进来曲唑等芳香化酶抑制剂在男性患者中的合理应用。方法:抽取我院2017年8月~2022年8月内男性患者使用来曲唑的处方153张,对超说明书用药类型进行分类,并按照《药品超说明书使用循证评价》中证据推荐意见对评价结果进行分级。结果:超适应证用药、超适用人群用药以及超剂量和频次给药占比分别为90.51%、6.33%和3.16%;对超说明书用药11种逐一进行循证评价,其中A级、B级、C级、不推荐的分别为1、2、2、6种。结论:来曲唑治疗男性乳腺癌、男性不育、男性性腺功能低下有一定疗效。精索静脉曲张、无精子症和男性乳房发育,不推荐常规使用,无替代方案时可以考虑选择。前列腺炎/前列腺肥大/附睾炎、阴茎海绵体硬结症、男性勃起障碍、雌激素分泌过多症,不推荐使用。

黄颡鱼XX伪雄鱼制备与全雌种群规模化繁育

研究以XX遗传型全雌黄颡鱼(Tachysurus fulvidraco)群体为实验材料,利用加氢甲基睾酮(17α-methyldihydrotestosterone,MDHT)和来曲唑(Letrozole,LZ)对性别分化关键时期(12-60日龄)黄颡鱼幼鱼进行投喂处理,设置MH组(50 mg/kg MDHT)、ML组(10 mg/kg MDHT)、MH+L组(50 mg/kg MDHT,1000 mg/kg LZ)、ML+L组(10 mg/kg MDHT,1000 mg/kg LZ)及对照CR组(0 MDHT,0 LZ)。结果显示,ML组和ML+L组雄性化个体比例较高,分别为66.7%和83.3%,其性腺类型包括间性性腺(37.5%和50.0%)和全精巢性腺(29.2%和33.3%),且两组中均获得了43.8%的功能性XX伪雄鱼。以XX伪雄鱼为父本、以经多代选育的全雌黄颡鱼为母本,进行规模化人工繁殖,获得了280万尾XX遗传型黄颡鱼苗种。在92日龄时发现,在室外池塘养殖条件下,98.0%的个体卵巢发育良好,2.0%的个体性逆转为非功能性XX伪雄鱼。研究建立了一套黄颡鱼全雌种群规模化繁育技术体系,为黄颡鱼规模化人工繁育与遗传改良、黄颡鱼产业健康可持续发展提供保障。

Effectiveness of co-treatment with traditional Chinese medicine and letrozole for polycystic ovary syndrome:a meta-analysis

BACKGROUND： Polycystic ovary syndrome （PCOS） is an endocrine disease that affects gynecologica health. Treatment of PCOS remains a big challenge for clinicians. OBJECTIVE： This meta-analysis was developed to compare the efficacy of co-treatment with traditiona Chinese medicine （TCM） and letrozole against letrozole monotherapy in the treatment of PCOS. SEARCH STRATEGY： Randomized controlled trials （RCTs） were electronically retrieved from PubMed, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang Data; related papers that were not available electronically were manually checked. All papers were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and the valid data were analyzed using Revman software （The Cochrane Collaboration, Copenhagen, Denmark） INCLUSION CRITERIA： We included RCTs that compared co-treatment with TCM and letrozole against letrozole monotherapy in women with PCOS, which was defined by anovulation, biochemical or clinical hyperandrogenemia and polycystic ovaries. We included trials from all sources. DATA EXTRACTION AND ANALYSIS： Two independent reviewers extracted data, and evaluated study quality according to the Cochrane Handbook for Systematic Reviews of Interventions criteria for RCT, including issues of patient randomization, blinding and bias. RESULTS： Eight RCTs, involving a total of 537 patients, were included in the present study. The meta-analysis showed that the cycle ovulation rate, the pregnancy rate and the total effective rate of symptom treatment were higher in treatments combining TCM with letrozole, compared with letrozole monotherapy. Although the rate of luteinizing hormone （LH）/follicle-stimulating hormone （FSH） and the body mass index of the group receiving combined therapy were lower than in letrozole monotherapy, no statistical difference was found in the LH and FSH level between the two groups. CONCLUSION： Available evidence showed that co-treatment with TCM and letrozole was more effective than letrozole monotherapy in the treatment of PCOS.

补肾化痰汤联合来曲唑治疗多囊卵巢综合征临床研究

目的:探讨补肾化痰汤联合来曲唑治疗多囊卵巢综合征的效果及对患者成纤维细胞生长因子21(FGF-21)、生长激素释放肽(Ghrelin)及内分泌的影响。方法:选择200例多囊卵巢综合征患者,采用随机数字表法分为试验组和对照组,各100例。对照组给予来曲唑治疗,试验组在对照组的基础上给予补肾化痰汤治疗。比较两组临床疗效、FGF-21、Ghrelin、内分泌、卵巢功能变化情况及不良反应发生情况。结果:治疗后,两组总有效率比较差异有统计学意义(P<0.05);治疗后,两组FGF-21水平均降低,试验组降低更为明显,Ghrelin水平均升高,试验组升高更为明显(P<0.05);治疗后,两组促黄体生成素(LH)水平均降低,试验组降低更为明显,卵泡雌激素(FSH)、雌二醇(E2)水平均升高,试验组升高更为明显(P<0.05);治疗后,两组卵巢体积、卵泡个数及阻力指数水平均降低,试验组降低更为明显,搏动指数水平均升高,试验组升高更为明显(P<0.05);治疗期间,不良反应主要有恶心呕吐、腹部不适及月经量增多,两组发生率比较差异无统计学意义(P>0.05)。结论:在多囊卵巢综合征中应用补肾化痰汤联合来曲唑效果显著,可能与其可有效改善患者FGF-21、Ghrelin及内分泌水平有关。

桂枝茯苓丸加味联合来曲唑治疗多囊卵巢综合征所致不孕症临床研究

目的:观察桂枝茯苓丸加味联合来曲唑治疗肾虚血瘀型多囊卵巢综合征所致不孕症的临床疗效。方法:选取96例多囊卵巢综合征所致不孕症肾虚血瘀证患者,按随机数字表法分为对照组和观察组,每组48例。对照组予以来曲唑片治疗,观察组在对照组基础上予以桂枝茯苓丸加味治疗。1个月经周期为1个疗程,2组均治疗3个疗程。比较2组临床疗效、性激素指标、凝血指标、脂代谢指标及不良反应发生率。结果:治疗后随访1年,观察组总有效率95.83%,高于对照组81.25%(P<0.05)。治疗后,2组黄体生成素(LH)/卵泡刺激素(FSH)值及血清LH、睾酮(T)、纤维蛋白原(FIB)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)水平均较治疗前降低(P<0.05),观察组LH/FSH值及血清LH、T、FIB、TC、LDL-C、TG水平均低于对照组(P<0.05)。2组血清凝血酶时间(PT)、凝血酶原时间(TT)均较治疗前增加(P<0.05),观察组血清PT、TT均长于对照组(P<0.05)。2组血清高密度脂蛋白胆固醇(HDL-C)水平均较治疗前升高(P<0.05),观察组血清HDL-C水平高于对照组(P<0.05)。观察组不良反应发生率8.33%,与对照组12.50%比较,差异无统计学意义(P>0.05)。结论:桂枝茯苓丸加味联合来曲唑治疗肾虚血瘀型多囊卵巢综合征所致不孕症疗效确切,能纠正性激素紊乱,改善凝血及脂代谢指标,安全性好。