二甲双胍联合克罗米芬治疗多囊卵巢综合征临床疗效效果观察

发布时间：2018-05-05 12:37

本文选题：二甲双胍 + 克罗米芬　；参考：《山东医药》2016年46期

【摘要】：目的探讨二甲双胍联合克罗米芬治疗多囊卵巢综合征(PCOS)临床疗效,并观察其对患者血清指标的改善作用。方法回顾性分析63例PCOS患者的治疗情况,其中32例仅以克罗米芬治疗者为对照组,另31例采用克罗米芬与二甲双胍治疗者作为观察组。治疗前后,测算两组患者BMI、腰围臀围比(WHR),检测血清性激素及正性激素结合蛋白(SHBG)、硫酸脱氢表雄酮(DHEAS)水平变化,采用B超监测两组患者卵泡发育及妊娠情况。结果两组患者治疗后BMI较治疗前下降,且观察组BMI低于对照组(P0.05)。观察组治疗后黄体生成素(LH)及睾酮(T)水平较治疗前下降,对照组治疗后T水平较治疗前下降,且观察组治疗后LH及T水平均低于对照组(P0.05)。两组患者SHBG水平较治疗前明显升高,而DHEAS水平较治疗前明显下降,且观察组SHBG水平升高程度及DHEAS水平下降程度均优于对照组(P均0.05)。观察组HCG日内膜厚度和HCG日优势卵泡个数分别为(12.10±1.39)mm、(1.1±0.7)个,与对照组(8.06±1.22)mm、(2.3±0.9)个相比,P均0.05;观察组单卵泡排卵率、排卵率及妊娠率分别为74.2%、80.6%、38.7%,对照组分别为31.3%、56.3%、12.5%,观察组单卵泡排卵率、排卵率及妊娠率均高于对照组(P均0.05)。结论二甲双胍联合克罗米芬治疗PCOS可促进排卵、提高妊娠率,与其降低患者BMI及改善性激素水平有关。
[Abstract]:Objective to investigate the clinical efficacy of metformin combined with clomiphene in the treatment of polycystic ovary syndrome (PCOS) and to observe its effect on the improvement of serum index. Methods 63 patients with PCOS were treated with clomiphene as control group (n = 32) and control group (n = 31) treated with clomiphene and metformin respectively. Before and after treatment, the BMIs, waist circumference to hip ratio (WHR), serum sex hormone and positive hormone binding protein (SHBGN), and dehydroepiandrosterone sulfate (DHEASS) levels were measured. Follicular development and pregnancy were monitored by B-ultrasound. Results the BMI of the two groups was lower than that of the control group, and the BMI of the observation group was lower than that of the control group (P 0.05). After treatment, the levels of luteinizing hormone (LHH) and testosterone (T) in the observation group were lower than those in the control group, and the levels of LH and T in the control group were lower than those in the control group (P 0.05). The levels of SHBG and DHEAS in the two groups were significantly higher than those before treatment, and the SHBG level and the DHEAS level in the observation group were significantly lower than those in the control group (P < 0.05). The thickness of HCG intima and the number of dominant follicles per day of HCG were 12.10 卤1.39mm and 1.1 卤0.7, respectively, compared with those of control group (8.06 卤1.22) and 2.3 卤0.9, respectively (P < 0.05). The ovulation rate, ovulation rate and pregnancy rate of single follicle in observation group were 74.280.6 and 38.7respectively, and those in control group were 31.36.30.The ovulation rate of single follicle in observation group was 56.35.The ovulation rate of single follicle in observation group was 38.7. The ovulation rate and pregnancy rate were higher than those in the control group (P < 0.05). Conclusion Metformin combined with clomiphene can improve ovulation and pregnancy rate in patients with PCOS, which is related to the decrease of BMI and the improvement of sex hormone level.
【作者单位】：安顺市人民医院;贵航集团三0二医院;
【分类号】：R711.75

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