单药或联合用药对多囊卵巢综合征促排卵效果的对照研究  

On the ovulation effects in patients with polycystic ovary syndrome that one drug or in combination with others have

作　　者：卢姗[1] 马向华[1] 沈捷[1] 

机构地区：[1]南京医科大学第一附属医院内分泌科,南京医学硕士研究生210029

出　　处：《医学研究生学报》2011年第3期263-267,共5页Journal of Medical Postgraduates

基　　金：江苏省卫生重点学科基金(XK200701)

摘　　要：目的针对多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的胰岛素抵抗、高雄激素血症,用胰岛素增敏剂二甲双胍及盐酸吡格列酮联合避孕药炔雌醇环丙孕酮片对治疗效果进行评估,观察单独及联合用药对促排卵的疗效。方法回顾性分析171例具有胰岛素抵抗的PCOS患者,随机分为对照组和实验组,对照组34例,使用炔雌醇环丙孕酮片治疗。实验组分为4组:A组35例,二甲双胍治疗;B组33例,炔雌醇环丙孕酮片联合二甲双胍治疗;C组36例,盐酸吡格列酮联合炔雌醇环丙孕酮片治疗;D组33例,二甲双胍、盐酸吡格列酮联合炔雌醇环丙孕酮片治疗。各组患者均治疗3个月,然后观察各组患者治疗前后体重指数(body mass index,BMI)、腰围、性激素、糖脂代谢指标及排卵情况。结果各实验组较对照组胰岛素抵抗、高雄激素血症有明显改善,各组排卵率比较上升趋势,差异无统计学意义(P>0.05)。对照组恢复排卵率61.76%(21/34);实验组:A组恢复排卵率62.86%(22/35),B组为75.76%(25/33),C组为72.22%(26/36),D组为84.85%(28/33)。结论二甲双胍、盐酸吡格列酮、炔雌醇环丙孕酮片对于PCOS伴胰岛素抵抗患者均有排卵作用,3种药交叉及序贯联合应用,对胰岛素抵抗的PCOS患者促排卵治疗具有协同作用,可有效提高排卵率,是安全有效恢复排卵的方法。Objective Insulin resistance and hyperandrogenism are the characteristics of patients with polycystic ovary syndrome（PCOS）.The paper evaluated the therapeutic and ovulation of metformin,glitazones and Ethinylestradiol and cyproterone acetate tablets.Methods171 PCOS patients with insulin resistance have been studied in this reach.These patients were randomly divided into four groups： group A（control）（treated with Ethinylestradiol and cyproterone acetate tablets） including 34 cases,group B（treated with Metformin） including 35 cases,group C（treated with Ethinylestradiol and cyproterone acetate tablets and Metformin） including 33 cases,group D（treated with Ethinylestradiol and cyproterone acetate tablets and Pioglitazone） including 36 cases and group E（treat with Ethinylestradiol and cyproterone acetate tablets and Metformin,Pioglitazone） 33 patients.Each group was treated for 3 months and at the same time,body mass index,waistline,sex hormone,glucolipid metabolism index and ovulation were observed in each group.ResultsInsulin resistance and hyperandrogenism in each group were changed and the ovulation rate has upgrade trend but has no significantly difference（P0.05）,the ovulation rate in Group A,B.C,D,E were 61.76%（21/34）,62.86%（22/35）,75.76%（25/33）,72.22%（26/36）,84.85%（28/33）respectively.ConclusionAll the three drugs can promote ovulation for PCOS patients with insulin resistance.Application of the drugs either in combination or crisscrossing can yield coordinating effects in PCOS patients with insulin resistance on ovulation,effectively improve the ovulation rate,which makes it a safe and effective method.

关 键 词：二甲双胍 盐酸吡格列酮 炔雌醇环丙孕酮片 多囊卵巢 促排卵 

分 类 号：R711.75[医药卫生—妇产科学]