吡格列酮联合克罗米芬促进多囊卵巢综合征排卵的临床研究

摘要

目的：观察吡格列酮（pioglitazone，Pio）与克罗米芬（clomiphene citrate，Cc）合用对多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者排卵的促进作用。方法选择2013年6月至2015年6月接受治疗的PCOS患者84例，按照随机数字表法分为观察组和对照组，各42例。对照组月经后5 d口服克罗米芬治疗，观察组在对照组基础上口服吡格列酮治疗。比较两组治疗前后性激素水平、卵巢大小、绒毛膜促性腺激素( HCG )日成熟卵泡数及子宫内膜厚度（endometrial thickness，EMT），并评价综合疗效。结果治疗前，两组性激素水平、卵巢大小、成熟卵泡数和EMT相比，差异无统计学意义（ P﹥0.05）；治疗后，观察组促黄体生成素（LH）、促卵泡生成激素（FSH）、睾酮（TEST）水平分别为（6.7±1.5）U／L、（3.5±0.7）U／L和（1.5±0.6）nmol／L，对照组为（8.2±2.4）U／L、（5.6±1.5）U／L和（3.2±0.7）nmol／L，观察组明显低于对照组（ P﹤0.05）；治疗后，观察组卵巢大小和HCG日成熟卵泡数明显小于对照组，而HCG日EMT明显大于对照组（ P﹤0.05）；观察组总有效率为92.86%，对照组为73.81%，两组相比，差异具有统计学意义（ P﹤0.05）。结论吡格列酮联合克罗米芬治疗PCOS可明显改善内分泌，促进排卵，疗效显著，是治疗PCOS安全有效的方案。%Objective To observe and explore the ovulation promotion effect of Pioglitazone ( Pio ) combined with Clomiphene citrate ( Cc ) in patients with PCOS. Methods 84 PCOS patients from June 2013 to June 2015 in the hospital were selected and divided into two groups according to the random number table method, 42 cases in each group for 5 ds. The control group was treated with Oral Cc, while the observation group was treated with Pio on the basis of the control group. Sex hormone ( LH, FSH, TEST ) levels, ovarian size, the number of mature follicles and endometrial thickness ( EMT ) at HCG day before and after treatment were recorded and com-pared and integrated effect were evaluated. Results The difference of LH, FSH, TEST, ovarian size, number of mature follicles and EMT at HCG day was not statistically significant before treatment ( P ﹥ 0. 05 );after treatment, LH, FSH and TEST in the observation group were (6.7±1.5)U/L, (3.5±0.7)U/L and (1.5±0.6)nmol/L,while was (8.2±2.4)U/L, (5.6±1.5)U/L and (3.2±0.7)nmol/L in the control group, while the LH, FSH and TEST in observation group were significantly lower than the control group ( P ﹤ 0. 05 );after treatment, ovarian size, number of mature follicles was significantly lower in observation group than in the control group ( P ﹤ 0. 05 ) , while EMT was significantly higher in observation group than in the control group ( P ﹤ 0. 05 ); the total effective rate in observation group was 92. 86%, which was significantly higher than 73. 81% in the control group, the difference was statistically significant ( P ﹤0. 05 ) . Conclusion Pio combine with Cc therapy can significantly improve endocrine and promote ovulation in PCOS patients, has a significant effect, is a safe and effective treatment of PCOS.