[1]梁新新,林 睿.二甲双胍联合戊酸雌二醇、克罗米芬治疗多囊卵巢综合征所致不孕症对患者胰岛素、胰岛素抵抗指数水平及卵巢排卵功能的影响[J].陕西医学杂志,2023,52(4):460-463.[doi:DOI:10.3969/j.issn.1000-7377.2023.04.022]
　LIANG Xinxin,LIN Rui.Effects of metformin combined with estradiol valerate and clomiphene in treatment of patients with infertility caused by polycystic ovary syndrome on levels of FINS,HOMA-IR and ovarian ovulation function[J].,2023,52(4):460-463.[doi:DOI:10.3969/j.issn.1000-7377.2023.04.022]
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二甲双胍联合戊酸雌二醇、克罗米芬治疗多囊卵巢综合征所致不孕症对患者胰岛素、胰岛素抵抗指数水平及卵巢排卵功能的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年4期
页码:
460-463
栏目:
药物与临床
出版日期:
2023-04-05

文章信息/Info

Title:
Effects of metformin combined with estradiol valerate and clomiphene in treatment of patients with infertility caused by polycystic ovary syndrome on levels of FINS,HOMA-IR and ovarian ovulation function
作者:
梁新新1; 林 睿2
(1.空军军医大学唐都医院妇产科生殖医学中心,陕西 西安 710038; 2.西安安琪儿妇产医院,陕西 西安 710000)
Author(s):
LIANG Xinxin; LIN Rui
(Reproductive Medicine Center,Department of Obstetrics and Gynecology,Tangdu Hospital,Air Force Medical University,Xi'an 710038,China)
关键词:
二甲双胍;  戊酸雌二醇;  克罗米芬;  多囊卵巢综合征;  不孕症;  胰岛素抵抗指数水平;  卵巢排卵功能
Keywords:
Metformin;  Estradiol valerate;  Clomiphene;  Polycystic ovary syndrome;  Infertility;  HOMA-IR level;  Ovarian ovulation function
分类号:
R 711.6
DOI:
DOI:10.3969/j.issn.1000-7377.2023.04.022
文献标志码:
A
摘要:
目的:分析二甲双胍联合戊酸雌二醇、克罗米芬治疗多囊卵巢综合征(PCOS)所致不孕症对患者胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平及卵巢排卵功能的影响。方法:回顾性分析100例PCOS合并不孕症患者的临床资料。依据不同疗法分成对照组(二甲双胍和克罗米芬治疗)和研究组(二甲双胍联合戊酸雌二醇、克罗米芬治疗)。比较两组患者治疗前后体重、体重指数(BMI)、子宫内膜厚度、FINS、HOMA-IR水平及两组治疗后妊娠率、排卵率、早孕流产率、成熟卵泡数、不良反应发生情况。 结果:①治疗后,两组体重、BMI及子宫内膜厚度均较治疗前降低(均P<0.05); 两组治疗后子宫内膜厚度比较有统计学差异(P<0.05)。②治疗后,两组FINS、HOMA-IR水平均较治疗前降低,且研究组明显低于对照组(均P<0.05)。③治疗后,研究组妊娠、排卵率及成熟卵泡数高于对照组(均P<0.05),而两组早孕流产率比较无统计学差异(P>0.05)。④对照组并发症发生率为24.44%; 研究组并发症发生率为18.18%,组间比较无统计学差异(P>0.05)。 结论:在PCOS所致不孕症患者的治疗中,选用二甲双胍联合戊酸雌二醇、克罗米芬可有效降低FINS、HOMA-IR水平,改善卵巢排卵功能,提高其妊娠率,具有较高的临床应用价值。
Abstract:
Objective:To analyze the effects of metformin combined with estradiol valerate and clomiphene in the treatment of patients with infertility caused by polycystic ovary syndrome(PCOS)on the levels of insulin(FINS),homa insulin-resistance(HOMA-IR)and ovarian ovulation function.Methods:The clinical data of 100 PCOS patients with infertility were retrospectively analyzed.According to different treatments,they were divided into control group(metformin and clomiphene)and study group(metformin combined with estradiol valerate and clomiphene).The body weight,body mass index(BMI),endometrial thickness,FINS and HOMA-IR levels before and after treatment were compared between the two groups.The pregnancy rate,ovulation rate,early pregnancy abortion rate,the number of mature follicles,and the incidence of adverse reactions were compared between the two groups after treatment.Results:After treatment,the body weight,BMI and endometrial thickness of the two groups were lower(all P<0.05).There was a difference in endometrial thickness between the two groups after treatment(P<0.05).After treatment,the levels of FINS and HOMA-IR in the two groups were lower,and the level of the study group was significantly lower than that of the control group(all P<0.05).After treatment,the pregnancy rate,ovulation rate and the number of mature follicles in the study group were significantly higher than those in the control group(all P<0.05),while there was no difference in the early pregnancy abortion rate between the two groups(P>0.05).The incidence of complications in the control group was 24.44%,the incidence of complications in the study group was 18.18%,and there was no difference between the groups(P>0.05).Conclusion:Metformin combined with estradiol valerate and clomiphene was used in the treatment of infertility caused by PCOS can effectively reduce FINS and HOMA-IR levels,improve ovarian ovulation function,and increase the pregnancy rate,which has high clinical application value.

参考文献/References:

[1] 王改梅,李 晶,张 励,等.苍附导痰方联合法地兰对PCOS合并不孕症患者性激素水平及子宫内膜容受性的影响[J].陕西中医,2019,40(2):201-203.
[2] 白淑芳,柏 璐,白雅维,等.来曲唑分别联合氯米芬与尿促性腺激素治疗对多囊卵巢综合征患者血清性激素及COR水平的影响[J].解放军医药杂志,2019,44(8):135-136.
[3] Min M,Ruan X,Mueck AO.Advanced therapy of overweight or obese polycystic ovary syndrome:A prospective study[J].Global Health Journal,2022,6(2):75-79.
[4] 侯 敬,张 义,郭艳巍,等.二甲双胍联合炔雌醇环丙孕酮治疗多囊卵巢综合征的效果[J].河北医学,2020,26(1):101-105.
[5] 蔡莹莹,阮青青,张佳美.二甲双胍联合炔雌醇环丙孕酮治疗后促排卵方案对多囊卵巢综合征不孕患者的疗效观察[J].浙江医学,2020,42(4):382-385.
[6] 马 兰,王 星.二甲双胍对多囊卵巢综合征不孕患者糖脂代谢指标的影响[J].中国医师杂志,2020,22(1):84-86,90.
[7] 刘文娟,孙小红,刘晓娟,等.炔雌醇环丙孕酮片联合二甲双胍对多囊卵巢综合征患者血清DHEA、AMH及SHBG水平的影响[J].中国现代医学杂志,2020,30(12):109-113.
[8] 郭书焕,周艳艳.补肾化痰汤对多囊卵巢不孕症患者卵巢功能、妊娠的影响研究[J].陕西中医,2019,40(2):195-197.
[9] Fei WP,Zhuo LR,Zhang W,et al.Polycystic ovary syndrome is not associated with offspring birth weight:A mendelian randomization study[J].Biomedical and Environmental Sciences,2021,34(2):53-72.
[10] 姜晓琳,刘 静,张 阳,等.苍附导痰汤加二甲双胍联合穴位埋线对肥胖型多囊卵巢综合征不孕症患者免疫功能及肠道菌群的影响[J].临床误诊误治,2020,33(8):51-56.
[11] 马志宾,陈 燕,苏 永.促排卵汤对多囊卵巢综合征患者血清淀粉样蛋白P、脂肪因子与白介素-18的影响研究[J].陕西中医,2019,40(5):651-654.
[12] 任玮玮,孙 林.来曲唑联合二甲双胍治疗多囊卵巢综合征不孕症的临床疗效观察[J].中国医师进修杂志,2020,43(8):741-744.
[13] 刘淑玉,郑 轶,张兰玲,等.克罗米芬联用黄体酮和戊酸雌二醇治疗多囊卵巢综合征不孕效果[J].中国计划生育学杂志,2020,28(5):726-729.
[14] Farkhad SA,Khazali H.Therapeutic effects of isoflavone-aglycone fraction from soybean(Glycine max L.Merrill)in rats with estradiol valerate-induced polycystic ovary syndrome as an inflammatory state[J].Gynecological Endocrinology,2019,35(12):1-6.
[15] 马景卉,罗 娟,祝 润,等.地屈孕酮联合二甲双胍治疗多囊卵巢综合征及对糖脂代谢、性激素及肥胖指标的影响[J].实用医院临床杂志,2020,17(2):198-201.
[16] 王 蕊,张 岩,孙 旸,等.二甲双胍联合克罗米芬在多囊卵巢综合征患者诱导排卵中疗效的Meta分析[J].武警后勤学院学报:医学版,2020,29(4):1-7.
[17] 黄晓晓,陈晓璐,王晓艳.炔雌醇环丙孕酮联合二甲双胍治疗多囊卵巢综合征伴胰岛素抵抗的临床效果[J].中国基层医药,2020,27(6):650-654.
[18] 金淑杰,王高娃,春 莲,等.黄连素联合克罗米芬对多囊卵巢综合征并不孕症患者内皮功能及内分泌指标和临床结局的影响[J].实用医学杂志,2019,35(1):111-114.
[19] 胡瑞杰,宋民喜,徐 琳,等.吡格列酮二甲双胍对多囊卵巢综合征不孕患者糖脂代谢及妊娠率的影响[J].陕西医学杂志,2021,50(2):221-224.
[20] 李 婷,李雪倩,尹东升.多囊卵巢综合征患者妊娠期体内维生素D水平与血脂代谢以及妊娠结局的关系[J].陕西医学杂志,2022,51(1):55-58.
[21] 李丽丽,师萍萍.血黄体生成素检测、经阴道超声卵泡监测联合不同促排卵方案对多囊卵巢综合征患者妊娠结局的影响[J].陕西医学杂志,2020,49(1):64-67.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2017SF-217)
更新日期/Last Update: 2023-04-06