二甲双胍联合达英35治疗多囊卵巢综合征不孕疗效观察.docVIP

二甲双胍联合达英-35治疗多囊卵巢综合征不孕的疗效观察 　　【摘要】目的：观察PCOS不孕患者采用达英－35与二甲双胍预处理与单用达英-35预处理，在排卵率、妊娠率、OHSS发生率作比较。方法：将PCOS不孕患者83例随机分为2组，A组与B组，A组42例，采用达英－35联合二甲双胍预处理，再用克罗米芬＋HMG＋HCG促排卵；B组41例，单用达英-35预处理后，再同A组促排卵，观察治疗前后内分泌与生化指标的变化，两组比较，排卵率、妊娠率与OHSS发生率作比较。结果：二甲双胍联合达英-35用药后LH、空腹胰岛素、睾酮明显下降，P＜0.05。达英-35联合二甲双胍预处理后，排卵率、妊娠率明显高于单一应用达英－35预处理，P＜0.05。结论：达英-35联合二甲双胍预处理可改善临床症状，降低睾酮、胰岛素，提高胰岛素的敏感性，提高排卵率、妊娠率。 　　【关键词】二甲双胍；多囊卵巢综合征；达英－35 　　Effects of metformin plus Diane-35 in treatment of polycystic ovary syndrome 　　ZengYuena 　　【Abstract】 Objective：To observe the effects of metformin plus Diane-35 and Diane-35 alone in the treatment of patients with polycystic ovary syndrome, in ovulation rate, pregnancy rate, OHSS incidence for comparison. Methods: 83 cases of PCOS patients with infertility were randomly divided into 2 groups, A and B. A group of 42 cases was given metformin plus Diane-35 pretreatment, then given clomiphene + HMG + HCG improved pregnant rates;B group of 41 cases was given Diane-35 pretreatment alone , then ditto A group.Observe before and after treatment of endocrine and biochemical changes and ovulation rate, pregnancy rate, OHSS incidence for comparison in both A and B group.Results: The levels of serum LH、fasting insulin and testosterone were significantly decreased with the treatment of Metformin plus Diane-35 (P＜0.05). Metformin plus Diane-35 pretreatment, ovulation rate、pregnancy rate was significantly higher than Diane-35 alone(P＞0.05).Conclusions : Metformin plus Diane-35 can improve the clinical symptoms, reducing testosterone、insulin, improve insulin sensitivity, ovulation rate and pregnancy rate. 　　【Key words】metformin ；polycystic ovary syndrome；Diane-35 　　【中图分类号】R556 【文献标识码】B 【文章编号】1005-0515(2011)07-0232-02 　　 　　多囊卵巢综合征是一种好发于育龄期妇女的妇科内分泌紊乱的综合征，是引起女性不排卵性不孕的主要原因之一。约在无排卵性不孕症的75%[1]，PCOS患者的主要病理生理变化为胰岛素抵抗高胰岛素血症及高雄激素血症，二甲双胍是胰岛素增敏剂，可改善患者对胰岛素的抵抗，增强组织对胰岛素的敏感性，从而降低血液中的胰岛素水平，应用二甲双胍治疗PCOS不孕病人，已成为妇科内分泌的热点，解决胰岛素抵抗是治疗PCOS的关键，本研究通过对达英－35联合二甲双胍与单用达英－35在PCOS不孕病人预处理治疗效果的比较如下： 　　1资料与方法