二甲双胍联合枸橼酸氯米芬对多囊卵巢综合征不孕患者性激素和胰岛素水平的影响

目的:探讨二甲双胍、枸橼酸氯米芬联合治疗对多囊卵巢综合征(PCOS)不孕患者性激素和胰岛素水平的影响。方法:选取我院于2017年1月到2018年7月期间收治的101例PCOS不孕患者,采用数字表法将患者随机分为对照组(n=50)和研究组(n=51),对照组给予枸橼酸氯米芬治疗,研究组在对照组基础上联合二甲双胍治疗,采用门诊复查等方式随访6个月,记录两组患者排卵率及妊娠率,比较两组患者治疗前、治疗后的性激素、胰岛素以及血管活性因子水平,记录不良反应发生情况。结果:两组患者治疗后黄体生成素(LH)、睾酮(T)、胰岛素(INS)、LH/卵泡刺激素(FSH)均较治疗前降低,且研究组低于对照组(P0.05)。研究组排卵率、妊娠率均高于对照组(P0.05)。两组患者治疗后血管紧张素(AT-Ⅱ)、血管内皮生长因子(VEGF)均较治疗前降低,且研究组低于对照组(P0.05)。两组不良反应发生率对比无统计学差异(P0.05)。结论:二甲双胍联合枸橼酸氯米芬治疗PCOS不孕,安全有效,可有效调节患者胰岛素、性激素水平,提高排卵率、妊娠率,改善血管活性因子水平。

Effects of Metformin Combined with Clomiphene Citrate on Sex Hormone and Insulin Levels in Infertile Women with Polycystic Ovary Syndrome

ABSTRACT Objective: To investigate the effects of metformin combined with clomiphene citrate on sex hormone and insulin levels in infertile women with polycystic ovary syndrome (PCOS). Methods: 101 infertile patients with PCOS who were admitted to our hospital from January , 2017 to july 2018 were selected, and they were divided into control group (n=50) and study group (n=51) according to random number table method. The control group was treated with clomiphene citrate. The study group was treated with metformin on the basis of the control group. The patients were followed up for 6 months by outpatient reexamination, and the ovulation rate and pregnancy rate of the two groups were recorded. The sex hormone, insulin and vasoactive factor levels before and after treatment were compared between the two groups, and adverse reactions during treatment were recorded. Results: The luteinizing hormone (LH), testosterone (T), insulin (INS), LH/follicle stimulating hormone (FSH) in the two groups after treatment were lower than those before treatment, and those in the study group were lower than those in the control group (P<0.05). The ovulation rate and pregnancy rate in the study group were higher than those in the control group (P<0.05). Angiotensin (AT-II) and vascular endothelial growth factor (VEGF) were lower in the two groups after treatment than before treatment, and those in the study group were lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Metformin combined with clomiphene citrate is safe and effective in the treatment of PCOS infertility. It can effectively regulate the levels of serum sex hormones and insulin, improve ovulation rate, pregnancy rate and vasoactive factors in patients with PCOS infertility.