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目的探讨克罗米酚(CC)联合二甲双胍治疗多囊卵巢综合征(PCOS)的临床疗效及对内分泌代谢的影响。方法选择湖北省妇幼保健院2010年3月-2015年5月收治的98例PCOS患者,根据随机数字表法分为对照组(49例,以克罗米酚治疗)和观察组(49例,在对照组基础上联合二甲双胍治疗),治疗3个月后,比较两组患者临床症状改善、性激素指标、胰岛素抵抗(IR)、促排卵疗效及妊娠情况。结果治疗3个月后,观察组月经稀发、面部痤疮、多毛等临床症状的改善率明显优于对照组(P<0.05)。观察组治疗后促卵泡素(FSH)、雌二醇(E_2)、黄体生成素(LH)、睾酮(T)、HOMA-IR水平与治疗前相比明显改善(P<0.05);并且改善幅度大于对照组(P<0.05)。观察组治疗后,患者排卵率、妊娠率、子宫内膜厚度、优势卵泡数均显著优于对照组(P<0.05)。结论二甲双胍联合CC治疗PCOS能显著改善患者的临床症状和性激素水平,促进患者排卵,有效提高妊娠率。
Objective To investigate the clinical efficacy of clomiphene citrate (CC) combined with metformin in the treatment of polycystic ovary syndrome (PCOS) and its effect on endocrine and metabolism. METHODS: A total of 98 PCOS patients who were treated in Hubei Maternal and Child Health Hospital from March 2010 to May 2015 were randomly divided into control group (49 cases treated with clomiphene citrate) and observation group (49 cases) On the basis of the control group combined with metformin treatment), after 3 months of treatment, clinical symptoms, sex hormone, insulin resistance (IR), ovulation induction and pregnancy were compared between the two groups. Results After 3 months of treatment, the improvement rates of clinical symptoms such as thinning of the menstruation, facial acne and hirsutism in the observation group were significantly better than those in the control group (P <0.05). The levels of FSH, E2, LH, T and HOMA-IR in the observation group were significantly improved compared with those before treatment (P <0.05), and the improvement was greater than that of the control Group (P <0.05). Observation group after treatment, the patient’s ovulation rate, pregnancy rate, endometrial thickness, the number of dominant follicles were significantly better than the control group (P <0.05). Conclusion Metformin combined with CC treatment of PCOS can significantly improve the clinical symptoms and sex hormone levels, promote ovulation and improve pregnancy rate.