桂枝茯苓胶囊联合达英-35和枸椽酸氯米芬治疗多囊卵巢综合征合并不孕症的临床观察

目的: 观察桂枝茯苓胶囊联合达英-35和枸椽酸氯米芬(CC)治疗多囊卵巢综合征(PCOS)合并不孕症的临床疗效。方法: 选择2009年2月至2011年2月,在浙江中医药大学附属第二医院妇产科不孕不育门诊就诊的PCOS不孕患者60例,随机分为对照组30例(达英-35和CC)和治疗组30例(桂枝茯苓胶囊联合达英-35和CC),治疗3疗程,促排卵3个周期,观察患者治疗前后的体重指数(BMI)、腰臀比(WHR)、多毛评分、痤疮评分、卵巢体积、血清黄体生成素(LH)、LH/卵泡刺激素(FSH)、总睾酮(TT),性激素结合球蛋白(SHBG)、空腹血糖(FPG)、空腹胰岛素(FINS)的变化,同时观察排卵率和妊娠率。结果: (1)两组患者WHR、多毛评分、痤疮评分统计学上无明显变化(P>0.05),卵巢体积均明显缩小,统计学上有显著意义(P<0.05)。治疗组BMI显著下降(P<0.05),对照组无显著变化(P>0.05)。(2)治疗后两组患者的LH、LH/FSH比值、TT均下降,SHBG均升高,均有统计学意义(P均<0.01),治疗组FINS显著下降(P<0.05),对照组无明显下降(P>0.05)。(3)治疗组的周期排卵率及周期妊娠率均高于对照组,但统计学上均无显著差异(P>0.05)结论:桂枝茯苓胶囊联合达英-35和CC能显著改善PCOS患者的生殖内分泌情况,改善糖脂代谢,增加CC的敏感性,改善排卵率及妊娠率。

Clinical observation on treating polycystic ovary syndrome with sterility with Guizhifulin capsule and Diane-35 and clomifene citrate

AIM: To observe the clinical effect of Guizhifulin capsule, together with Diane-35 and clomifene citrate on polycystic ovary syndrome (PCOS) with sterility. METHODS: From February 2009 to February 2011, 60 PCOS patients with sterility who visiting the out-patient clinic of Obstetrics and Gynecology Sterility Department, Second Affiliated Hospital, Chinese Medical University,were enrolled to be divided randomly into control group (Diane-35+clomifene citrate) and treatment group (Guizhifulin capsule + Diane-35+clomifene citrate).Before and after 3 months treatment, the changes of the following items were observed: body mass index(BMI),waist-to-hip ratio(WHR), hairness score, acne score, volume of ovary,total testosterone(TT),luteinizing hormone (LH), LH-to-Follicular Stimulating Hormone(FSH) ratio,fasting plasma glucose (FPG),fasting insulin(FINS). Additionally, the ovulation rate and pregnancy rate were detected after 3 treatments. RESULTS: (1)There was no statistical difference in WHR, hairness score,acne score between the treatment group and the control group. The volume of ovary was smaller both in the treatment group and control group. BMI was statistically decreased in the treatment group(P<0.05), and no in control group.(2)After treatment,there were statistically decrease in LH,LH-to-FSH ratio, TT ,and increase in SHBG both in treatment group and control group(P<0.05).There was statically decrease in FINS in treatment group(P<0.05), and no in control group(P>0.05).(3)The rate of ovulation and pregnancy was more in treatment group than that in control group, but there was no statisically difference (P>0.05). CONCLUSION: Guizhifulin capsule and Diane-35 and clomifene citrate are able to improve the status of genito-endocrine, glycolipin metabolism, sensitivity to CC and the rate of ovulation and pregnancy.