多囊卵巢综合征采用二甲双胍联合炔雌醇环丙孕酮片治疗疗效对其性激素水平的影响

目的:探讨二甲双胍联合炔雌醇环丙孕酮片治疗多囊卵巢综合征患者临床疗效。方法:回顾性分析宝鸡市妇幼保健院88例经诊断为多囊卵巢综合征患者临床诊治资料,其中以44例炔雌醇环丙孕酮片治疗者为对照组;采用二甲双胍联合炔雌醇环丙孕酮片治疗者44例为观察组。统计两组患者临床效果、排卵率、妊娠率,检测两组治疗前、后血清性激素水平;应用稳态模型测定胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β),评定外周组织的胰岛素抵抗情况。记录治疗期间不良反应。结果:观察组治疗总有效率明显高于对照组,差异具有统计学意义(P 0. 05);观察组排卵率、妊娠率明显高于对照组,差异具有统计学意义(P 0. 05);。观察组治疗后LH、T水平分别为(6. 69±1. 32) IU/L、(0. 97±0. 55) ng/ml,明显低于对照组(9. 88±1. 78) IU/L、(1. 36±0. 81) ng/ml,E_2水平(44. 25±10. 71) pg/ml明显高于对照组(39. 35±7. 69) pg/ml,差异具有统计学意义(P 0. 05);治疗期间未见明显不良反应。结论:二甲双胍联合炔雌醇环丙孕酮片治疗多囊卵巢综合征患者疗效显著,值得推广。     

探讨二甲双胍与炔雌醇环丙孕酮片治疗多囊卵巢综合征的疗效及其对性激素、血糖的影响

目的探讨对多囊卵巢综合征患者应用二甲双胍与炔雌醇环丙孕酮片口服联合治疗后对其临床疗效以及性激素、血糖的影响情况。方法选取2017年8月至2018年8月期间衡水市第二人民医院诊治的多囊卵巢综合征患者420例作为临床研究对象,采用随机数字表法分为对照组(炔雌醇环丙孕酮片口服治疗)和观察组(二甲双胍与炔雌醇环丙孕酮片口服联合治疗),每组患者210例。对比治疗后患者的临床疗效以及性激素、血糖的影响情况。结果经治疗后,观察组患者LH(6.11±0.97)IU/L、T(1.39±0.20)nmol/L以及FSH(2.87±0.77)IU/L的值明显低于对照组患者的LH(11.70±1.50)IU/L、T(3.21±0.39)nmol/L以及FSH(4.24±1.30)IU/L的值;观察组患者HOMA-IR(1.32±0.22)、 HOMA-β(5.11±0.19)以及FPG(4.50±0.40)mmol/L的值明显低于对照组患者的HOMA-IR(2.11±0.31)、 HOMA-β(6.29±0.38)以及FPG(5.19±0.41)mmol/L的值;观察组患者E_2(114.99±12.87)pmol/L的值明显高于对照组患者的E_2(76.93±7.91)pmol/L的值;观察组患者排卵率(88.57%)、妊娠率(66.67%)以及治疗总有效率(93.33%)明显高于对照组患者的排卵率(51.43%)、妊娠率(21.90%)以及治疗总有效率(66.67%),差异均具有统计学意义(均P0.05)。结论对于多囊卵巢综合征患者,采取二甲双胍与炔雌醇环丙孕酮片口服联合治疗,可有效提高临床疗效,改善患者血糖水平以及性激素水平,且治疗安全性高,有较高临床应用价值。     

醋酸曲普瑞林注射液联合炔雌醇环丙孕酮片治疗PCOS不孕症的效果及对相关激素水平的影响

目的探讨醋酸曲普瑞林注射液联合炔雌醇环丙孕酮片治疗多囊卵巢综合征(PCOS)不孕症的效果及对血清睾酮、促甲状腺素水平的影响。方法选取2015年3月至2017年3月湖北省武汉市中西医结合医院诊治的多囊卵巢综合征不孕症患者110例作为研究对象。按随机数字表法分为观察组和对照组,各55例。对照组予醋酸曲普瑞林注射液治疗,观察组予炔雌醇环丙孕酮片与醋酸曲普瑞林联合治疗,比较两组患者的治疗效果及雌激素、睾酮、促甲状腺激素等的水平及超氧化物歧化酶活性。结果观察组的总有效率为96.4%,对照组为80.0%,观察组高于对照组,差异具有统计学意义(P<0.05);在本研究中治疗前两组患者的睾酮、促卵泡激素、黄体生成素、超氧化物歧化酶、促甲状腺素的水平差异无统计学意义(P>0.05),治疗后促卵泡激素水平、超氧化物歧化酶活性均升高,且观察组升高较对照组更多,睾酮、黄体生成素、促甲状腺素水平均下降,且观察组下降更多,差异均具有统计学意义(P<0.05);观察组的累积排卵率为87.27%,累积妊娠率为72.73%,对照组分别为76.27%、45.45%,观察组高于对照组,差异具有统计学意义(P<0.05);观察组的痤疮、月经稀发、多毛症状少于对照组,差异具有统计学意义(P<0.05),两组患者在治疗过程中均未发生不良反应。结论醋酸曲普瑞林注射液联合炔雌醇环丙孕酮片治疗多囊卵巢综合征不孕症的效果较好,可有效提高排卵率、妊娠率,有效调节血性激素、促甲状腺素等激素的水平,增加超氧化物歧化酶活性,在临床上可广泛使用。     

炔雌醇环丙孕酮在降低多囊卵巢综合征合并念珠菌阴道病复发中的临床效果研究

目的:分析炔雌醇环丙孕酮在降低多囊卵巢综合征合并念珠菌阴道病复发中的临床效果。方法:选取2015年1月至2016年9月50例多囊卵巢综合征合并念珠菌阴道病复发患者作为观察对象,按照随机数字表法分为观察组与对照组,每组各50例。对照组采用氯米芬治疗,观察组采用炔雌醇环丙孕酮治疗。观察两组患者的临床疗效、治疗前后血清激素水平以及念珠菌阴道病的改善情况。结果:观察组在各方面显著优于对照组(P0.05)。结论:炔雌醇环丙孕酮在多囊卵巢综合征合并念珠菌阴道病中具有较好的应用效果,能够有效改善患者血清激素水平,降低念珠菌阴道病的发生率,有助于提高患者的生活水平,值得在临床中推广使用。     

二甲双胍对不同肥胖类型多囊卵巢综合征患者生殖指标的影响比较

目的探究二甲双胍对不同肥胖类型多囊卵巢综合征患者生殖指标的影响。方法选取2017年10月至2018年6月中国人民解放军联勤保障部队第九六七医院诊治的78例多囊卵巢综合征肥胖患者作为研究对象。按照肥胖类型将患者分为中心性肥胖组(腰围≥80cm,n=41)和全身性肥胖组(腰围80cm,n=37)。两组均给予二甲双胍配合炔雌醇环丙孕酮治疗,比较两组3个月后性激素[雌二醇(E_2)、卵泡刺激素(FSH)、黄体生成素(LH)和睾酮(T)]水平、治疗期间不良反应发生率、月经周期改善率及排卵率和妊娠率。结果两组治疗前E_2、FSH、LH、T水平比较,差异无统计学意义(P0.05);治疗后,全身性肥胖组E_2、FSH、LH、T水平分别为(115.42±18.53)pmol/L、(3.12±0.84)U/L、(6.33±1.05)U/L、(1.43±0.51)nmol/L,中心性肥胖组分别为(80.26±14.98)pmol/L、(5.31±1.01)U/L、(9.22±1.17)U/L、(3.20±0.62)nmol/L,组间比较,差异均具有统计学意义(P0.05);全身性肥胖组不良反应发生率为31.71%,中心性肥胖组为29.73%,组间比较,差异无统计学意义(P0.05);全身性肥胖组治疗后BMI为(25.24±1.66)kg/m~2,中心性肥胖组为(25.19±1.91)kg/m~2,差异具有统计学意义(P0.05);全身性肥胖组治疗后月经周期改善率为97.56%,排卵率为92.68%,妊娠率为58.54%,中心性肥胖组分别为89.19%、81.08%、37.84%,组间比较,差异均具有统计学意义(P0.05)。结论二甲双胍用于治疗多囊卵巢综合征患者时,全身性肥胖患者性激素水平和月经周期改善情况优于中心性肥胖患者,且排卵率和妊娠率更高。     

炔雌醇环丙孕酮片联合生活方式干预治疗肥胖型多囊卵巢综合征的疗效观察

目的：探讨炔雌醇环丙孕酮片（达英-35）联合生活方式调整对肥胖型多囊卵巢综合征生殖内分泌和脂代谢的影响.方法：选取2011年7月至2013年7月来我院就诊的肥胖型多囊卵巢综合征不孕患者105例,随机分为观察组（53例）和对照组（52例）.对照组采用达英-35进行治疗,观察组在对照组基础上联合生活方式调整治疗.观察治疗前后患者体重、体重指数（BMI）及腰围指数（WHR）,检测生殖激素、卵巢及子宫内膜变化,及观察月经恢复率、排卵率以及妊娠率.结果：观察组体重、BMI治疗后明显低于治疗前及对照组治疗后（P＜0.05）,WHR则无显著性差异.观察组治疗后的LH、T、LH/FSH、FINS、TG各指标与治疗前及对照组治疗后比较,差异有统计学意义（P＜0.05）.观察组左、右卵巢体积治疗后明显低于治疗前及对照组治疗后（P＜0.05）.观察组的月经恢复率、排卵率以及妊娠率均明显高于对照组（P＜0.05）.结论：达英-35联合生活方式调整可改善肥胖型多囊卵巢综合征患者的生殖内分泌及脂代谢的水平,改善左、右卵巢体积及月经恢复率、排卵率以及妊娠率.     

苍附导痰汤联合二甲双胍治疗多囊卵巢综合征痰湿内阻型患者的临床研究

目的 观察苍附导痰汤联合二甲双胍治疗多囊卵巢综合征(PCOS)痰湿内阻型患者的临床效果。方法 选取2020年6月至2021年12月利辛县中医院诊治的72例PCOS且证型为痰湿内阻型的患者作为研究对象。随机分为试验组与对照组,每组36例。对照组予以二甲双胍治疗,试验组在对照组的基础上联合苍附导痰汤治疗,两组均干预3个月经周期,比较干预前后两组的糖代谢水平、卵巢情况、排卵结局的情况。结果 干预后,两组空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、卵泡数目、两侧卵巢体积均较干预前降低,且试验组降低幅度大于对照组,差异具有统计学意义(P<0.05)。干预后,试验组排卵率、妊娠率均显著高于对照组,差异具有统计学意义(P<0.05)。结论 苍附导痰汤联合二甲双胍治疗PCOS痰湿内阻型患者,能改善其的胰岛素抵抗状态及卵巢多囊样改变,提高排卵率及妊娠率。     

温肾健脾化痰法对痰湿型多囊卵巢综合征患者胰岛素抵抗及血清性激素水平的影响

目的观察温肾健脾化痰方剂对痰湿型多囊卵巢综合征患者的临床疗效。方法选取2017年5月至2019年5月浙江中医药大学附属广兴医院妇产科诊治的80例痰湿型多囊卵巢综合征患者作为研究对象。随机分为两组,治疗组及对照组各40例。对照组口服炔雌醇环丙孕酮及二甲双胍片,治疗组在此基础上联合应用自拟温肾健脾化痰方剂。疗程结束后,比较两组患者临床症状、身体质量指数(BMI)、胰岛素抵抗指数(HOMA-IR)、血清性激素水平、卵泡发育、妊娠率、流产率等指标的变化。结果①治疗组总有效率达90.0%,临床疗效高于对照组,差异具有统计学意义(P0.05)。②2组患者在月经周期、多毛、痤疮、溢脂、黑棘皮等临床症状方面均明显改善;且治疗组优于对照组。③疗程结束后,2组患者空腹血糖(FBG)、空腹胰岛素水平(FINS)、胰岛素抵抗指数水平等均明显降低,且治疗组低于对照组,差异具有统计学意义(P0.05)。④治疗后,2组患者卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平降低,雌二醇(E2)水平升高。⑤治疗后,2组患者的卵巢体积及卵泡个数均下降。结论温肾健脾化痰方剂结合西药治疗痰湿型PCOS,能有效改善症状,优化相关指标,提高妊娠率,值得临床推广。     

多囊卵巢综合征不孕症患者血清氧化应激和IGF-I检测的临床意义

目的探讨血清氧化应激和IGF-I水平在多囊卵巢综合征不孕症患者中检测的临床价值。方法选取112例多囊卵巢综合征不孕症患者为病例组,选取因男方少弱精子症需要进行夫精宫腔内人工授精的妇女50例为对照组,对比分析两组研究对象的氧化应激及IGF-I等指标水平是否存在差异,以及相关指标与多囊卵巢综合征患者促排卵及妊娠结局等的相关性。结果病例组患者SOD水平低于对照组(68.64±12.22vs113.62±23.60μU/ml),血清MDA、 LPO、GSH-Px和IGF-1水平高对照组(13.25±4.67VS6.7 3±2.75 U/L、8.34±1.27 VS 3.48±0.68μU/ml、211.86±32.27 VS 161.48±21.68 U/L、262.83±29.94 VS 149.38±12.50μg/L),差异具有统计学意义(P0.01);病例组中排卵率以及妊娠率均明显低于对照组(78.57 VS 94.00%、15.18 VS36.00%),差异具有统计学意义(P0.05);而流产率及多胎率高于对照组(4.46 VS 2.00%、3.57VS 0.00%),但差异无统计学意义(P0.05));血清氧化应激MDA、 LPO、GSH-Px和IGF-1水平与多囊卵巢综合征不孕症患者排卵率、妊娠率呈负相关相关(r值分别为-0.731,-0.562,-0.689,-7.786;-0.685,-0.680,-0.776,-0.742),差异具有统计学意义(P0.05);与流产率以及早产率呈正相关(r值分别为0.687, 0.664, 0.685, 6.038; 0.587, 0.634, 0.564, 0.656),差异具有统计学意义(P0.05);血清SOD与多囊卵巢综合征不孕症患者排卵率、妊娠率呈正相关(r=7.834),差异具有统计学意义(P0.05);与流产率以及早产率呈正相关(r=-0.834),差异具有统计学意义(P0.05);临床妊娠组血清MDA,LPO,GSH-Px和IGF-1水平高于未妊娠组,而血清SOD水平明显高于未妊娠组,差异具有统计学意义(P0.01)。结论多囊卵巢综合征患者血清氧化应激和IGF-I与促排卵疗效和妊娠结局具有一定的相关性,上述指标可能在临床多囊卵巢综合征不孕症患者的治疗中具有一定的参考价值。     

疏肝益肾方结合来曲唑治疗肾虚肝郁型多囊卵巢综合征伴不孕症患者对其孕激素及受孕率的影响

目的探讨疏肝益肾方结合来曲唑肾虚肝郁型多囊卵巢综合征(PCOS)伴不孕症患者对其孕激素及受孕率的影响。方法选取2018年5月至2019年12月宁德师范学院附属宁德市医院诊治的92例肾虚肝郁型PCOS伴不孕症患者作为研究对象。根据随机数表法分为对照组和研究组,各46例。对照组采用来曲唑治疗,研究组在对照组基础上结合疏肝益肾方治疗。比较两组受孕情况、性激素、卵巢储备功能及不良反应。结果研究组排卵率、妊娠率均比对照组高,差异具有统计学意义(P0.05)。治疗后,研究组血清总睾酮(T)、促黄体素(LH)、卵泡刺激素(FSH)水平均比对照组低,孕酮(P)水平比对照组高,差异具有统计学意义(P0.05)。治疗后,研究组卵巢动脉收缩期峰值流速(PSV)比对照组高,阻力指数(RI)比对照组低,差异具有统计学意义(P0.05)。两组自然流产率、不良反应总发生率比较,差异无统计学意义(P0.05)。结论疏肝益肾方结合来曲唑治疗肾虚肝郁型PCOS伴不孕症患者,可有效改善患者的性激素水平和卵巢血流循环,促进排卵及妊娠。     

Correlation between the greasiness and the plasticizing effect of moisturizers

Moisturizers are used as cosmetics and as adjuvant therapy in dermatology. The strength or relative efficacy of moisturizers is poorly described and thus advising patients is difficult. It has been suggested that lipidization of the skin by moisturizers and the changes in skin mechanics following the application of a moisturizer may be useful measures of outcome. The aim of this study is to describe the relative efficacy of 5 different moisturizers, a barrier cream and a gel in terms of changes in skin mechanics and electrical capacitance before and after application. Assessment of the greasiness or absorption of the cream was made by standardized blotting of unabsorbed residue. Lipid-rich creams (Vaseline, Locobase and Decubal creme) caused increased skin distensibility, while no differences were found in hysteresis changes. In contrast, the relative efficacy in increasing skin capacitance was significantly greater in the moisturizers with a lower lipid content (Clinique, Nivea) and gel. The results suggest that lipidization is of major importance to the plasticity of the skin. When moisturizers are used to improve skin plasticity it is suggested that lipid-rich formulations be used. Cosmetically more acceptable creams and gel were however better at increasing skin capacitance which has been interpreted as a measure of skin hydration. The difference may reflect a design adaptation of these creams to a specific outcome measure and our results raise the question of appropriate outcome measures and our results raise the question of appropriate outcome measures in future moisturizer studies.     

The effect of bath additive concentration and the water temperature on the refatting effect of oil bath additives]

The refatting effects of three different oil bath products was tested in 30 healthy subjects. In each case the concentration of the therapeutic bath oils and the temperature of the bath water were varied. It could be demonstrated in 2 of the tested products that a threefold increase in the concentrations (as recommended by the companies) significantly enlarges the refatting effect. A further increase in the concentrations significantly reduces this effect. An increase in the temperature of the bath water from 32 degrees to 38 degrees C significantly lessened the refatting effects of all 3 products.     

Stratum corneum lipids: the effect of ageing and the seasons

Stratum corneum lipids play a predominant role in maintaining the water barrier of the skin. In order to understand the biological variation in the levels and composition of ceramides, ceramide 1 subtypes, cholesterol and fatty acids, stratum corneum lipids collected from tape strippings from three body sites (face, hand, leg) of female Caucasians of different age groups were analysed. In addition, we studied the influence of seasonal variation on the lipid composition of stratum corneum from the same body sites. The main lipid species were quantified using high-performance thin-layer chromatography and individual fatty acids using gas chromatography. Our findings demonstrated significantly decreased levels of all major lipid species, in particular ceramides, with increasing age. Similarly, the stratum corneum lipid levels of all the body sites examined were dramatically depleted in winter compared with spring and summer. The relative levels of ceramide 1 linoleate were also depleted in winter and in aged skin whereas ceramide 1 oleate levels increased. The other fatty acid levels remained fairly constant with both season and age, apart from lignoceric and heptadecanoic acid which showed a decrease in winter compared with summer. The decrease in the mass levels of intercellular lipids and the altered ratios of fatty acids esterified to ceramide 1, are likely to contribute to the increased susceptibility of aged skin to perturbation of barrier function and xerosis, particularly during the winter months. Received: 17 October 1995     

The phototoxic inhibitory effect and phototoxic killing effect of micro-organisms

The toxic and phototoxic growth inhibitory and killing effect of Staphylococcus aureus, S. epidermidis, Escherichia coli, Pseudomonas aeruginosa, Streptococcus pyogenus gr. A, St. viridans, Pityrosporum ovale and Candida albicans were studied. P. ovale and St. viridans were the only micro-organisms with any toxic effect against the other micro-organisms tested. P. ovale inhibited the growth of S. aureus, S. epidermidis, Ps. aeruginosa and E. coli. St. viridans inhibited the growth of S. aureus, S. epidermidis, Ps. aeruginosa, E. coli, St. pyogenus gr. A and P. ovale. This effect was only growth inhibitory and not direct killing. The activity was increased by UVA on S. aureus, S. epidermidis and Ps. aeruginosa but not on E. coli and St. pyogenes gr. A. These effects of P. ovale and St. viridans may be of importance in the defense against infections.     

硫磺软膏对真菌的作用及其在临床效果方面的探讨

硫磺是据《中国药典》中提到,“它有杀疥虫及霉菌的作用”①,因此国内也用它的软膏制剂作为治疗头癣的外用药物.1976年我们在探讨硫磺消毒头癣患者污染物的作用时,曾用硫磺熏蒸三种头癣的病发,结果未见有杀灭作用②.     

Treatment of urticaria with the new H1 antihistaminic astemizole--with special reference to the time of onset of effect and maximum effect

20 patients, 12 suffering from chronic urticaria, 2 from acute urticaria, 1 from pressure urticaria, 2 from cold urticaria and 3 from urticaria factitia were treated in an open pilot study with the new H1-antihistamine Astemizole. The dosage was in all cases 1 X 10 mg per day. The onset of action as well as the efficacy maximum were registered. Astemizole proved in this study to be a very effective antihistamine being able to achieve good results even in hard to cure cases like cold urticaria. On the 1. day 35% of the patients had noticed an onset of action. 75% of the patients had an onset of action within the first 2 days. The efficacy maximum was achieved within the first 2 days in 60% of the patients.