二甲双胍联合来曲唑治疗耐克罗米芬多囊卵巢综合征不孕症的疗效观察

目的探究二甲双胍联合来曲唑治疗耐克罗米芬多囊卵巢综合征(PCOS)不孕症的效果。方法选取2016年6月至2020年6月本院收治的60例耐克罗米芬PCOS不孕症患者,采用随机数字表法分为两组,各30例。对照组给予来曲唑治疗,观察组给予来曲唑+二甲双胍治疗,比较两组性激素水平、排卵妊娠情况、胰岛素抵抗及不良反应发生率。结果治疗前,两组卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)水平比较差异无统计学意义;治疗2个月经周期后,观察组FSH、E2、LH水平均低于对照组,差异有统计学意义(P<0.05)。观察组排卵率和妊娠率均高于对照组,卵巢过度刺激综合征(OHSS)发生率和周期取消率均低于对照组,差异有统计学意义(P<0.05)。治疗前,两组瘦素(LEP)、脂联素(APN)、空腹胰岛素(FINS)、空腹血糖(FPG)水平比较差异无统计学意义;治疗2个月经周期后,观察组LEP、FINS、FPG水平均低于对照组,APN水平高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论二甲双胍联合来曲唑能调节耐克罗米芬PCOS不孕症患者性激素水平,改善排卵妊娠情况及胰岛素抵抗,且具有一定安全性。

Observation on the curative effect of metformin combined with letrozole in the treatment of clomiphene-resistant polycystic ovary syndrome infertility

Objective To explore the effect of metformin combined with letrozole in the treatment of clomiphene-resistant polycystic ovary syndrome(PCOS) infertility. Methods A total of 60 patients with clomiphene-resistant PCOS infertility who were admitted to our hospital from June2016 to June 2020 were selected and they were divided into two groups by random number table, with 30 cases in each group. The control group was given letrozole treatment, and the observation group was given letrozole+metformin treatment. The levels of sex hormones, ovulation and pregnancy,insulin resistance and the incidence of adverse reactions were compared between the two groups. Results Before treatment, there was no significant difference in the levels of follicle stimulating hormone(FSH), estradiol(E2), and luteinizing hormone(LH) between the two groups;after treatment for 2 menstrual cycles, the levels of FSH, E2 and LH in the observation group were lower than those in the control group, the difference was statistically significant(P<0.05). The ovulation rate and pregnancy rate of the observation group were higher than those of the control group, and the incidence and cycle cancellation rate of ovarian hyperstimulation syndrome(OHSS) were lower than those of the control group, and the difference was statistically significant(P<0.05). Before treatment, there was no significant difference in the levels of leptin(LEP), adiponectin(APN), fasting insulin(FINS), and fasting blood glucose(FPG) between the two groups;after treatment for 2 menstrual cycles, the observation group LEP, FINS, FPG level was lower than that of the control group, and the APN level was higher than that of the control group, and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups. Conclusion Metformin combined with letrozole can regulate the level of sex hormones in patients with clomiphene-resistant PCOS infertility, improve ovulation pregnancy and insulin resistance, and has certain degree of safety.