枸橼酸氯米芬联合戊酸雌二醇治疗排卵障碍性不孕症的临床观察

目的观察枸橼酸氯米芬联合戊酸雌二醇治疗排卵障碍性不孕症的临床疗效及安全性。方法选取110例排卵障碍性不孕症患者,采用信封法随机分为2组,每组55例。对照组患者单用枸橼酸氯米芬治疗,在月经周期第5天开始服用,连续用药5 d。观察组患者在对照组基础上联合使用戊酸雌二醇,在月经周期第8天开始用药,直至阴道B超检查显示卵泡成熟且排卵成功为止。对两组患者治疗期间及治疗后1年进行随访,定期行阴道B超检查,以检查患者排卵情况,并详细记录患者用药期间不良反应发生情况及随访期间患者妊娠情况。根据患者是否受孕进行疗效评定。结果观察组、对照组的治愈率分别为72.73%、45.45%,观察组治愈率明显高于对照组(P<0.05)。两组患者均无明显严重不良反应发生,观察组5例(9.09%)表现为头痛、腹痛及恶心,对照组3例(5.45%)表现为消化道不适,两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论枸橼酸氯米芬联合戊酸雌二醇治疗排卵障碍性不孕症患者,可有效促进排卵,提高受孕率,效果优于单用枸橼酸氯米芬,而且不良反应少,是治疗排卵障碍性不孕症的理想方法。

Clinical observation of clomiphene citrate combined with estradiol valerate in the treatment of anovulatory infertility

Objective To observe the efficacy and safety of clotniphene citrate combined with estradiol valetate in the treatment of anovulatory infertility. Methods 110 patients with anovulatory infertility were randomly divided into two groups using envelope method,55 cases in each group. Patients in control group were treated with clomiphene citrate at the 5th day in menstrual cycle,the patients were treated continuously for 5 d. Patients in observation group were treated with basic treatment of control group combined with estradiol valerate at the 8th day in the menstrual cycle until the vaginal B ultrasound examination showed follicular maturation and ovulation success so far. The patients were followed up at one year after treatment, the periodic vaginal ultrasound B was checked, and the adverse events and the pregnancy situation in the one-year follow-up were recorded. The efficacy was evaluated according to pregnant situa- tion. Results The curative rate of control group and observation group were 72.73 % and 45.45 % , there were significant differences between the two groups（ P 〈 0.05 ）. No obvious serious adverse reaction was found in the two groups. There were 5 cases （ 9.09 % ） of headache, abdominal pain and nausea in observation group, and 3 cases （ 5.45 % ） of gastrointestinal discomfort in control group, there was no significant difference in the incidences of adverse reactions be- tween the two groups （ P 〉 0.05 ）. Conclusion Clomiphene combined with estradiol valerate therapy in patients with anovulatory infertility, can effectively promote ovulation, improve the conception rates, and the efficacy was better than that of the patients treated with clomiphene alone with fewer adverse reactions,it is ideal for the treatment of ovulatory infertility.