多囊卵巢综合征患者应用二甲双胍增强氯米酚的促排卵效果观察

目的 :探讨二甲双胍对耐氯米酚 (CC)的多囊卵巢综合征 (PCOS)患者的疗效。方法 :选择耐CC的PCOS患者 5 6例 ,分成A、B两组 ,采用随机、双盲、安慰剂控制试验。A组给二甲双胍 5 0 0mg 3次·d- 1 ,月经第 5～ 9天予安慰剂治疗 ;B组给二甲双胍 5 0 0mg 3次·d- 1 ,月经第 5～ 9天予CC 5 0mg 1次·d- 1 治疗。测定所有患者治疗前和治疗 3个月后的性激素水平、空腹血糖(FG)、空腹胰岛素 (FINS)以及胰岛素抵抗指数 (HOMA IR) ,B超监测排卵情况。结果 :两组患者治疗后黄体生成素 (LH)、睾酮(T)、FINS、HOMA IR均明显下降 (P <0 .0 0 1) ,B组排卵率明显优于A组 (P <0 .0 0 1)。结论 :二甲双胍能使部分PCOS患者恢复排卵 ,二甲双胍和CC共同使用能明显提高耐CC的PCOS患者的排卵率。

Efficacy of metformin in promoting ovulation of clomiphene-resistant polycystic ovary syndrome

Objective To observe the effect of metformin in th e treatment of patients with polycystic ovary syndrome (PCOS) who are resistant t o clomiphene citrate(CC). Methods In a double-blind, randomiz ed, placebo-controlled trail, 56 PCOS patients with CC-resi sta nt were randomly assigned into two groups. Patients in group A(n=28) randoml y received metformin 500-mg t.i.d and a placebo on day 5th-9th of menstruation . Group B(n=28) was rand omized to receive metformin 500-mg t.i.d with CC 50-mg q.d on day 5th-9th of menstruation.The d uration of the study was 3 months. The levels of serum FSH,LH T, glucose and i nsuli n at fasting (FG and FINS) were measured in all-patients. Transvaginal-ultraso nography was used for monitoring .Results IngroupA and B ,the levels of serumLH ,T ,FIN Sand HOMA IRweresignificantlyde creasedwhencomparedwiththoseofpre treatmentlevels(P <0.001) .The ovulationrateingroupBwereremarkablyhigher thanthatingroupA(P <0.01) .Conclusions Met for minthe rapyinwomen with PCOS can induce ovulation .Met for minplus CC ovulation is very effective in the treatment of CC-resistant PCOS .