二甲双胍联合克罗米芬治疗多囊卵巢综合征合并高胰岛素血症原发不孕35例临床观察

目的探讨二甲双胍联合克罗米芬治疗多囊卵巢综合征(PCOS)合并高胰岛素血症原发不孕患者的临床效果。方法随机将PCOS合并高胰岛素血症原发不孕患者60例分为2组,研究组35例从月经周期或撤退性出血第1天始服用二甲双胍500mg/次,每天3次,连服3个月;并于第5天始加服克罗米芬50mg/次,每天1次,连服5d。对照组25例于月经第5天始单用克罗米芬,连用5d。治疗后测定2组体质量指数(BMI)、性激素水平[黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)]和空腹胰岛素(FINS)水平。结果服药后,研究组LH、T、FINS水平低于对照组,差异均有统计学意义(P<0.05);研究组排卵率及妊娠率均明显高于对照组(P<0.05)。结论二甲双胍联合克罗米芬治疗PCOS合并高胰岛素血症原发不孕患者,能降低LH、T、FINS水平,提高排卵及妊娠率,值得推广应用。

Clinical observation of metformin combined with clomiphene citrate on 35 cases of citrate in polycystic ovary syn-drome with hyperinsulinemia primary infertility

Objective To explore the effect of metformin combined with clomiphene citrate on 35 cases of citrate in polycystic ovary syndrome（PCOS） with hyperinsulinemia primary infertility. Methods 60 cases of PCOS with hyperinsuline- mia primary infertility were randomly divided into study group（ 35 cases） and control group（ 25 cases）. From the first day of the menstrual cycle or withdrawal bleeding study group began took mefformin 500mg, three times a day, and even served three months;The fifth day began took clomiphene citrate 50mg, once daily, and even served 5d. Control group began with clomiphene citrate from the fifth day,used in conjunction 5d. Determined body mass index（ BMI）, sex hormone levels and fasting insulin （FINS） level after the treatment. Results After treatment, the LH,T, FINS level of study group were lower than those of con- trol group,the differences were statistically significant （ P 〈 0.05 ）. The ovulation rate and pregnancy rate of study group were significantly higher than those of control group（P 〈 O. 05 ）. Conclusion Mefformin compared with clomiphene citrate treat P- COS with hyperinsutinemia primary infertility, can reduce LH,T, FINS level and improve ovulation and pregnancy rate, should be widely applied.