多囊卵巢综合征个体化调整内分泌治疗疗效观察
Efficacy of individualized adjustment of endocrine in patients with polycystic ovary syndrome

目的:探讨个体化调整内分泌策略治疗多囊卵巢综合征(PCOS)的临床疗效。方法:根据睾酮(T)、促黄体生成素(LH)水平将220例PCOS患者分为3组。A1组(基础状态血清T、LH水平同时升高)50例,给予炔雌醇环丙孕酮(达英-35)2个周期、去氧孕烯炔雌醇(妈富隆)1个周期口服; A2组(基础状态血清T水平升高)40例,给予达英-35 1个周期、屈螺酮炔雌醇(优思明)2个周期口服; A3组(基础状态血清LH水平升高)130例,行达英-35 1个周期、妈富隆2个周期口服; 然后促排卵。结果:A1组调整内分泌后血清T、LH、FSH、LH/FSH较调整前下降(P<0.05),A2组调整后血清T、LH/FSH较调整前下降(P<0.05),A3组调整后血清T、LH、LH/FSH较调整前下降(P<0.05)。3组排卵率、有效率、不良反应发生率差异无统计学意义(P>0.05)。220例总体排卵率达60.0%,总体有效率达54.5%,总体不良反应发生率为5.5%。结论:个体化调整内分泌能明显改善PCOS患者体内内分泌紊乱状态,提高排卵率及临床妊娠率,安全性较高。
Aim: To explore the efficacy of individualized adjustment of endocrine in the treatment of polycystic ovary syndrome(PCOS).Methods: A total of 220 patients with PCOS were collected, and divided into A1, A2 and A3 groups according to the levels of testosterone(T)and luteinizing hormone(LH)before treatment. A1 group(high level of T and LH,n=50)was given Diane-35 for 2 cycles and Marvelon for 1 cycle, A2 group(high level of T,n=40)was given Diane-35 for 1 cycle and Yasmin for 2 cycles, and A3 group(high level of LH,n=130)was given Diane-35 for 1 cycle and Marvelon for 2 cycles. Then ovulation induction was performed.Results:After the adjustment,serum T, LH, FSH and LH/FSH in A1 group decreased(P<0.05); serum T and LH/FSH in A2 group decreased(P<0.05); serum T, LH and LH/FSH in A3 group decreased significantly(P<0.05). The ovulation rate,effective rate, and the incidence of adverse reactions among the three groups had no statistical differences(P>0.05). The total ovulation rate,effective rate, and the incidence of adverse reactions of the 220 cases were 60.0%,54.5% and 5.5%.Conclusion: Individualized adjustment of endocrine can relieve endocrine disorder situation of patients with PCOS, and increase the ovulation rate and clinical pregnancy rate, with high safety