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目的探讨联合应用复方醋酸环丙孕酮(即达英-35)和二甲双胍治疗多囊卵巢综合征(PCOS)的临床疗效。方法30例PCOS合并高雄激素和胰岛素抵抗患者于自然月经或撤退性出血第5天服用达英-353个周期和二甲双胍3个月。服药前后观察临床表现、阴道超声卵巢体积及卵泡个数、血清生殖激素、血脂分析、空腹及餐后2小时血糖及胰岛素水平。在上述观察指标接近正常后,再用克罗米酚促排卵,待B超监测卵泡成熟,肌注绒毛膜促性腺素5000-10000U,并指导受孕。结果服药前后对比,30例患者血清黄体生成素(LH)、睾酮(T)水平均显著下降(P<0.01);空腹及餐后血清胰岛素(INS)水平显著下降(P<0.01);双侧卵巢体积和卵泡数目显著减少(P<0.01)。HDL-C上升,LDL-C下降(P<0.01),治疗后随访,20例患者恢复排卵性月经,并有17例妊娠。结论联合应用达英-35和二甲双胍治疗PCOS,可减轻临床症状,降低胰岛素水平,降低血脂,恢复正常的血激素相,卵巢大小、形态从卵泡数目均得到有效改善,有助于恢复排卵性月经,并获得妊娠。药物治疗能成功地为多囊卵巢综合征性不孕的患者解决生育问题并改善患者血脂及血糖的代谢。
Objective To investigate the clinical efficacy of the combination of cyproterone acetate (ie Ying-35) and metformin in the treatment of polycystic ovary syndrome (PCOS). Methods Thirty patients with PCOS accompanied by hyperandrogenism and insulin resistance were treated with da-Ying-353 cycles and metformin for 3 months on the 5th day of natural menstruation or withdrawal bleeding. Observed before and after taking the clinical manifestations, vaginal ultrasound ovarian volume and the number of follicles, serum reproductive hormones, blood lipids, fasting and postprandial blood glucose and insulin levels 2 hours. In the observation of indicators close to normal, and then use clomiphene ovulation, to be B-monitoring follicle maturation, intramuscular injection of chorionic gonadotropin 5000-10000U, and to guide the pregnancy. Results Before and after taking the medicine, the levels of serum LH and T were significantly decreased in 30 patients (P <0.01); the levels of fasting and postprandial serum insulin (INS) were significantly decreased (P <0.01) The ovarian volume and the number of follicles decreased significantly (P <0.01). HDL-C increased, LDL-C decreased (P <0.01). After treatment, 20 patients recovered from ovulatory menstruation and 17 cases were pregnant. Conclusions Combined use of Da-Ying-35 and metformin in the treatment of PCOS can reduce clinical symptoms, reduce insulin levels, reduce blood fat, restore normal blood hormone phase, ovarian size and shape are effectively improved from the follicle number, help to restore ovulatory menstruation , And get pregnant. Medication can successfully solve fertility problems and improve blood lipid and glucose metabolism in patients with polycystic ovary syndrome infertility.