甘芍胶囊治疗耐克罗米芬性多囊卵巢综合征的临床研究

目的评价甘芍胶囊(GSC)治疗耐克罗米芬(CC)、高雄激素血症多囊卵巢综合征(PCOS)患者的有效性、安全性,探索停药后CC改善促排卵效果的可行性。方法给27例PCOS患者服GSC,共8周(2个月经周期)。服药前、服药4周及8周末,观察血清生殖激素、体重指数(BMI)、盆腔超声相的变化及不良反应。停药后,将血清睾酮(T)<(2·1±0·8)nmol/L的未排卵者再行CC促排卵,监测卵泡发育及效果。结果服药4周末,血清生殖激素均有显著变化。服药8周末,双侧卵巢体积、卵泡数及卵泡直径均显著减小,子宫内膜明显变薄。停中药2个月内,27例中6例自然排卵,2例自然妊娠。19例37个周期行CC促排卵,17例25个周期排卵,7例妊娠,排卵率89·5%,排卵周期率67·6%,妊娠率36·8%,妊娠周期率28·0%。结论采用GSC治疗耐CC、高雄激素血症PCOS患者,可使子宫内膜、卵巢形态及BMI得到明显改善,并提高耐CC者对CC促排卵的敏感性。

英文摘要:

ObjectiveTo assess the efficacy and safety of Ganshao Capsule (GSC) in treating clomiphene (CC)-resistant hyperandrogenemic polycystic ovarian syndrome (PCOS), and to explore the feasibility of using CC for improving ovulation induction after withdrawal of GSC. MethodsTwenty-seven PCOS patients were given GSC for 8 weeks (2 cycles). Changes in serum reproductive hormone, body mass index (BMI), adverse reaction, as well as pelvic ultrasonographic feature were observed before treatment, at the end of 4 weeks and 8 weeks after treatment. After stopping GSC medication, CC was used to induce ovulation in patients whose serum testosterone (T) <(2.1±0.8)nmol/L but without ovulation. Condition of follicle growth and effect of GSC were monitored. ResultsAfter 4 weeks of treatment, serum reproductive hormones were significantly changed. At the end of 8 weeks, bilateral ovarian volume, number of follicles, and diameter of follicles were significantly reduced, and endometrium obviously thinned. Within 2 months after stopping medication, 6 in the 27 patients got natural ovulation, and 2 natural pregnancy. In the other 19 patients who received ovulation induction during the 37th cycles, 17 had ovulation in the 25th cycles, 7 got pregnancy, the ovulation rate being 89.5%, ovulation cycle rate 67.6%, pregnant rate 36.8%, and pregnant cycle rate 28.0%. ConclusionEndometrium, ovarian morphology and BMI got significant improvement in PCOS patients with CC- resistance and hyperandrogenemia. The sensitivity to ovulation induction with CC were also improved.

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