罗格列酮联合复方环丙孕酮治疗PCOS 17例临床观察

目的观察联合应用罗格列酮和复方环丙孕酮(CPA)治疗多囊卵巢综合征(PCOS)的临床效果。方法49例PCOS患者,随机分为联合用药组17例、罗格列酮组和CPA组各16例,治疗3个月后用克罗米芬促排卵治疗。观察各组治疗前后黄体生成素(LH)/卵泡刺激素(FSH)、LH、睾酮(T)、胰岛素抵抗(IR)、卵泡数的变化,以及促排卵治疗后的排卵率。结果除CPA组的IR与治疗前比较差异无显著性外,各组T、LH、LH/FSH以及IR均较治疗前降低(P<0.01);联合用药组T分别较其他两组显著降低,IR较CPA组显著降低(P<0.01);双侧卵巢中卵泡个数各组均较治疗前明显减少(P<0.01),联合用药组的卵泡数较罗格列酮、CPA组的卵泡数更少(P<0.01);各组促排卵治疗后排卵率的差异无显著性(P>0.05)。结论罗格列酮联合CPA可以提高PCOS的治疗效果,值得临床进一步扩大观察和应用。

Clinical observation of therapeutic efficacies of rosiglitazone in combination with compound cyproterone in the treatment of polycystic ovarian syndrome (PCOS)

Objective To observe the clinical therapeutic efficacies of rosiglitazone in combination with compound cyproterone in the treatment of polycystic ovarian syndrome(PCOS). Methods 49 patients of polycystic ovarian syndrome were randomly divided into group of therapy of rosiglitazone in combination with compound cyproterone(17 patients),group of therapy of rosiglitazone(16 patients) and group of therapy of CPA(16 patients).Luteinizing hormone(LH)/ follicle stimulating hormone(FSH),LH,testosterone(T),insulin resistance(IR),and variations of number of follicles were tested before and after the treatments;and ovulation rates were monitored after the treatments.Results The levels of T,LH,LH/FSH,and IR decreased in different therapeutic groups(P<0.01),except IR in CPA group showed no significant differences before and after treatment.The level of T in the therapeutic group of rosiglitazone in combination with compound cyproterone decreased more than that in the other therapeutic groups significantly,and the level of IR decreased more than that in CPA group.Follicle numbers in the two ovaries of patients decreased in all the therapeutic groups significantly compared with those before the treatments(P<0.01);there were no significant difference in ovulation rates in different therapeutic groups after ovulation induction treatment(P>0.05);with follicle numbers the lowest in the group of rosiglitazone in combination with compound cyproterone;and T levels in this group decreased more than those in other two therapeutic groups,and IR decreased more than that in CPA group significantly.Conclusion Therapy of rosiglitazone in combination with compound cyproterone can improve the therapeutic efficacies of PCOS,and further clinical applications are expected.