摘要
目的探讨N-乙酰半胱氨酸联合他莫昔芬治疗氯米芬抵抗多囊卵巢综合征的效果评价及对促排卵和性激素的影响。方法选取2015年9月~2017年10月4家医院妇科门诊就诊的110例多囊卵巢综合征患者,将其随机分为观察组和对照组,每组55例。对照组采用他莫昔芬治疗,观察组采用N-乙酰半胱氨酸联合他莫昔芬治疗。比较两组患者临床疗效、临床症状、雌激素水平、排卵和妊娠情况、胰岛素抵抗指标及不良反应发生情况。结果观察组的总有效率高于对照组(90.9%vs72.7%,P<0.05);观察组多毛评分和卵巢体积均低于对照组,子宫内膜厚度和宫颈黏液评分高于对照组(P<0.05);观察组血清黄体生成素、睾酮、雌二醇低于对照组(P<0.05),而促卵泡激素差异无统计学意义(P>0.05);观察组排卵率、成熟卵泡数及妊娠率均高于对照组,早期流产率低于对照组(P<0.05);观察组FBG、FINs、HOMA-IR、HOMA-β低于对照组(P<0.05);两组患者不良反应发生率差异无统计学意义(P>0.05)。结论N-乙酰半胱氨酸联合他莫昔芬治疗可有效改善氯米芬抵抗多囊卵巢综合征患者的胰岛素抵抗和高雄激素血症症状,促进排卵和妊娠。
Objective To investigate the effect evaluation of N-acetylcysteine combined with tamoxifen for the treatment of clomiphene resistant polycystic ovary syndrome evaluation and its effect on ovulation and sex hormone. Methods A total of 110 patients with PCOS were selected from September 2015 to October 2017 in our hospital. All patients were randomly divided into the observation group and the control group, with 55 cases in each group. The control group was treated with tamoxifen, and the observation group was treated with N-acetylcysteine combined with tamoxifen. The clinical efficacy, clinical symptoms, estrogen levels, ovulation and pregnancy, insulin resistance index and adverse reactions were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group(90.9% vs 72.7%, P<0.05). The scores of hirsutism and ovary in the observation group were significantly lower than those in the control group. The endometrial thickness and cervical mucus score were significantly higher in the observation group than the control group(P<0.05). The levels of LH, T and E2 in the observation group were significantly lower than those in the control group(P<0.05), while there was no significant difference of FSH(P>0.05). The ovulation rate, the number of mature follicles and the pregnancy rate of the observation group were significantly higher than those of the control group. The rate of early abortion was significantly lower than that of the control group (P<0.05). The levels of FBG, FINs, HOMA-IR and HOMA-β in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference of the incidence of adverse reactions between the two groups (P>0.05). Conclusion N-acetylcysteine combined with tamoxifen therapy can effectively improve the clomiphene resistant polycystic ovary syndrome patients with insulin resistance and Kaohsiung hormones symptoms, promote ovulation and pregnancy.
作者
邹青娥
于灵
魏青文
杨佩娴
ZOU Qing-e;YU Ling;WEI Qingwen;YANG Peixian(Dongguan Nancheng Hospital, Dongguan 523071, China;First People's Hospital of Kashgar, Kashgar 844000, China;Department of Obstetrics and Gynecology, Dongguan Kanghua Hospital, Dongguan 523749, China;Department of Gynecology, Kaiping Hospital of Guangdong Medical University, Kaiping 529300, China)
出处
《分子影像学杂志》
2019年第3期401-405,共5页
Journal of Molecular Imaging
基金
国家卫计委医药卫生科研中心项目(W2016CWGD05)
