目的 探討坤泰膠囊聯(lián)合炔雌醇環(huán)丙孕酮片和鹽酸二甲雙胍片治療多囊卵巢綜合征的臨床療效。方法 選擇2013年3月-2015年3月汕頭大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院收治的多囊卵巢綜合征患者98例,按治療方案的差別分為治療組和對照組,每組各49例。對照組患者口服炔雌醇環(huán)丙孕酮片,1片/次,1次/d,同時口服鹽酸二甲雙胍片,1片/次,3次/d。治療組在對照組基礎(chǔ)上口服坤泰膠囊,4粒/次,3次/d。所有患者均由第1個月經(jīng)周期的第5天開始用藥,治療4個月。觀察兩組臨床療效,比較兩組患者性激素水平、胰島素抵抗、排卵率及妊娠率變化。結(jié)果 治療后,對照組和治療組總有效率分別為85.11%、95.92%,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者的黃體激素(LH)、促卵泡激素(FSH)、睪酮(T)、胰島素分泌指數(shù)(HOMA-β)和胰島素抵抗指數(shù)(HOMA-IR)均明顯降低,雌激素(E₂)明顯升高,同組治療前后差異具有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度均優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,對照組和治療組排卵率分別為79.59%、93.88%,妊娠率分別為65.31%、83.67%,兩組排卵率和妊娠率比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 坤泰膠囊聯(lián)合炔雌醇環(huán)丙孕酮片和二甲雙胍治療多囊卵巢綜合征具有較好的臨床療效,可明顯改善患者性激素水平和胰島素抵抗,有利于提高妊娠率,具有一定的臨床推廣價值。

Objective To explore the clinical effect of Kuntai Capsules combined with Ethinylestradiol and Cyproterone Acetate Tablets and Metformin Hydrochloride Tablets in treatment of polycystic ovary syndrome. Methods Patients (98 cases) with polycystic ovary syndrome in Department of Obstetrics and Gynecology, the First Affiliated Hospital of Shantou University Medical College from March 2013 to March 2014 were enrolled in the study. According to the different treatment plans, patients were divided into treatment group and control group, and each group had 49 cases. The patients in control group were po administered with Ethinylestradiol and Cyproterone Acetate Tablets, 1 tablet/time, once daily. And they were po administered with Metformin Hydrochloride Tablets at the same time, 1 tablet/time, three times daily. The patients in treatment group were po administered with Kuntai Capsules on the basis of the control group, 4 grains/time, three times daily. The patients in two groups were given the drugs from day 5 of the first menstrual cycle, and were treated for 4 months. After treatment, the efficacy was evaluated, and the changes of sex hormone levels, insulin resistance, ovulation rate, and pregnancy rate in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 85.11% and 95.92%, respectively, and there were differences between two groups (P < 0.05). After treatment, LH, FSH, T, HOMA-IR, and HOMA-β in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in treatment group were better than those in control group, with significant difference between two groups (P < 0.05). After treatment, ovulation rate in the control and treatment groups were 79.59% and 93.88%, respectively. And pregnancy rate in the control and treatment groups were 65.31% and 83.67%, respectively. And ovulation rate and pregnancy rate had significant difference between two groups (P < 0.05). Conclusion Kuntai Capsules combined with Ethinylestradiol and Cyproterone Acetate Tablets and Metformin Hydrochloride Tablets has clinical curative effect in treatment of polycystic ovary syndrome, and can improve sex hormone levels and insulin resistance, and is helpful to increase pregnancy rate, which has a certain clinical application value.