摘要
他莫昔芬(三苯氧胺,Tamoxifen简写TMX)具有与克罗米芬相似的化学结构,是雌激素的拮抗剂。Klopper与Hall于1971年首次应用TMX诱发排卵,其后又有不少关于TMX诱发排卵的报道,其副作用少,对宫颈粘液影响较小,甚至比克罗米芬更有效,国内尚缺乏这方面的研究,本文对此进行初步探讨。 材料和方法 收集1990年8月～1991年4月在我科专科门诊就诊的41例月经失调或不孕的无排卵病人,初诊时询问病史,行全身和妇科检查,指导病人自测基础体温2～3个月,其间常规行内分泌激素测定[FSH(促性腺激素)、LH(黄体生成素)、E_2(雌二醇)、P(黄体酮)、PRL(催乳素)、T(睾酮)及T_3和T_4]、肝、肾功能和血、尿常规等检查,部分病人检查阴道细胞激素水平、B超、腹腔镜、子宫内膜活检,综合上述指标将这41例无排卵者分为三组:1.无排卵型功血10例,平均年龄26.8±6.14岁(21～36岁);2.多囊卵巢综合征18例,平均年龄28.44±3.47岁(22～35),3.卵巢功能低下。
Forty-one anovulatory women was given tamoxifen 20mg twice a day for 5 consecutive days started on the 5th day of the onset of menstruation or withdrawal bleeding.Small dosage of stilbestrol or dexamethasone were added to the patients who had failed to ovulate with tamoxifen according to their individual condition. One hundred treatment cycles were carried out in 41 patients.Forty-two ovulatory cycles were successfully induced in 22 of 41 patients.In the 41 patients using tamoxifen,9 of 10 women(90%)with anovulatory dysfunctional uterine bleeding ovulated in 23 cycles of 27 treatment cycles (85.19%), 12 of 18(66.67%) patients with polycystic ovarian syndrome ovulated in 18 cycles of 40 treatment cycles (45%), 4 patients became pregnancy and 1 of 13 patients (7.69%)with hypofunctional ovary ovulated in 1 cycles of 33 treatment cycles(3.03%)The mean luteal phase of induced ovulatory cycles in 13.08 ±0.95 days and about 69.04% induced ovulation occurred between 7th to 15th day after the cessation of tamoxifen administration. Tamoxifen is more effective to the patients with anovulatory dysfunctional uterine bleeding or polycystic ovarian syndrome who have some certain level of estrogen.lt' s less effective to the patients with hypofunctional ovary.The effect of ovulation induction with tamoxifen can not be improved by the addition of stilbestrol for the patients with low level of estrogen.In some patients,it is helpful for tamoxifen inducing ovulation when dexamethasone added promptly.
出处
《广东医学》
CAS
CSCD
1994年第3期149-151,共3页
Guangdong Medical Journal
