摘要
目的探讨克罗米芬与来曲唑联合治疗多囊卵巢综合征型不孕症的临床效果。方法选择2023年11月至2024年11月苏州圣爱医院诊治的60例多囊卵巢综合征(PCOS)型不孕症患者为研究对象,按照治疗方法将患者分为来曲唑组、克罗米芬组和联合用药组,每组20例。来曲唑组患者每晚服用2.5 mg来曲唑,克罗米芬组患者每晚服用2.5 mg克罗米芬,联合用药组患者每晚服用2.5 mg来曲唑和2.5 mg克罗米芬,均持续治疗4个月经周期。比较3组患者治疗前后的体质量指数(BMI)、体质量和血清中睾酮(T)、促黄体生成素(LH)、促卵泡刺激素(FSH)、雌二醇(E_(2))水平及排卵率、妊娠率和并发症发生率。结果治疗前,3组患者的体质量、BMI、FSH、LH、T及E_(2)比较差异均无统计学意义(F=1.842、2.116、1.973、2.271、1.682、2.065,P>0.05)。治疗后,联合用药组患者的体质量、BMI、LH、T、E_(2)显著低于来曲唑组和克罗米芬组(P<0.05);来曲唑组与克罗米芬组患者的体质量、BMI、LH、T、E_(2)比较差异无统计学意义(P>0.05);3组患者的FSH水平比较差异无统计学意义(F=2.762,P>0.05)。联合用药组患者的月经恢复率、排卵率、妊娠率显著高于克罗米芬组和来曲唑组(P<0.05);克罗米芬组与来曲唑组患者治疗后的月经恢复率、排卵率、妊娠率比较差异无统计学意义(P>0.05)。来曲唑组、克罗米芬组及联合用药组患者的并发症发生率分别为40.0%(8/20)、45.0%(9/20)及15.0%(3/20);联合用药组患者的并发症发生率显著低于来曲唑组和克罗米芬组(χ^(2)=5.982、5.887,P<0.05),来曲唑组与克罗米芬组患者的并发症发生率比较差异无统计学意义(χ^(2)=4.863,P>0.05)。结论克罗米芬与来曲唑联合治疗多囊卵巢综合征型不孕症能够显著提升治疗效果,降低并发症的发生。
Objective To investigate the clinical efficacy of combined clomiphene and letrozole in the treatment of infertility associated with polycystic ovary syndrome(PCOS).Methods Sixty patients diagnosed with PCOS-related infertility at Suzhou Sheng′ai Hospital from November 2023 to November 2024 were enrolled as research subjects.They were divided into the letrozole group,clomiphene group,and combination therapy group according to the treatment regimen,with 20 cases in each group.Patients in the letrozole group received 2.5 mg of letrozole orally each night.Patients in the clomiphene group received 2.5 mg of clomiphene orally each night.Patients in the combination therapy group received both 2.5 mg of letrozole and 2.5 mg of clomiphene orally each night.All treatments were administered continuously over four menstrual cycles.The body mass index(BMI),body weight,serum levels of testosterone(T),luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E_(2)),as well as ovulation rate,pregnancy rate,and the incidence of complications were compared among the three groups before and after treatment.Results Before treatment,there were no statistically significant differences in BMI,FSH,LH,T,and E_(2) levels among the three groups(F=1.842,2.116,1.973,2.271,1.682;P>0.05).After treatment,the combination therapy group showed significantly lower body weight,BMI,LH,T,and E_(2) levels compared to both the letrozole group and the clomiphene group(P<0.05).There were no significant differences in body weight,BMI,LH,T,and E_(2) levels between the letrozole and clomiphene groups post-treatment(P>0.05).There was no statistically significant difference in FSH levels of patients among the three groups(F=2.762,P>0.05).The combination therapy group demonstrated significantly higher rates of menstrual recovery,ovulation,and pregnancy compared to both the clomiphene group and the letrozole group(P<0.05).There were no significant differences in post-treatment menstrual recovery rate,ovulation rate,and pregnancy rate between the clomiphene group and the letrozole group(P>0.05).The complication rates in the letrozole group,clomiphene group,and combination therapy group were 40.0%(8/20),45.0%(9/20),and 15.0%(3/20),respectively.The complication rate in the combination therapy group was significantly lower than that in both the letrozole group and the clomiphene group(χ^(2)=5.982,5.887;P<0.05).There was no statistically significant difference in complication rates between the letrozole group and the clomiphene group(χ^(2)=4.863,P>0.05).Conclusion The combination of clomiphene and letrozole significantly enhances therapeutic efficacy in treating PCOS-related infertility.Furthermore,the combined regimen effectively reduces the incidence of complications,offering a novel clinical treatment strategy.
作者
李恩芳
LI Enfang(Department of Gynecology,Suzhou Sheng′ai Hospital,Suzhou 215000,Jiangsu Province,China)
出处
《新乡医学院学报》
2025年第8期659-663,共5页
Journal of Xinxiang Medical University
关键词
克罗米芬
来曲唑
多囊卵巢综合征型不孕症
clomiphene
letrozole
polycystic ovary syndrome-related infertility
