目的 探讨地屈孕酮联合来曲唑治疗多囊卵巢综合征(PCOS)对炎症因子及血清硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)的影响.方法 选取该院2020年1月至2021年1月收治的PCOS患者84例,将其随机分为观察组和对照组,各42例.在口服二甲双胍片治疗的基础上,对照组予以来曲唑治疗,观察组在上述基础上予以地屈孕酮治疗.治疗12个月经周期后,比较两组临床疗效.比较治疗前后两组性激素水平、排卵情况、炎症因子、血清DHEAS及SHBG水平.比较治疗完成后6个月内两组妊娠情况及治疗期间不良反应发生情况.结果 治疗完成后,观察组患者临床疗效优于对照组(P<0.05);治疗后两组患者雌二醇(E2)、促黄体生成素(LH)、DHEAS、血清肿瘤坏死因子(TNF)-α及白细胞介素(IL)-6水平较治疗前均降低,且观察组低于对照组,差异均有统计意义(P<0.05);治疗后两组患者卵泡刺激素(FSH)、成熟卵泡数、排卵数及SHBG水平较治疗前升高,且观察组高于对照组,差异均有统计意义(P<0.05);治疗完成后6个月,观察组患者妊娠率高于对照组(P<0.05);两组总不良反应发生率比较,差异无统计学意义(P>0.05).结论 地屈孕酮联合来曲唑治疗PCOS,可有效抑制机体炎症因子水平,改善其临床症状,同时可纠正性激素分泌紊乱,促进排卵,提升患者妊娠率,且安全性较高,临床效果显著,值得推广应用.
Objective To explore the effects of dydrogesterone combined with letrozole for treating poly-cystic ovary syndrome(PCOS)on the inflammatory factors,serum dehydroepiandrosterone sulfate(DHEAS)and sex hormone binding globulin(SHBG).Methods A total of 84 patients with PCOS admitted and treated in this hospital from January 2020 to January 2021 were selected and randomly divided into the observation group and control group with 42 cases in each group.On the basis of oral metformin tables,the control group was treated with letrozole,and the observation group was treated with dydrogesterone on the above basis.Af-ter 12 menstrual cycles of treatment,the clinical efficacy was compared between the two groups.The sex hor-mones levels,ovulation situation,inflammatory factors,serum DHEAS and SHBG levels before and after treatment were compared between the two groups.The pregnancy status within 6 months after treatment fin-ish was compared between the two groups.The occurrence situation of adverse reactions during the treatment period was compared between the two groups.Results After treatment finished,the clinical efficacy of the observation group was better than that of the control group(P<0.05).After treatment,the estradiol(E2),luteinizing hormone(LH),DHEAS,serum tumor necrosis factor-a(TNF-a)and interleukin(IL)-6 were de-creased compared with those before treatment,moreover the observation group was lower than the control group,and the differences were statistically significant(P<0.05).The follicle-stimulating hormone(FSH),number of mature follicles,ovulation number and SHBG level after treatment in the two groups were in-creased compared with those before treatment,moreover the observation group was higher than the control group,and the differences were statistically significant(P<0.05);the pregnancy rate in 6 months after the treatment finish in the observation group was higher than that in the control group(P<0.05).There was no signifi-cant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion Dydrogest-erone combined with letrozole in the treatment of PCOS could effectively inhibit the level of inflammatory fac-tors in the body,improve its clinical symptoms,correct the disorder of sex hormone secretion,promote ovula-tion,and increase the pregnancy rate of the patients,with high safety and obvious clinical effect,which is wor-thy of promotion and application.