本文選題：雷洛昔芬 + 氯米芬�。� 參考：《中國藥房》2017年23期

【摘要】：目的:比較雷洛昔芬與氯米芬治療多囊卵巢綜合征(PCOS)合并不孕癥的臨床效果。方法:采用回顧性研究法,選擇2012年6月-2015年2月在我院治療的137例PCOS合并不孕癥患者的臨床資料,按照治療方案不同分為雷洛昔芬組(70例)和氯米芬組(67例)。雷洛昔芬組患者于月經(jīng)周期第5天口服鹽酸雷洛昔芬片120 mg,qd,連服5 d;氯米芬組患者于月經(jīng)周期第5天口服枸櫞酸氯米芬膠囊100 mg,qd,連服5 d。兩組患者均于月經(jīng)周期第12天行B超檢測卵泡直徑及子宮內(nèi)膜發(fā)育情況,當子宮內(nèi)膜厚度≥7 mm、不少于1個卵泡直徑≥18 mm時,于腹部皮下注射醋酸曲普瑞林注射液0.1 mg誘發(fā)排卵,48 h后B超確認排卵;黃體功能不足者酌情口服地屈孕酮10 mg,q12 h,服用至排卵后15 d。比較兩組患者醋酸曲普瑞林注射當日的子宮內(nèi)膜厚度、直徑≥18 mm的卵泡數(shù)、卵泡成熟時間,治療前與醋酸曲普瑞林注射當日的血清性激素水平,排卵情況,隨訪期間的結(jié)局指標,以及不良反應發(fā)生情況。結(jié)果:雷洛昔芬組患者的子宮內(nèi)膜厚度明顯大于氯米芬組,直徑≥18 mm的卵泡數(shù)明顯多于氯米芬組,卵泡成熟時間明顯短于氯米芬組,差異均有統(tǒng)計學意義(P0.05)。治療前,兩組患者血清孕激素(P)、雌二醇(E2)、卵泡雌激素(FSH)和黃體生存素(LH)水平比較,差異均無統(tǒng)計學意義(P0.05);醋酸曲普瑞林注射當日,兩組患者血清P、E2、FSH與治療前比較,差異均無統(tǒng)計學意義(P0.05),但血清LH水平均明顯降低,且雷洛昔芬組的LH水平明顯低于氯米芬組,差異均有統(tǒng)計學意義(P0.05)。雷洛昔芬組患者的排卵率明顯高于氯米芬組,差異有統(tǒng)計學意義(P0.05);兩組患者的妊娠率、流產(chǎn)率、繼續(xù)妊娠率比較,差異均無統(tǒng)計學意義(P0.05)。兩組患者總不良反應發(fā)生率比較(5.71%vs.8.96%),差異無統(tǒng)計學意義(P0.05)。結(jié)論:雷洛昔芬較氯米芬有更好的促排卵效應,可有效改善PCOS合并不孕癥患者的性激素水平,不良反應較少,且與氯米芬的遠期臨床效應類似。
[Abstract]:Objective: to compare the clinical effects of raloxifen and clomiphene in the treatment of polycystic ovary syndrome (PCOS) with infertility. Methods: the clinical data of 137 patients with PCOS combined with infertility treated in our hospital from June 2012 to February 2015 were retrospectively studied. According to different treatment schemes, they were divided into two groups: raloxifene group (n = 70) and clomiphene group (n = 67). The patients in the raloxifene group received oral administration of loroxifene hydrochloride 120 mg / g QD for 5 days on the 5th day of menstrual cycle, and clomiphene group took 100 mg clomiphene citrate capsule for 5 days on the 5th day of menstrual cycle. The follicle diameter and endometrial development were measured by B-ultrasound on the 12th day of menstrual cycle. When the thickness of endometrium was 鈮，

本文編號：1916161