目的 探讨坤泰胶囊联合炔雌醇环丙孕酮片和盐酸二甲双胍片治疗多囊卵巢综合征的临床疗效。方法 选择2013年3月-2015年3月汕头大学医学院第一附属医院收治的多囊卵巢综合征患者98例,按治疗方案的差别分为治疗组和对照组,每组各49例。对照组患者口服炔雌醇环丙孕酮片,1片/次,1次/d,同时口服盐酸二甲双胍片,1片/次,3次/d。治疗组在对照组基础上口服坤泰胶囊,4粒/次,3次/d。所有患者均由第1个月经周期的第5天开始用药,治疗4个月。观察两组临床疗效,比较两组患者性激素水平、胰岛素抵抗、排卵率及妊娠率变化。结果 治疗后,对照组和治疗组总有效率分别为85.11%、95.92%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者的黄体激素(LH)、促卵泡激素(FSH)、睾酮(T)、胰岛素分泌指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)均明显降低,雌激素(E₂)明显升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度均优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组排卵率分别为79.59%、93.88%,妊娠率分别为65.31%、83.67%,两组排卵率和妊娠率比较差异有统计学意义(P<0.05)。结论 坤泰胶囊联合炔雌醇环丙孕酮片和二甲双胍治疗多囊卵巢综合征具有较好的临床疗效,可明显改善患者性激素水平和胰岛素抵抗,有利于提高妊娠率,具有一定的临床推广价值。

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.