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目的观察普丽康小剂量逐步递减促排卵治疗多囊卵巢综合征的效果。方法选择2014年12月—2015年11月收治的多囊卵巢综合征患者80例,根据随机数表法将患者均分为两组,每组40例。观察组使用普丽康小剂量逐步递减法进行治疗,对照组使用普丽康小剂量逐步递增法进行治疗,两组均根据雌激素含量肌注HCG,然后给予黄体酮补充两周后验孕。记录两组的排卵率和妊娠率;对比两组子宫内膜厚度、搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、血流收缩时的最高血流速度(S)/血流舒张期末的血流速度(D);记录两组治疗过程中发生的不良反应。计量资料比较采用t检验;计数资料比较采用χ~2检验。P<0.05为差异有统计学意义。结果观察组排卵率、妊娠率(87.5%、47.5%)高于对照组(67.5%、20.0%),比较差异有统计学意义(均P<0.05)。观察组RI、PI、S/D、子宫内膜厚度[中期0.52±0.03、0.74±0.03、2.12±0.09、(8.59±0.83)mm,后期或HCG日0.50±0.02、0.64±0.02、2.06±0.03、(10.51±0.92)mm]与对照组[中期0.59±0.02、1.14±0.18、2.52±0.19、(6.09±0.89)mm,后期或HCG日0.57±0.01、0.94±0.05、2.32±0.17、(8.46±0.74)mm]比较差异有统计学意义(均P<0.05)。治疗过程中两组未发生明显的不良反应,肝肾功能无异常。结论采用普丽康小剂量逐步递减的方法促使多囊卵巢综合征患者排卵,可以显著增加患者子宫内膜的厚度,提高排卵率和妊娠率。
Objective To observe the effect of Prilimin’s small dose esophageal ovulation induction for the treatment of polycystic ovary syndrome. Methods 80 patients with polycystic ovary syndrome who were admitted from December 2014 to November 2015 were divided into two groups (n = 40) according to random number table. The observation group was treated with Progan’s small-dose step-down method. The control group was treated with small doses of Promelazole gradually. The two groups were given HCG intramuscularly according to the estrogen content, and then were given progesterone two weeks later for pregnancy test. The ovulation rate and pregnancy rate of the two groups were recorded. The changes of endometrial thickness, pulsatility index (PI), resistance index (RI), maximum blood flow velocity (S) / blood Flow at the end of diastolic flow velocity (D); recorded two groups occurred during the treatment of adverse reactions. Measurement data were compared using t test; count data were compared using χ ~ 2 test. P <0.05 for the difference was statistically significant. Results The ovulation rate, pregnancy rate (87.5%, 47.5%) in the observation group were significantly higher than those in the control group (67.5%, 20.0%) (P <0.05). The RI, PI, S / D, endometrial thickness in the observation group (0.52 ± 0.03,0.74 ± 0.03,2.12 ± 0.09, (8.59 ± 0.83) mm, 0.50 ± 0.02,0.64 ± 0.02,2.06 ± 0.03 , (10.51 ± 0.92) mm] compared with the control group [interim 0.59 ± 0.02, 1.14 ± 0.18,2.52 ± 0.19, (6.09 ± 0.89) mm, late / HCG 0.57 ± 0.01,0.94 ± 0.05,2.32 ± 0.17, (8.46 ± 0.74) mm], the difference was statistically significant (all P <0.05). No significant adverse reactions occurred in the two groups during treatment, and no abnormalities in liver and kidney function were found. Conclusions The use of low dose of Promelazine step by step to promote ovulation in patients with PCOS can significantly increase the thickness of the endometrium in patients with increased ovulation and pregnancy rates.