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目的观察来曲唑(LE)和克罗米芬(CC)治疗多囊卵巢综合征(PCOS)排卵障碍的临床疗效。方法将符合PCOS排卵障碍及中医辨证属肾阴虚型的60例患者随机分为两组:LE组(LE+中药,n=30),CC组(CC+中药,n=30)。1个月经周期为1个疗程,观察3个月经周期内两组的卵泡发育、排卵、子宫内膜和受孕的情况。结果排卵情况:两组的卵泡直径≥16mm,卵泡数、排卵率差异无统计学意义(P>0.05),均无卵巢过度刺激综合征(OHSS)发生;子宫内膜及宫颈粘液情况:LE组人绒毛膜促性腺激素(hCG)日子宫内膜平均厚度、A型内膜、宫颈粘液平均评分与CC组比较差异有统计学意义(P<0.05);受孕情况:LE组妊娠率为73.33%,CC组妊娠率为56.67%,两组比较差异有统计学意义(P<0.05)。结论 LE与CC均有促卵泡生长作用,LE可作为CC反应不良患者促排卵的替代治疗,LE较CC有较高的妊娠率,可能与其不影响子宫内膜容受性有关。
Objective To observe the clinical efficacy of letrozole (LE) and clomiphene citrate (CC) in the treatment of ovulation disorders in patients with polycystic ovary syndrome (PCOS). Methods 60 patients with PCOS ovulation disorder and TCM syndrome of kidney yin deficiency were randomly divided into two groups: LE group (LE + TCM, n = 30), CC group (CC + TCM, n = 30). 1 menstrual cycle for a course of treatment, observed three menstrual cycle within the two groups of follicular development, ovulation, endometrial and conception. Results Ovulation: There was no significant difference in the number of follicles and ovulation between the two groups (P> 0.05). There was no ovarian hyperstimulation syndrome (OHSS) in the two groups. The endometrium and cervical mucus status: LE group The average endometrial thickness, type A endometrium and cervical mucus average score of human chorionic gonadotropin (hCG) were significantly different from those of CC group (P <0.05) .Conclusion: The pregnancy rate of LE group was 73.33% The pregnancy rate in CC group was 56.67%, there was significant difference between the two groups (P <0.05). Conclusions Both LE and CC have follicular growth promoting effects. LE can be used as an alternative treatment for ovulation induction in patients with poor response to CC. LE has a higher pregnancy rate than CC, which may be related to its effect on endometrial receptivity.