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枸橼酸克罗米芬下简称CC,又称氯蔗酚胺或舒经芬,是三苯乙烯的衍生物,是合成的非类固醇物质,结构与乙烯雌酚相似。一、药理作用~([l+2])口服CC后能与内源性雌激素竞争,结合下丘脑垂体、卵巢、子宫腺体内的雌激素受体,解除其对下丘脑、垂体的负反馈抑制,使下丘脑GnRH释放增加,垂体促性腺激素,促卵泡成熟素FSH和促黄体生成素LH分泌增多,卵泡可继续发育成熟分泌雌激素。后者的自我增强效应形成雌激素高峰,诱发促性腺激素的排卵峰(血清LH/FSH峰)而导致排卵。CC在体内由胃肠道吸收,肝内代谢,经粪、尿及胆汁排出体外,半衰期24小时。二、临床应用(一)病例的选择:应用CC治疗的对象,其下丘脑必须产生GnRH,垂体对GnRH能产生反应以及卵巢含有各阶段发育的卵泡诸条件,临床上用于下列情况。1．用于下丘脑,垂体功能失调所引起无排卵性月经或月经稀发病例:如多囊卵巢综合征(PCOS)。2．功能失调性子宫出血．
Clomiphene citrate, referred to as CC, also known as catecholaminergic or Shu Fen, is a derivative of tristyryl is a synthetic non-steroidal substance, the structure and diethylstilbestrol similar. First, the pharmacological effects of ~ ([l +2]) after oral CC with endogenous estrogen competition, combined with hypothalamic pituitary, ovarian, uterine gland estrogen receptors, lifting of the hypothalamus, pituitary negative Feedback inhibition, so that increased release of hypothalamic GnRH, pituitary gonadotropin, follicle-stimulating hormone FSH and luteinizing hormone LH secretion increased follicles can continue to mature mature secretion of estrogen. The latter self-enhancing effect of the formation of estrogen peak induced gonadotropin ovulation peak (serum LH / FSH peak) and lead to ovulation. CC in the body by the gastrointestinal tract absorption, intrahepatic metabolism, excretion, urine and bile excreted, the half-life of 24 hours. Second, the clinical application of (a) the choice of case: the application of CC treatment of the object, the hypothalamus must produce GnRH, pituitary GnRH can react and ovarian follicles containing various stages of development conditions, the clinical use of the following conditions. 1. For the hypothalamus, pituitary dysfunction caused by anovulatory or anaplastic menstruation cases: such as polycystic ovary syndrome (PCOS). 2. Dysfunctional uterine bleeding.