中国临床药学杂志

目的探讨复方玄驹胶囊联合来曲唑对排卵障碍性不孕症的临床疗效及对患者激素水平的影响。方法选择排卵障碍性不孕症患者98例,依据随机数字表法分为观察组与对照组,各49例。对照组:于月经周期开始第5天给予来曲唑片2.5 mg,po,qd,连续5 d,B超监测患者卵泡发育情况,当患者优势卵泡直径≥18 mm时,则注射人绒毛膜促性腺激素10 000 U,注射后24～36 h内指导性生活试孕;观察组:在对照组治疗基础上予复方玄驹胶囊3粒,po,tid。2组患者治疗疗程均为3个月经周期。比较2组治疗前后主卵泡直径、子宫内膜厚度、血清激素水平、排卵率、妊娠率,以及临床疗效和不良反应。结果治疗后,观察组主卵泡直径和子宫内膜厚度大于对照组(t=7.462、8.441,P<0.05);血清孕酮(T)水平低于对照组,而血清雌二醇(E₂)、卵泡刺激素(FSH)和黄体生成素(LH)水平高于对照组(t=7.721、12.227、12.922、9.556,P<0.05)。观察组排卵率(69.39%)和妊娠率(42.86%)均高于对照组排卵率(46.94%)和妊娠率(22.45%)(P<0.05);观察组治疗总有效率高于对照组(91.84%vs 71.43%,P<0.05)。2组均未发生明显不良反应。结论复方玄驹胶囊联合来曲唑对排卵障碍性不孕症患者疗效明显,有助于改善激素水平及排卵等情况。

AIM To investigate the therapeutic effect of compound Xuanju capsule combined with letrozole on infertility patients with ovulation disorder and its effect on the expression of hormone level. METHODS A total of 98 infertility patients with ovulation disorder admitted from May 2017 to May 2019 were randomly divided into observation group(49 patients) and control group(49 patients) according to random number table method. In the control group, letrozole tablets(2.5 mg,po,qd) were given on the 5 th day of the menstrual cycle, for 5 consecutive days. The follicular development of the patients was monitored by B-ultrasound. When the dominant follicular diameters of the patients were≥18 mm, 10 000 U human chorionic gonadotropin was injected. Within 24-36 h after the injection, the pilot life trial pregnancy was conducted. In the observation group, 3 capsules of compound Xuanju, po, tid were taken on the basis of the control group. The treatment course of the 2 groups were three menstrual cycles. The main follicle diameter, endometrial thickness, serum hormone level, ovulation rate and pregnancy rate, as well as clinical efficacy and adverse drug reactions were compared before and after treatment. RESULTS The main follicle diameter and the endometrium thickness in the observation group were higher than those in the control group(t=7.462, 8.441, P<0.05). After treatment, the serum progesterone(T) level in the observation group was lower than that in the control group, while the serum estradiol(E₂),follicle stimulating hormone(FSH) and luteinizing hormone(LH) levels were higher than those in the control group(t=7.721, 12.227, 12.922, and 9.556, P<0.05). The total effective rate was 91.84% in the observation group and 71.43% in the control group, respectively. There was significant difference between the 2 groups(P<0.05). The ovulation rate(69.39%) and pregnancy rate(42.86%) in observation group were higher than those in control group(46.94% and 22.45% respectively)(P<0.05). No significant adverse drug reactions occurred in both groups. CONCLUSION Compound Xuanju capsule combined with letrozole is effective in the treatment of ovulation disorder infertility, and it is helpful to improve the hormone level and ovulation situation.