吡格列酮二甲双胍片联合去氧孕烯炔雌醇片治疗多囊卵巢综合征合并不孕患者的疗效观察

Efficacy of pioglitazone/metformin tablets combined with desogestrel/ethinyl estradiol tablets in treating infertility in patients with polycystic ovary syndrome

摘要:

目的 观察吡格列酮二甲双胍片联合去氧孕烯炔雌醇片治疗多囊卵巢综合征（PCOS）合并不孕患者的疗效。方法 选取2022年5月—2024年10月在西安市人民医院就诊的83例PCOS合并不孕患者的病历资料，根据治疗方法分为观察组（42例，在对照组的基础上采用吡格列酮二甲双胍片治疗）、对照组（41例，采用去氧孕烯炔雌醇片治疗）。两组均治疗3个月。比较两组性激素水平［雌二醇（E2）、促黄体生成激素（LH）与促卵泡生成激素（FSH）］、血清孕酮（SP）、临床疗效、卵巢体积、卵泡数、血清指标［血清可溶性晚期糖基化终末产物受体（sRAGE）、总抗氧化能力（T-AOC）、肿瘤坏死因子α（TNF-α）、氧化应激指数（OSI）］及不良反应。结果 观察组治疗后E2、FSH、SP均高于对照组（P <0.05），LH低于对照组（P <0.05）。观察组治疗前后E2、LH、FSH、SP的差值均大于对照组（P <0.05）。观察组总有效率高于对照组（P <0.05）。观察组治疗后卵巢体积小于对照组（P <0.05），卵泡数少于对照组（P <0.05）。观察组治疗前后卵巢体积、卵泡数的差值均大于对照组（P <0.05）。观察组治疗后sRAGE、T-AOC、TNF-α、OSI均低于对照组（P <0.05）。观察组治疗前后sRAGE、T-AOC、TNF-α、OSI的差值均大于对照组（P <0.05）。观察组与对照组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 吡格列酮二甲双胍片联合去氧孕烯炔雌醇片治疗PCOS合并不孕患者疗效确切，可调节性激素及血清TOS、OSI水平，改善临床症状，减轻炎症反应，且安全性可靠。

Abstract:

Objective To observe the effect of pioglitazone/metformin tablets combined with desogestrel/ethinyl estradiol tablets in treating infertility in patients with polycystic ovary syndrome (PCOS).Methods The medical records of 83 PCOS patients with infertility treated at Xi'an People's Hospital from May 2022 to October 2024 were retrospectively analyzed and divided into the observation group (42 cases treated with pioglitazone/metformin tablets and desogestrel/ethinyl estradiol tablets) and the control group (41 cases treated with desogestrel/ethinyl estradiol tablets) based on the treatment regimens. Both groups were treated for 3 months. Levels of sex hormones [estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) ] and serum progesterone (SP), clinical efficacy, ovarian volume, follicle count, serum indicators [soluble receptor for advanced glycation end products (sRAGE), total antioxidant capacity (T-AOC), tumor necrosis factor-α (TNF-α), and oxidative stress index (OSI) ], and adverse reactions were compared between the two groups.Results After treatment, levels of E2, FSH, and SP in the observation group were significantly higher than those in the control group (all P < 0.05), whereas LH levels were significantly lower (P < 0.05). The changes in E2, LH, FSH, and SP levels before and after treatment were all significantly greater in the observation group than in the control group (all P < 0.05). The overall clinical efficacy rate was significantly higher in the observation group compared with the control group (P < 0.05). After treatment, ovarian volume and follicle count were significantly lower in the observation group than in the control group (both P < 0.05), and the changes in ovarian volume and follicle count before and after treatment were significantly greater in the observation group (both P < 0.05). Post-treatment levels of sRAGE, T-AOC, levels of TNF-α, and OSI were all significantly lower in the observation group than in the control group (all P < 0.05). Moreover, the changes in levels of sRAGE, T-AOC, levels of TNF-α, and OSI before and after treatment were significantly greater in the observation group (all P < 0.05). There was no statistically significant difference in the overall incidence of adverse events between the two groups (P > 0.05).Conclusion Pioglitazone/metformin tablets combined with desogestrel/ethinyl estradiol tablets are effective in the treatment of PCOS patients with infertility. This combination regulates the levels of sex hormones and serum TOS and OSI, improves clinical symptoms, mitigates inflammation, and is safe and reliable.