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Objective To investigate the effects of Shengxuening tablets combined with ethinylestradiol and cycloproterone acetate on endometrial thickness and hemoglobin level in patients with endometrial polyps for transcervical resection of polyp. Methods A total of 150 patients with hysteroscopic endometrial polypectomy were randomly divided into three groups, 50 in each group. The control group was treated with hysteroscopy endometrial polyp electrotomy, while the western medicine group was treated with ethinylestradiol and cycloprogesterone acetate tablets on the basis of the control group, and the combined group was treated with Shengxuening tablets on the basis of the western medicine group. The menstrual volume, endometrial thickness and hemoglobin levels were observed before treatment, at 3 month, 6 month and 12 month after treatment, and the clinical efficacy and recurrence during follow-up were evaluated. Results The total effective rate was 98.0％(49/50) in the combined group, 96.0％ (48/50) in the western medicine group, 86.0％ (43/50) in the control group. The total effective rate in the combined group and the western medicine group was significantly higher than that in the control group (χ2=6.643, P=0.036). The menstrual volume (F=28.096, 49.096, 33.303), endometrial thickness (F=11.214, 20.265, 63.947) in the three groups were significantly different after treatment (P<0.01), and which in the combined group were significantly lower than those in the western medicine group, menstrual volume at 36,12 after treatment (t value were 4.747, 2.244, 4.489, P<0.01); endometrial thickness at 3, 6, 12 month after treatment (t value were 3.293, 3.356, 5.293, P<0.01); there were significant differences in hemoglobin levels in the three groups (F=11.002, 8.662, 8.958, P<0.01), and which in the combined group was significantly higher than that in the western medicine group at 3,6,12 month after treatment (t value were 2.722, 2.074, 2.028, P<0.05). During the follow-up period, 2 cases (4.1％) recurred in the combined group, 3 cases (6.3％) recurred in the western medicine group and 9 cases (20.9％) recurred in the control group. The recurrence rate in the combined group or the western medicine group was significantly lower than that in the control group (χ2=6.775, P=0.034). There was no significant difference in the recurrence rate in the combined group and the western medicine group (χ2=0.211, P=0.646). Conclusions The Ethynestradiol and Cyproterone acetate combined with Shengxuening tablets could improve the curative effect, reduce menstrual volume and endometrial thickness, increase hemoglobin level and reduce recurrence rate in patients with endometrial polyps for transcervical resection of polyp.
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OBJECTIVE:To discuss the effect of Ethinylestradiol and cyproterone acetate tablet combined with metformin on ovulation induction of patients with polycystic ovarian syndrome(PCOS). METHODS:184 PCOS patients were randomly divided into control group(92 cases)and observation group(92 cases). Control group orally received 1 Ethinylestradiol and cyproterone ac-etate tablet in 5 d of menstruation,once a day,it stopped after 21 d,the next cycle of treatment was started on the 5th of with-drawal bleeding. Observation group additionally received 3 Metformin tablet,once a day,without drug withdrawal during menstrua-tion,and lasted for 3 menstrual cycles. After 3 menstrual cycles,all patients received ovulation induction treatment [(50-100 mg clomiphene was orally given from the 5th day of the 4th menstrual cycle,for 5 days,or 75-150 U postmenopausal gonadotropin by intramuscular injection,when the dominant follicle diameter was(19.0±2.0)mm,10 000 U human chorionic gonadotropin(HCG) was intramuscularly injected,the ovulation was continuously monitored and whether there was ovarian hyperstimulation syndrome (OHSS)was observed]. Body mass index(BMI),follicle estrogen(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol (E2)and testosterone(T)before and after treatment,fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance in-dex(HOMA-IR),pregnancy rate,ovulation rate and the incidences of OHSS and adverse reactions in 2 groups were observed.RE-SULTS:Before treatment,there were no significant differences in the BMI,FSH,LH,PRL,E2,T,FPG,FINS and HOMA-IR between 2 groups(P>0.05). After treatment,BMI,LH,PRL,E2,T,FPG,FINS and HOMA-IR in observation group and LH, E2 and FINS in control group were significantly lower than before,and BMI,PRL,E2,T,FPG,FINS and HOMA-IR in observa-tion group were lower than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Ethinylestradiol and cyproterone acetate combined with metfor-min can effectively improve insulin resistance of POCS patients,recovery sex hormone secretion,promote ovulation and improve pregnancy rate,with good safety.
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Objective To observe the effect of rosiglitazone combined with ethinylestradiol cyproterone on treatment of polycystic ovary syndrome (PCOS).Methods Sixty-eight cases with PCOS combined with insulin resistance (experimental group) and 68 cases with PCOS combined without insulin resistance (control group) were selected.The patients in experimental group were given rosiglihtazone combined with ethinylestradiol cyproterone,the patients in control group were not given rosiglitazone.The level of seurm adiponectin and lepfin was measured before and after treatment in two groups,body mass index (BMI),Homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated before and after treatment in two groups,and drug adverse reaction was observed.Results There was no significant difference in serum adiponeetin,leptin,BMI before treatment between two groups (P ＞ 0.05).HOMA-IR in experimental group was higher than that in control group (3.90 ± 0.87 vs.2.15 ± 0.62),and there was significant difference (P ＜ 0.05).BMI,leptin after treatment in experimental group and control group was decreased compared with that before treatment [experimental group:(25.41 ± 1.01) kg/m2 vs.(30.11 ± 1.51) kg/m2,(0.25 ± 0.08) μ g/L vs.(0.44 ± 0.11) p g/L; control group:(26.68 ± 1.12) kg/m2 vs.(30.55 ± 1.42) kg/m2,(0.23 ± 0.1 0) μ g/L vs.(0.39 ± 0.23) μ g/L],adponectin was increased compared with that before treatment [experimental group:(1.39 ± 1.10) μ g/L vs.(0.89 ± 0.15) μ g/L;control group:(1.42 ± 1.05) μ g/L vs.(0.91 ± 0.44) μ g/L],and HOMA-IR after treatment (2.09 ± 0.68) in experimental group was lower than that before treatment,and there was significant difference (P ＜ 0.05).There was no significant difference between two groups (P ＞0.05).Experimental group did not appear obvious drug adverse reaction in the process of treatment.Conclusion Ethinylestradiol cyproterone can improve metabolic disorders indicators,PCOS combined with insulin resistance should add rosiglitazone to improve insulin resistance.
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Objective To evaluate the ovulation effect of ethinylestradiol and cyproterone acetate combined with metformin on obesity type polycystic ovary syndrome (PCOS).Methods Sixty-two patients with obesity type PCOS were divided into 2 groups by random digits table method:control group (30 cases) was treated with letrozole;observation group (32 cases) was treated with letrozole after 3 months treated with ethinylestradiol and cyproterone acetate combined with metformin.The weight,body mass index (BMI),glycometabolism indexes [fasting plasma glucose (FPG),fasting insulin (FINS) and homeostasis model of assessment for insulin resistance index (HOMA-IR)],hormone [follicle-stimulating hormone (FSH),luteotrophic hormone (LH),estradiol (E2) and testosterone (T)] before and after treatment and ovulation rate and pregnancy rate were compared between 2 groups.Results There were no statistical differences in weight,BMI,FPG,FINS and HOMA-IR in control group between before treatment and after treatment (P ＞ 0.05).The indexes in observation group after treatment were significantly lower than those before treatment [(55.76 ± 2.69) kg vs.(64.42 ± 4.93) kg,(21.52 ± 1.43) kg/m2 vs.(25.74 ± 1.58) kg/m2,(4.46 ± 0.89) mmol/L vs.(5.69 ± 2.01) mmol/L,(12.24 ± 1.82) mU/L vs.(22.88 ± 2.06) mU/L,2.94 ± 1.76 vs.5.27 ± 1.18],there were statistical differences (P＜ 0.05).There were no statistical differences in FSH and E2 in 2 groups between before treatment and after treatment (P ＞ 0.05).There were no statistical differences in LH and T before treatment between 2 groups (P ＞ 0.05),but after treatment were significantly lower than before treatment [control group:(10.33 ±0.57) mU/L vs.(15.63 ± 1.32) mU/L and (1.22 ±0.96) μg/L vs.(2.21 ± 1.24) μ g/L;observation group:(9.07 ± 0.82) mU/L vs.(16.18 ± 1.24) mU/L and (0.71 ± 1.24) μ g/L vs.(2.43 ± 1.52) μ g/L],furthermore the observation group was lower,there were statistical differences (P ＜ 0.05).The ovulation rate and pregnancy rate in observation group were significantly higher than those in control group [78.12％(25/32) vs.53.33％(16/30) and 53.12％(17/32) vs.26.67％(8/30)],there were statistical differences (P ＜ 0.05).Conclusion Ethinylestradiol and cyproterone acetate combined with metformin is more effective on obesity type PCOS,which can improve the ovulation rate and pregnancy rate.
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Objective To explore the clinical efficacy of ethinylestradiol and cyproterone acetate (Diane-35) combined with mefformin in patients with polycystic ovary syndrome (PCOS).Methods One hundred and sixty patients with PCOS were divided into control group and observation group by random digits table method with 80 cases each.Patients in the control group were given Diane-35 only,while patients in the observation group were given Diane-35 combined with metformin.The triglycerides (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),fasting insulin (FINS),fasting blood glucose (FBG),follicle-stimulating hormone (FSH),luteinizing hormone (LH) and testosterone (T) of patients in the two groups were measured before treatment and after treatment 6 months,the rates of pregnancy and abortion were recorded.Results TC,LDL-C,FINS,FBG,FSH,LHt and T of both the 2 groups after treatment decreased obviously than before treatment,and TG in observation group decreased obviously than before treatment,there were statistical differences (P ＜ 0.05).There was no statistical difference in TG in control group between before treatment and after treatment (P ＞ 0.05).After treatment,TG,FINS,FBG,LH in observation group were lower than those in control group [(1.0 ± 0.2) mmol/L vs.(1.6 ± 0.8) mmol/L,(15.2 ± 6.3) mU/L vs.(18.9 ± 6.2) mU/L,(4.5 ± 1.1) mmol/L vs.(5.1 ± 0.9) mmol/L,(6.3 ± 3.0) U/L vs.(7.4 ± 2.9) U/L],there were statistical differences (P ＜ 0.05).After treatment,the rate of pregnancy in observation group was higher than that in control group [61.2％(49/80) vs.42.5％(34/80)],there was statistical difference (x2 =5.633,P＜ 0.05).The rote of abortion in observation group was lower than that in control group [6.1％(3/49) vs.17.6％(6/34)],but there was no statistical difference (x2 =1.694,P ＞ 0.05).Conclusion The clinical effect of Diane-35 combined with metformin in patients with PCOS is better than Diane-35 only.
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Objective To investigate the effects of ethinylestradiol and cyproterone acetate tablets(Diane-35)on endocrine metabolism in non-obese women with polycystic ovary syndrome(PCOS). Methods Fifty-three non-obese patients with PCOS were assigned to the 6-month treatment with Diane-35.Body mass index(BMI),waist to hip ratio(WHR),F-G score and acne score were recorded before treatment and at the end of the third and sixth cycle after treatment.Serum total testosterone,follicle stimulating hormone(FSH),luteinizing hormone(LH),LH/FSH,fast plasma glucose,fast insulin and insulin resistance index(HOMA-IR)were obtained at early follicular phase and at the end of the third and sixth month.Results There was no significant change in BMI and WHR after treatment.Compared with those before treatment.F-G score,acne score,serum total testosterone,LH and LH/FSH were significantly decreased at two time points after treatment (P<0.05).BMI and HOMA-IR in patients with insulin resistance were significantly higher at the end of the sixth cycle after treatment than those before treatment(P<0.05). Conclusion Diane-35 can improve hyperandrogenism in non-obese patients with PCOS.However,Diane-35 may aggravate insulin resistance in those with insulin resistance.