【摘要】 目的 探討絕經期促性腺激素及氯米芬在促排卵治療中適宜的治療方法。 方法 2004年8月〖CD3/5〗2008年5月對80例不孕患者實施促排卵治療。測定血雌激素、黃體生成素水平、陰道B型超聲、子宮頸黏液評分及基礎體溫測定監測排卵,并觀察不良反應的發生情況。 結果 使用氯米芬及絕經期促性腺激素排卵率分別為773%和856%；卵巢過度刺激綜合癥發生率為150%,大多由使用絕經期促性腺激素方案引起,且起始劑量150 U；未破裂卵泡黃素化綜合征的發生率為90%。 結論 絕經期促性腺激素和氯米芬治療排卵障礙性不孕有較好的療效,絕經期促性腺激素和氯米芬促排卵治療效果與卵巢的狀態及激素水平有關。促性腺激素的使用應強調個體化,以達到較好的治療效果并降低卵巢過度刺激綜合癥的發生。【Abstract】 Objective To explore the proper method with human menopausal gonadotropin and clomiphene in facilitating ovulation treatment. Methods Eighty infertility patients with the facilitating ovulation treatment were included from August 2004 to May 2008. Ovulation monitoring was based on the level of estrogen and luteinizing hormone, transvaginal B ultrasound, the cervical Inlser score and assay of basal body temperature. Besides, adverse reactions were observed. Results The rates of ovulation of clomiphene and human menopausal gonadotropin were 77.3% and 85.6%. The rate of ovarian hyperstimulation syndrome (OHSS), which was mostly caused by human menopausal gonadotropin with 150 IU, was 150%. The rate of luteinized unruptured follicle syndrome (LUFS) was 90%. Conclusion Individual therapy with human menopausal gonadotropin and clomiphene is essential to infertility patients with ovulation barrier. The efficacy of human menopausal gonadotropin and clomiphene is relevant to the ovarian condition and the hormone levels. Individual using of hormone is important in the facilitating ovulation treatment, which is helpful to increase the effective efficacy and prevent the OHSS.
臨床試驗受試者用藥依從性可直接影響藥物療效終點指標的真實性。文章以多囊卵巢綜合征臨床試驗為例，闡述如何提高受試者克羅米芬用藥依從性問題。通過核查發現20（3+15+2）例受試者“違反方案”，另也存在研究者指導服藥錯誤或發藥錯誤等情況。針對上述問題產生原因總結經驗，建議今后臨床試驗在以下方面加大對用藥依從性的重視程度：①提高現場監察及遠程監查的及時性；②規范化培訓研究助手；③對受試者進行健康宣教等。