Buvat J, Buvat-Herbaut M, Marcolin G, Racadot A, Fourlinnie J C, Beuscart R, Fossati P
J Clin Endocrinol Metab. 1986 Jul;63(1):119-24. doi: 10.1210/jcem-63-1-119.
Previous studies on the efficacy of bromocriptine for the treatment of patients with the polycystic ovary syndrome failed to include control groups. This study, therefore, was undertaken to determine the clinical and endocrine effects of bromocriptine and a placebo (given in a random double blind fashion) in 55 patients with PCOS. The plasma levels of estrone, estradiol, testosterone, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, and serum PRL and gonadotropins (LH and FSH) were measured before treatment. In addition the serum PRL response to TRH and the serum LH and FSH response to GnRH were determined. The effects of acute administration of bromocriptine (2 X 2.5 mg at 12-h intervals) on serum gonadotropins and their response to GnRH were studied to explore the possibility that this test might predict the response to chronic bromocriptine treatment. Bromocriptine then was given at an initial dose of 1.25 mg twice daily. If no clinical improvement occurred 2.5 mg were given twice daily for at least 6 months. Hormonal measurements and dynamic tests were repeated after 3 and 6 months of therapy. The endocrine profile of the two groups was not different before treatment. The clinical results were not better in the treatment group than in the placebo-treated patients: therapy was successful (restoration of ovulatory cycles of less than 35 days duration) in 12 of 28 patients taking bromocriptine vs. 8 of 27 taking placebo. Slight improvement (1 or 2 ovulations) occurred in 3 of 28 vs. 3 of 27, and failure (no clinical change) in 13 of 28 taking bromocriptine vs. 16 of 27 taking placebo, respectively. Serum PRL fell significantly in the bromocriptine group, and there was a significant fall in the serum LH response to GnRH in both groups. No hormonal measurement or response predicted the clinical response to treatment. The only significant effect of chronic bromocriptine therapy (5 mg/day) in patients with the polycystic ovary syndrome was to lower the serum PRL concentration.
先前关于溴隐亭治疗多囊卵巢综合征患者疗效的研究未纳入对照组。因此，本研究旨在确定溴隐亭和安慰剂（采用随机双盲方式给药）对55例多囊卵巢综合征患者的临床和内分泌影响。在治疗前测量了雌酮、雌二醇、睾酮、雄烯二酮、脱氢表雄酮、硫酸脱氢表雄酮、17-羟孕酮的血浆水平，以及血清泌乳素和促性腺激素（促黄体生成素和促卵泡生成素）水平。此外，还测定了血清泌乳素对促甲状腺激素释放激素的反应以及血清促黄体生成素和促卵泡生成素对促性腺激素释放激素的反应。研究了急性给予溴隐亭（2×2.5mg，间隔12小时）对血清促性腺激素及其对促性腺激素释放激素反应的影响，以探讨该试验是否可预测对慢性溴隐亭治疗的反应。随后，溴隐亭初始剂量为每日两次，每次1.25mg。如果6个月内未出现临床改善，则每日两次给予2.5mg，持续至少6个月。治疗3个月和6个月后重复进行激素测量和动态试验。两组治疗前的内分泌特征无差异。治疗组的临床结果并不优于安慰剂治疗组：服用溴隐亭的28例患者中有12例治疗成功（恢复排卵周期，周期时长小于35天），而服用安慰剂的27例患者中有8例；服用溴隐亭的28例中有3例有轻微改善（1或2次排卵），服用安慰剂的27例中有3例；服用溴隐亭的28例中有13例治疗失败（无临床变化），服用安慰剂的27例中有16例。溴隐亭组血清泌乳素显著下降，两组血清促黄体生成素对促性腺激素释放激素的反应均显著下降。没有激素测量或反应能够预测治疗的临床反应。慢性溴隐亭治疗（5mg/天）对多囊卵巢综合征患者的唯一显著作用是降低血清泌乳素浓度。
