曹玲仙教授论治多囊卵巢综合征的辨证特色及其分型与性激素的关系  

Professor Cao Lingxian's Experience in the Syndrome Differentiation and Treatment of Polycystic Ovary Syndrome and the Relationship between Classification and Sex Hormones

作　　者：姚笛 俞而慨 曹玲仙 章浩伟[3] 钱俏红 

机构地区：[1]同济大学附属第一妇婴保健院中西医结合科,上海200040 [2]复旦大学附属妇产科医院中西医结合科,上海200011 [3]上海理工大学医疗器械与食品学院,上海200093

出　　处：《上海中医药大学学报》2017年第5期1-5,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委中医引导科研基金项目(12401907700);同济大学青年优秀人才培养行动计划资助项目(1400808)

摘　　要：目的:以名老中医曹玲仙教授辨证治疗多囊卵巢综合征(PCOS)的学术思想基础为蓝本,探讨PCOS临床中医辨证规律、证候特点及其与生殖内分泌的关系。方法:收集曹教授临床诊疗PCOS病例病史资料,详细记录症状、体征、辨证分型结果;采用Logistic回归分析法、模糊C聚类及Fisher判别分析法对PCOS中医证候进行研究,并分析各证型与性激素的关系。结果:127例确诊PCOS患者经曹教授临床辨证分型为肾虚证42例、肾虚痰阻证47例和肾虚肝郁证38例。采用Logistic回归分析法对PCOS中医证候进行二次分型,即先将肾虚证分离出来,再对剩余的兼夹证进行第二次分型,正确率分别为90.5%和92.9%;模糊C聚类算法对PCOS兼夹证分型的总正确率为90.6%,Fisher判别分析法对PCOS兼夹证分型的总正确率为87.1%。各证型组性激素比较,肾虚肝郁证的血清泌乳素(PRL)显著高于肾虚证。结论:临床辨治PCOS的中医证候以兼夹证多见,肾虚、痰湿、肝郁为基本证候;肝郁和PRL升高有一定关联性。Objective： To discuss the clinical role of TCM syndrome differentiation, syndrome characteristics and relationship with reproductive endocrinology based on Professor Cao Lingxian＇ s academic thoughts in the syndrome differentiation and treatment of polycystic ovary syndrome （PCOS）. Methods： The PCOS data of medical cases history on clinical diagnosis and treatment by Professor Can were collected, and the symptoms, signs and syndrome differentiation and classification were recorded in detail. The studies on TCM syndrome of PCOS were performed by Logistic regression analysis, Fuzzy c-means clustering algorithm and Fisher discriminant analysis, and the correlations between different syndrome types and sex hormones were analyzed. Results： 127 PCOS patients were classified according to Professor Cac＇ s clinical syndrome differentiation, among 42 cases with syndrome of kidney deficiency, 47 cases with syndrome of kidney deficiency and phlegm obstruction, 38 cases with syndrome of kidney deficiency and liver-qi stagnation. The secondary classification on TCM syndrome of PCOS was performed by Logistic regression analysis, the syndrome of kidney deficiency was separated first and then the remaining concurrent syndromes were reclassified. The accuracy on classification of kidney deficiency syndrome and concurrent syndromes was 90.5%, and the accuracy on classification of different concurrent syndromes was 92.9%. According to Fuzzy C-means clustering algorithm, the total accuracy on classification of different concurrent syndromes was 90.6%. According to Fisher discriminant analysis, the total accuracy on classification of different concurrent syndromes was 87.1%. For the comparison of sex hormones levels in different syndrome types, the serum level of prolactin（PRL） in syndrome of kidney deficiency and liver-qi stagnation was significantly higher than that in syndrome of kidney deficiency. Conclusion： In clinical differentiation and treatment of PCOS, the concurrent syndromes are common and kidney defic

关 键 词：多囊卵巢综合征 曹玲仙 中医辨证 性激素 

分 类 号：R249[医药卫生—中医临床基础] R271.9[医药卫生—中医学]