不同表型多囊卵巢综合征伴先兆流产相关中医证型及各自特性分析  

Specificity analysis TCM syndrome type of different phenotypes of polycystic ovary syndrome with threatened abortion

作　　者：吕蓓丽[1] 王海燕[1] 张婷婷[2] LYU Bei-li;WANG Hai-yan;ZHANG Ting-ting(Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200090,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Chinese Medicine,Shanghai 200437,China)

机构地区：[1]复旦大学附属妇产科医院,上海200090 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中华中医药杂志》2018年第10期4376-4380,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81873868)~~

摘　　要：目的:分析不同表型多囊卵巢综合征(PCOS)患者发生先兆流产的相关中医证型及各自特性。方法:收集198例PCOS伴先兆流产患者,归纳不同西医表型、中医证型分布情况,两者各自特性及之间的对应联系。结果:经典型PCOS患者中肾虚血瘀型居多(P<0.05);肾虚痰湿型可能是非高雄型患者的主要中医证型(P<0.05)。在35～42岁年龄组中肾虚血瘀型相对居多(P<0.05)。非高雄型患者的体质量指数(BMI)和腰臀比(WHR)高于经典型患者(P<0.05);3种中医证型的BMI和WHR从高到低依次排序为:肾虚痰湿型>肾虚血瘀型>肝郁血热型。随着自然流产次数的上升,肾虚血瘀型所占的比例有上升的趋势。与经典型患者比较,非高雄型患者更易发生胰岛素抵抗(P<0.01);3种中医证型的糖代谢水平从高到低排序依次为:肾虚痰湿型>肾虚血瘀型>肝郁血热型(P<0.05)。结论:不同表型PCOS伴先兆流产与不同中医证型有着密切相关性,且这两种分型与患者年龄、BMI、WHR、自然流产史及糖代谢特点均有一定的联系。Objective： To analyze the TCM syndrome types and their characteristics of threatened abortion in patients with different phenotypes of polycystic ovary syndrome （PCOS）. Methods： A total of 198 patients with PCOS and threatened abortion were collected, and the distribution and corresponding connection of different western medical phenotypes and TCM syndromes were summarized. Results： Most of the patients with classic PCOS had kidney deficiency and blood stasis type （P〈0.05）; kidney deficiency and dampness type may be the main TCM syndromes of patients without higher androgen （P〈0.05）. In the 35- 42 years old age group, kidney deficiency and blood stasis type are relatively common （P〈0.05）. The body mass index （BMI） and waist-to-hip ratio （WHR） of patients without higher androgen were higher than those of classic patients （P〈0.05）. The BMI and WHR of the three TCM syndromes were ranked from high to low： kidney deficiency and dampness〉kidney deficiency and blood stasis type 〉 liver stagnation and blood heat type. With the increase in the number of spontaneous abortions, the proportion of kidney deficiency and blood stasis type has an increasing trend. Compared with the classic patients, patients without higher androgen were more prone to insulin resistance （P〈0.01）; the three levels of TCM syndromes were ranked from high to low： kidney deficiency and dampness〉kidney deficiency and blood stasis〉liver stagnation and blood heat type （P〈0.05）. Conclusion： Different phenotypes of PCOS with threatened abortion are closely related to different TCM syndromes, and these two types are related to patient age, BMI and WHR, spontaneous abortion history and glucose metabolism.

关 键 词：多囊卵巢综合征 先兆流产 临床表型 中医证型 相关性 

分 类 号：R271.9[医药卫生—中西医结合]