焦虑状态对多囊卵巢综合征不同中医证候患者的影响  

The influence of anxiety state on patients with different TCM syndromes of polycystic ovary syndrome

作　　者：张红阳 侯丽辉[2] Zhang Hongyang;Hou Lihui(Heilongjiang University of Chinese Medicine,Heilongjiang 150040;Departmnet of Obstrics and Gynecology,The First Affiliated Hospital of Heilongjiang University of Chinese Medicine)

机构地区：[1]黑龙江中医药大学,黑龙江150040 [2]黑龙江中医药大学附属第一医院妇产科

出　　处：《现代中医临床》2019年第3期11-17,共7页Modern Chinese Clinical Medicine

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项课题(No.JDZX2012039);国家中医药管理局全国名老中医药专家传承工作室建设项目;2016年黑龙江省政府博士后资助项目(No.LBH-Z16199)

摘　　要：目的探讨焦虑状态对多囊卵巢综合征(PCOS)不同中医证候患者的影响。方法将309例伴焦虑状态的PCOS患者进行中医辨证,观察其中医证候分布情况,并比较不同证候组Zung焦虑自评量表(SAS)评分,年龄、体重指数(BMI)、腰臀比(WHR),痤疮、多毛、黑棘皮评分,性激素指标及糖脂代谢指标,分析不同证候组患者焦虑状态评分与不同因素的相关性。结果 309例伴焦虑状态的PCOS患者中,肾虚肝郁组107例(34.63%)、痰瘀互结组80例(25.89%)、脾虚痰湿组62例(20.06%)、肾虚血瘀组60例(19.42%)。各组SAS评分比较,肾虚肝郁组SAS评分高于脾虚痰湿组、痰瘀互结组、肾虚血瘀组(P<0.05)。脾虚痰湿组、痰瘀互结组BMI和WHR均高于肾虚肝郁组、肾虚血瘀组(P<0.05)。痤疮评分由高到低分别为肾虚血瘀组、肾虚肝郁组、痰瘀互结组、脾虚痰湿组,且所有两两组比较均具有统计学意义(P<0.05);多毛评分肾虚肝郁组高于脾虚痰湿组、痰瘀互结组(P<0.05);黑棘皮评分脾虚痰湿组、痰瘀互结组均高于肾虚肝郁组、肾虚血瘀组(P<0.05)。促黄体生成素(LH)肾虚肝郁组、痰瘀互结组、肾虚血瘀组均高于脾虚痰湿组(P<0.05);促卵泡生成素(FSH)肾虚肝郁组、肾虚血瘀组均高于痰瘀互结组、脾虚痰湿组,其中痰瘀互结组又高于脾虚痰湿组(P<0.05)。胆固醇(TC)痰瘀互结组高于肾虚肝郁组、肾虚血瘀组(P<0.05);甘油三酯(TG)脾虚痰湿组、痰瘀互结组均高于肾虚肝郁组、肾虚血瘀组(P<0.05);低密度脂蛋白胆固醇(LDL-C)痰瘀互结组高于肾虚肝郁组、脾虚痰湿组、肾虚血瘀组,其中脾虚痰湿组又高于肾虚血瘀组(P<0.05);空腹血糖(FPG)脾虚痰湿组、痰瘀互结组均高于肾虚肝郁组、肾虚血瘀组,其中肾虚肝郁组又高于肾虚血瘀组(P<0.05);空腹胰岛素(FINS)与稳态模型胰岛素抵抗指数(HOMA-IR)均为脾虚痰湿组、痰瘀互结组高于肾虚肝郁组、肾虚血瘀组(P<0.05)�Objective To explore the effect of anxiety on patients with polycystic ovary syndrome(PCOS) with different TCM syndromes. Methods TCM syndrome differentiation was carried out on 309 PCOS patients with anxiety. Observing the distribution of TCM syndromes, Zung Self-rating Anxiety Scale(SAS) score, age, body mass index(BMI), waist-hip ratio(WHR), acne score, hirsutism score and acanthosis nigricans score, sex hormone index and glycolipid metabolism index among different syndromes groups, then analyzing the correlation between anxiety score and different factors in patients with different syndromes. Results In 309 PCOS anxiety patients, 107(34.63%)are in the kidney deficiency and liver constraint group, 80(25.89%) are in the binding of phlegm and stasis group, 62(20.06%)are in the spleen deficiency and phlegm-damp group, and 60(19.42%) are in the kidney deficiency and blood stasis group. SAS score of kidney deficiency and liver constraint group is higher than that of spleen deficiency and phlegm-damp group, binding of phlegm and stasis group and kidney deficiency and blood stasis group(P<0.05).BMI and WHR in spleen deficiency and phlegm-damp group and binding of phlegm and stasis group are higher than in the kidney deficiency and liver constraint group and kidney deficiency and blood stasis group(P<0.05). Acne scores ranged from high to low respectively is kidney deficiency and blood stasis group, kidney deficiency and liver constraint group, binding of phlegm and stasis group and spleen deficiency and phlegm-damp group, and the comparison between the two groups has statistical significance(P<0.05). Hirsutism score in kidney deficiency and liver constraint group is higher than spleen deficiency and phlegm-damp group and binding of phlegm and stasis group(P<0.05). Acanthosis nigricans socre in spleen deficiency and phlegm-damp group and binding of phlegm and stasis group is higher than in the kidney deficiency and liver constraint group and kidney deficiency and blood stasis group(P<0.05).Luteinizing hormone(LH) is t

关 键 词：多囊卵巢综合征 中医证候 焦虑状态 相关性 

分 类 号：R271[医药卫生—中医妇科学]