高雄激素血症对肾虚肝郁证多囊卵巢综合征的影响研究  

Effect of Hyperandrogenemia on Kidney Deficiency-Liver Stagnation Type of Polycystic Ovary Syndrome

作　　者：张美微[1] 侯丽辉[2] 李妍[2] 潘紫萌 ZHANG Meiwei;HOU Lihui;LI Yan;PAN Zimeng(Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;Obstetrics and Gynecology,The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

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

出　　处：《中华中医药学刊》2019年第7期1646-1649,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81704115,81804139);国家中医药行业科研专项项目(201207001);国家中医临床研究基地业务建设第二批科研专项基金项目(JDZX2015056);国家中医药管理局基金项目(JDZX2015058);黑龙江省中医药管理局基金项目(2HY12-W008);黑龙江省教育厅基金项目(12531651)

摘　　要：目的:通过比较不同水平雄激素状态下及不同HA表型的肾虚肝郁证多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)患者的临床及生化特征,探索出肾虚肝郁证PCOS伴/不伴HA及不同HA表型的肾虚肝郁证PCOS患者的临床特征,为疾病的个性化治疗和远期并发症的预防提供依据。方法:268例肾虚肝郁证PCOS患者,分为A组(肾虚肝郁证PCOS+HA)151例及B组(肾虚肝郁证PCOS+non-HA)117例;根据T及AND的值将肾虚肝郁证PCOS+HA组分为3组:Ⅰ组(单纯高T)、Ⅱ组(单纯高AND)及Ⅲ组(高T+AND组),比较各组的临床及生化特征。结果:(1)A组的臀围及FINS值小于B组, WHR、LH、LH/FSH、T、E2、P、PRL、DHEAS、AND、TG、FT4、痤疮及溢脂发生率均大于B组,差异有统计学意义(P<0.05);(2)Ⅰ组的AND值小于Ⅱ组及Ⅲ组,TG值大于Ⅲ组;Ⅱ组的多毛发生率高于Ⅰ组,HDL值大于Ⅲ组,FT4值大于Ⅰ组及Ⅲ组;Ⅰ组及Ⅱ组的LH/FSH、T值大于Ⅲ组,痤疮发生率低于Ⅲ组。结论:(1)肾虚肝郁证PCOS合并HA患者性激素及糖脂代谢紊乱较重;(2)不同HA表型的肾虚肝郁证PCOS患者的代谢特征存在差异:肾虚肝郁证PCOS伴高T患者脂代谢紊乱较重;肾虚肝郁证PCOS伴高AND患者其甲状腺激素水平紊乱较重;肾虚肝郁证PCOS伴高T+AND患者其性激素代谢紊乱较重。Objective: By comparing the clinical and biochemical features of different level of androgen condition and different HA phenotypes of kidney deficiency-liver stagnation type of PCOS, to explore its clinical and biochemical features, providing personalized treatment for disease and the reference for the prevention of long-term complication. Methods: We collected 268 cases of patients diagnosed with kidney deficiency-liver stagnation type of PCOS from October 2016 to March 2018. There were 151 cases of kidney deficiency-liver stagnation type of PCOS with HA and 117 cases of kidney deficiency-liver stagnation type of PCOS with non-HA. According to T and AND, kidney deficiency-liver stagnation type of PCOS with non-HA can be divided into three groups, then comparing the clinical and biochemical characteristics of each group. Results:(1)The HC and FINS of group A were smaller than that of the group B. WHR, LH, LH/FSH, T, E2, P, PRL, DHEAS, AND, TG, FT4, incidence of acne and excess fat were greater than those of group B(P<0.05).(2)The AND of group Ⅰ was less than that of group Ⅱ and group Ⅲ. TG was greater than that of group Ⅲ. The group Ⅱ’s incidence of hairy was higher than that of group Ⅰ. HDL was greater than that of group Ⅲ. FT4 was greater than that of group Ⅰ and group Ⅲ. LH/FSH and T of group Ⅰ and Ⅱ were higher than those of group Ⅲ. The incidence of acne was lower than that of Ⅲ group(P<0.05). Conclusions:(1)The patients with kidney deficiency-liver stagnation type of PCOS+HA have serious sex hormone and glucose lipid metabolic disorders.(2)There are differences in metabolic characteristics of kidney deficiency-liver stagnation type of PCOS patients with different HA phenotypes: kidney deficiency-liver stagnation type of PCOS with high T patients have serious lipid metabolism disorder;kidney deficiency-liver stagnation type of PCOS with high AND patients have serious thyroid hormone metabolism disorder;kidney deficiency-liver stagnation type of PCOS with high T+AND patients have s

关 键 词：多囊卵巢综合征 肾虚肝郁证 高雄激素血症 表型 

分 类 号：R711.75[医药卫生—妇产科学]