肾虚肝郁证型卵泡发育不良患者的临床特征初探  

Preliminary Exploration About Clinical Features of Patients with Follicular Dysplasia and Syndrome of Kidney Deficiency and Liver Stagnation

作　　者：谭丽[1] 王茜 孟瑶 周晓瑜 王唯迪[1] 张婷婷[1] TAN Li;WANG Xi;MENG Yao;ZHOU Xiaoyu;WANG Weidi;ZHANG Tingling(Department of Gynaecology,Yueyang Hospital of Integrative Chinese&Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;The Third Peopled Hospital of Chongming County,Shanghai 202153,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院妇科,上海200437 [2]上海市崇明县第三人民医院妇科,上海202153

出　　处：《辽宁中医杂志》2020年第4期108-112,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海市“十三五”临床重点专科(中医妇科)(shslczdzk04501);上海中医药大学杏林传承型人才培养项目(RY411.37.05);国家青年科学基金项目(81403425);全国中医学术流派传承工作室第二轮建设项目——上海蔡氏妇科流派传承工作室。

摘　　要：目的通过病例分析了解卵泡发育不良患者的临床特征,为临床诊断提供参考。方法对73例卵泡发育不良患者的一般情况、月经评分、中医证候评分、生化指标(血清FSH、LH、E2、PRL、T、P)及超声特点(窦卵泡数、子宫血流动力、卵巢血流动力)进行总结,初步探究卵泡发育不良患者的临床特征。结果73例卵泡发育不良患者小卵泡排卵、卵泡不生长分别占53.42%、27.40%;轻度与中度月经失调分别占86.3%、10.96%;血清性激素六项分别为FSH(8.67±3.44)m IU/mL、LH(6.01±5.05)m IU/mL、E2(40.90±28.32)pg/mL、PRL(13.42±5.90)pg/mL、T(0.52±0.5)ng/mL、P(7.38±6.83)ng/m;单侧卵巢窦卵泡数量<5、5~10、>10分别占35.62%,50.69%、13.70%;子宫动脉、卵巢动脉RI均值分别为0.86±0.08、0.63±0.09。结论卵泡发育不良患者以小卵泡排卵和卵泡不生长为主,轻度月经失调可能是其表现形式,肾虚肝郁型卵泡发育不良患者除肾虚、肝郁症状外,常兼夹气虚、阳虚、阴虚多种虚证症状;卵泡发育不良患者基础血清性激素六项正常者多,异常者FSH、PRL、T值高为主,E2、P值低为主,窦卵泡数正常者近半,异常者以窦卵泡数少为主,具有子宫及卵巢动脉血流阻力高的特征。Objective To understand the clinical features of patients with follicular dysplasia by case analysis and provide a clinical reference.Methods Based on the conclusion about general situation,menstrual score,TCM syndrome score,biochemical indicators(serum FSH,LH,E2,PRL,T,P)and the ultrasonic characteristics(sinus follicle number,uterine blood flow dynamics and ovarian blood flow dynamics)of 73 patients with follicular dysplasia,we preliminarily explored the clinical features.Results Among the 73 patients with follicular dysplasia,‘small follicle ovulation’and‘no follicular growth’accounted for 53.42%and 27.40%,respectively.Mild and moderate menstrual disorders accounted for 86.3%and 10.96%,respectively.The serum sex hormones FSH was(8.67±3.44)m IU/mL,LH(6.01±5.05)m IU/mL,E2(40.90±28.32)pg/mL,PRL(13.42±5.90)pg/mL,T(0.52±0.5)ng/mL and P(7.38±6.83)ng/m.The unilateral ovarian sinus follicle number less than 5,between 5-10 and more than 10 accounted for 35.62%,50.69%and 13.70%,respectively.The uterine artery and ovarian artery RI averages were 0.86±0.08 and 0.63±0.09,respectively.Conclusion We found that‘small follicle ovulation’and‘no follicular growth’are the two main types of follicular dysplasia patients.The disorder menstruation may be its manifestation.Patients with follicular dysplasia belong to the symptoms of kidney deficiency and liver depression,often combined with Qi deficiency,Yang deficiency or Yin deficiency syndrome.The basic serum sex hormones are often normal and abnormal sex hormones were often high in FSH,PRL,T and low in E2 and P.Nearly half patients had normal numbers of sinus follicles and the abnormal ones often have less sinus follicles,characterized with high resistance of blood flow of arteries of uterus and ovary.

关 键 词：卵泡发育不良 肾虚肝郁证 月经评分 中医证候评分 性激素六项 窦卵泡数 动脉血流阻力 

分 类 号：R711[医药卫生—妇产科学]