多囊卵巢综合征不孕患者中医证型与内分泌代谢指标的关联性  

The Association Between TCM Syndrome Differentiation and Endocrine Metabolic Indexes in Patients with PCOS Infertility

作　　者：韩倩 何军琴[1] 张莹[1] 杨维[1] 武颖[1] 尹晓丹[1] 管斯琪 辛明蔚[1] HAN Qian;HE Junqin;ZHANG Ying;YANG Wei;WU Ying;YIN Xiaodan;GUAN Siqi;XIN Mingwei(Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Maternal and Child Health Care Hospital,Beijing 100123,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院,北京100123

出　　处：《标记免疫分析与临床》2022年第4期549-553,共5页Labeled Immunoassays and Clinical Medicine

基　　金：北京市科学技术委员会首都临床特色应用研究项目(编号:Z181100001718163)。

摘　　要：目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)不孕患者中医证型分布特点及与内分泌代谢指标的关联性。方法对212例PCOS不孕患者进行中医辨证分型,测定其内分泌代谢相关指标(血清睾酮、LH、FSH、AMH、胰岛素、血糖),分析中医证型的分布特点及与内分泌代谢指标的关联性。结果(1)212例PCOS不孕患者中,痰湿证52例,肾虚证96例,气滞血瘀证50例,肝经湿热证14例,各证型在不孕时间、月经稀发的分布上差异无统计学意义(P>0.05),肝经湿热证年龄显著小于其他证型(P<0.05);(2)PCOS不孕患者超重和肥胖的概率高达56.6%,痰湿证超重和肥胖的概率高达94.2%,显著高于肾虚证、气滞血瘀证、肝经湿热证型,差异有统计学意义(P<0.05);(3)PCOS不孕患者高雄激素血症的概率高达32.55%,痰湿证、肝经湿热证高雄激素血症的概率显著高于肾虚证、气滞血瘀证(59.6%、57.1%vs 21.9%、18.0%),差异具有统计学意义(P<0.05);(4)PCOS不孕患者胰岛素抵抗的概率高达52.36%,痰湿证胰岛素抵抗的概率显著高于肾虚证、气滞血瘀证、肝经湿热证(80.8%vs 41.7%、44.0%、50.0%),差异具有统计学意义(P<0.05)。(5)各证型AMH、LH/FSH比值差异无统计学意义(P>0.05)。结论PCOS不孕患者中医证型与内分泌代谢指标具有一定的关联性,高雄激素血症主要与痰湿证、肝经湿热证相关,胰岛素抵抗主要与痰湿证相关。Objective To investigate the correlation between the TCM syndrome differentiation and endocrine metabolic indexes in patients with PCOS infertility.Methods A total of 212 patients with PCOS infertility were classified by TCM syndrome differentiation and endocrine metabolic indexes(serum testosterone,LH,FSH,AMH,insulin and glucose)were measured in all patients.The distribution characteristics of the TCM syndrome differentiation and the correlation with endocrine metabolic indexes were analyzed.Results(1)A total of 212 patients with PCOS infertility were included,including 52 cases with Phlegm-Dampness evidence,96 cases with kidney deficiency evidence,50 cases with Qi stagnation and blood stasis evidence,and 14 cases with Damp-Heat evidence in the Liver Meridian.There was no statistical difference in the distribution of infertility duration and menstrual scarcity among the evidence types(P>0.05),and the age of Damp-Heat in the liver was significantly younger than other evidence types(P<0.05).(2)The proportion of overweight and obese patients with PCOS infertility was 56.6%,and the proportion of overweight and obese patients with Phlegm-Dampness certificate was 94.2%,which was significantly higher than that of Kidney-Deficiency certificate,Qi-Stagnation-Blood-Stasis certificate and Damp-Heat certificate of Liver Meridian(P<0.05).(3)The proportion of hyperandrogenemia in patients with PCOS infertility was 32.55%,and the proportion of hyperandrogenemia in Phlegm-Dampness certificate and Damp-Heat certificate of Liver Meridian was significantly higher than that of Kidney-Deficiency certificate and Qi-Stagnation-Blood-Stasis certificate.(4)The proportion of insulin resistance in patients with PCOS infertility was 52.36%,and the proportion of insulin resistance in Phlegm-Dampness evidence was significantly higher than that in Kidney-Deficiency evidence,Qi-Stagnation-Blood-Stasis evidence and Liver-Menstruation-Damp-Heat evidence(80.8%vs 41.7%,44.0%,50.0%)(P<0.05).(5)AMH and LH/FSH ratios were not statistically different

关 键 词：多囊卵巢综合征 不孕症 中医证型 内分泌代谢 

分 类 号：R711.75[医药卫生—妇产科学]