自身免疫性甲状腺炎合并不孕症中医证候分布规律及临床特征研究  

Study on the Distribution and Clinical Characteristics of TCM Syndromes in Infertility Patients with Autoimmune Thyroiditis

作　　者：方小茹 吴丽敏[2] 方群英 王梦丽 赵世玉 乔宗惠 栾红兵 方朝晖[3] FANG Xiaoru;WU Limin;FANG Qunying;WANG Mengli;ZHAO Shiyu;QIAO Zonghui;LUAN Hongbing;FANG Zhaohui(Anhui University of Chinese Medicine,Hefei 230031,China;The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽中医药大学,安徽合肥230031 [2]中国科学技术大学附属第一医院,安徽合肥230001 [3]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中国中医药信息杂志》2024年第1期164-170,共7页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81971446)。

摘　　要：目的探讨自身免疫性甲状腺炎(AIT)合并不孕症患者的中医证候分布规律和临床特征。方法参照育龄期妇女AIT不孕症中医证候分布规律相关文献,制定《AIT合并不孕症患者中医证候调查表》。回顾性分析2019年6月-2020年12月在中国科学技术大学附属第一医院生殖中心行体外受精-胚胎移植(IVF-ET)的256例AIT合并不孕症患者,对其基本信息、中医证候、基础促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)等资料进行采集。利用频数分析、系统聚类分析方法,归纳AIT合并不孕症患者的中医证候分布规律。结果AIT患者常见的5个证候要素分别为气虚、肝郁、脾虚、肾虚和血瘀,多见复合证候。系统聚类分析得到的主要中医证候分别为气虚肝郁证(69例,26.9%)、脾肾两虚证(45例,17.6%)、脾气虚证(38例,14.8%)、气虚血瘀证(36例,14.1%)、肾虚肝郁证(32例,12.5%)和其他证(36例,14.1%)。基础TSH水平在气虚肝郁证、脾气虚证、气虚血瘀证中均高于其余各证候,差异有统计学意义(P<0.05)。不同证候患者TPO-Ab、TG-Ab滴度差异无统计学意义(P>0.05)。结论AIT合并不孕症患者主要中医证候为气虚肝郁证、脾肾两虚证、脾气虚证、气虚血瘀证、肾虚肝郁证、其他证,证候要素以气虚为主,病位涉及脾、肾、肝三脏,瘀血为主要的病理产物。针对有气虚表现的本病患者有必要关注其甲状腺功能。Objective To investigate the distribution and clinical characteristics of TCM syndromes in infertility patients with autoimmune thyroiditis(AIT).Methods By referring to the relevant literature on the distribution of TCM syndromes of AIT and infertility in women of childbearing age,the TCM Syndromes Survey of Infertility Patients with Autoimmune Thyroiditis was formulated.256 cases of infertility patients with AIT who underwent in vitro fertilization-embryo transfer(IVF-ET)at the Reproductive Center of The First Affiliated Hospital of University of Science and Technology of China from June 2019 to December 2020 were retrospectively analyzed.The data of basic information,TCM syndromes,basic thyroid-stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(TG-Ab)were collected.By means of frequency analysis and systematic cluster analysis,the distribution regularity of TCM syndromes in infertility patients with AIT were concluded.Results After analysis,the following 5 common syndrome elements were obtained,namely,qi deficiency,liver depression,spleen deficiency,kidney deficiency and blood stasis.In addition,it was concluded that this disease was more common in complex syndromes.Through systematic clustering analysis,main TCM syndromes of this disease were obtained,which were qi deficiency and liver depression syndrome(69 cases,26.9%),spleen and kidney deficiency syndrome(45 cases,17.6%),spleen qi deficiency syndrome(38 cases,14.8%),qi deficiency and blood stasis syndrome(36 cases,14.1%),kidney deficiency and liver depression syndrome(32 cases,12.5%)and other syndrome types(36 cases,14.1%).The basic TSH level was higher in patients with qi deficiency and liver depression syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome than other syndrome types,with statistical significance(P<0.05).There was no significant difference in TPO-Ab and TG-Ab titers among different syndromes(P>0.05).Conclusion TCM syndromes of infertility patients with AIT can be clustered into qi

关 键 词：自身免疫性甲状腺炎 不孕症 中医证候 体外受精-胚胎移植 

分 类 号：R259.81[医药卫生—中西医结合]