基于2 337例社区自然人群调查的女性肾阳虚证临床特点和危险因素研究  

Study on the Clinical Characteristics and Risk Factors of Shen Yang Deficiency Syndrome Female Based on 2 337 Cases of Community Natural Population Survey

作　　者：刘藜 刘晓林 王红芹 祁轶斐 陈瑶 陈宝鑫[3] 童文新[2] 张颖[2] LIU Li;LIU Xiao-lin;WANG Hong-qin;QI Yi-fei;CHEN Yao;CHEN Bao-xin;TONG Wen-xin;ZHANG Ying(Graduate School,China Academy of Chinese Medical Sciences,Bejing(100700);General Internal Department,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Bejing(100091);Second Department of Encephalopathy,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing(100078))

机构地区：[1]中国中医科学院研究生院,北京100700 [2]中国中医科学院西苑医院综合内科,北京100091 [3]北京中医药大学东方医院脑病二科,北京100078

出　　处：《中国中西医结合杂志》2024年第5期521-528,共8页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家重点研发计划资助项目(No.2018YFC1704303);中国中医科学院科技创新工程重大攻关项目(No.CI2021 A01407)。

摘　　要：目的 探讨女性肾阳虚证的临床特征、舌脉特点、危险因素,为其客观辨证及防治提供数据支持。方法 于2020年9月—2022年11月采集北京市海淀区的4个社区居民的一般信息、中医四诊信息、肾阳虚量表信息、血清样本。基于证型诊断标准及量表分数诊断肾阳虚证,筛选符合标准的居民。比较不同性别肾阳虚证量表条目积分、舌脉频数分布、基本信息、生活习惯、检测指标差异,将有统计学意义的项目纳入Logistic回归探讨女性肾阳虚证危险因素,并通过Spearman分析女性经产史与肾阳虚量表分数相关性。结果 完成调查的居民共2 416例。最终符合纳排标准的居民2 337例,其中男性924例,女性1 413例。与男性患者比较,女性患者肾阳虚量表总分及条目中腰部酸痛、膝软乏力、腰膝怕冷、不耐寒冷的分数更高,夜尿频多的分数降低(P<0.05,P<0.01)。女性患者高频舌脉为白苔、腻苔、红舌、沉脉、弦脉、细脉,多种舌脉往往共存,女性实性舌脉的占比低于男性,虚性脉象的占比高于男性。女性患者的年龄及体重指数(BMI)小于男性,烟酒史比例低于男性(P<0.05,P<0.01),女性口味偏淡偏素,叶酸维生素b12缺乏及甲减患病率、空腹血糖(FPG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)偏高(P<0.05,P<0.01)。女性肾阳虚分数与绝经年龄呈负相关(r=-0.76),与初潮年龄(r=0.05)、怀孕次数(r=0.10)、生育次数(r=0.09)呈正相关(P<0.05,P<0.01)。年龄、叶酸、维生素B12缺乏病史、甲减病史、抑郁量表分数、绝经年龄、怀孕次数与女性肾阳虚证的发生有关(P<0.05)。年龄增长、叶酸维生素B12缺乏史、甲减病史、抑郁量表分数高、绝经年龄小、怀孕次数多是女性肾阳虚证发生的独立危险因素(P<0.05)。结论 女性肾阳虚证腰部酸痛、膝软乏力、腰膝怕冷、不耐寒冷的表现更突出,多种舌脉共存,虚实夹杂。两性、Objective To explore the clinical characteristics,tongue and pulse characteristics and risk factors of Shen yang deficiency syndrome female,and to provide data support for objective syndrome differentiation and prevention. Methods The general information,Chinese medicine(CM) four diagnostic information,Shen yang deficiency scale information and serum samples of four community residents in Haidian District of Beijing were collected from September 2020 to November 2022. Shen yang deficiency syndrome was diagnosed based on the syndrome diagnostic criteria and scale scores,the residents who met the criteria were screened. The differences of item scores,tongue and pulse frequency distribution,basic information,living habits and detection indexes of Shen yang deficiency scale in different genders were compared. The statistically significant items were included in Logistic regression to explore the risk factors of female Shen yang deficiency syndrome, and Spearman was used to analyze the correlation between female menstrual history and Shen yang deficiency scale scores. Results A total of 2 416 residents completed the survey. Totally 2 337 residents met the standard of allotments,including 924 males and 1 413 females. Compared with male patients,the total scores and items of the Shen yang deficiency scale in female patients were higher in the scores of waist pain,knee weakness,waist and knee fear of cold,and intolerance to cold,and the scores of frequent nocturia were lower(P<0.05,P<0.01). The high-frequency tongue and pulse of female patients were white coating,greasy coating,red tongue,deep pulse, string pulse and thready pulse. The proportion of female solid tongue pulse was lower than that of male,and the proportion of virtual pulse was higher than that of male. The age and BMI of female patients were lower than those of male patients,and the proportion of smoking and drinking history was lower than that of male patients(P<0.05,P<0.01). Female patients had light taste, vitamin B12 deficiency and hypothyroidism,and T

关 键 词：肾阳虚证 中医证型 女性 虚实夹杂 月经史 经产史 

分 类 号：R173[医药卫生—妇幼卫生保健]