多囊卵巢综合征痰证病理与胰岛素抵抗、性激素关系的研究

Study on relation between phlegm symptom-complex pathology of polycystic ovarian syndrome and insulin resistance and sex hormone

目的探讨多囊卵巢综合征(PCOS)中医证候分布情况及其与性激素、胰岛素抵抗的相关性。方法检测PCOS患者60例、健康对照组16例的性激素、空腹血糖(FPG)和空腹胰岛素水平(FINS),计算胰岛素抵抗指数(HOMA-IR),对PCOS患者按中医辨证分型。结果证候分布以痰湿证所占比例最高、肾虚证次之。PCOS各证型组FINS均高于对照组,其中肾虚组、痰湿组与对照组比较有显著性差异(P均<0.01)。肾虚组、痰湿组HOMA-IR显著高于对照组(P均<0.05)。各证型组间胰岛素抵抗水平比较无显著性差异(P均>0.05)。结论PCOS证型与性激素变化及胰岛素抵抗状态有相关性,肾虚为PCOS的基本证候和原发病机,痰湿则是PCOS的基本病理环节。

Objective It is to discuss the distribution of traditional Chinese medical symptom-complex of polycystic ovarian syndrome （PCOS） and the correlativity between it and insulin resistance and sex hormone. Methods The levels of sex hormone, fasting plasma glucose （FPG） and fasting insulin （FINS） in 60 patients with PCOS and 16 cases of healthy control group were detected. The insulin resistance index （HOMAIR） was calculated. The differentiation of symptoms and signs for classification with traditional Chinese medicine was done on 60 patients with PCOS. Results Among the distribution of symptom-complex, the proportion of phlegmatic hygrosis syndrome was the highest and the proportion of nephrasthenia syndrome was posterior. FINS in all the syndrome type groups of PCOS was higher than that in control group, among them there was significant difference between nephrasthenia group or phlegmatic hygrosis group and control group （P 〈 0.01 ）. HOMA- IR in nephrasthenia group and phlegmatic hygrosis group was significantly higher than that in control group （P 〈0.05）. There was no significant difference on the level of insulin resistance among all the syndrome type groups. Conclusion The syndrome type of PCOS is related with sexual hormone and insulin resistance. Nephrasthenia is the basic symptom-complex and primary pathogenesis of PCOS and phlegmatic hygrosis is primary pathological stage of PCOS.