女性痤疮患者黄体期性激素水平与中医证型关系研究

Relationship between Serum Level of Sex Hormones in the Luteal of Menstrual Cycle in Women with Acne vulgaris and Typing of Traditional Chinese Medicine

目的探讨性激素水平与不同年龄段、不同中医分型女性痤疮患者的关系。方法118例女性痤疮分为青春期组(16～20岁)和青春期后组(21～45岁),根据中医理论分为肺胃积热型、脾胃湿热型、肝郁化火型和阴虚火旺型。应用化学发光法检测患者血清促卵泡激素(FSH)、促黄体激素(LH)、催乳素(PRL)、孕酮(P)、雌二醇(E2)和睾酮(T)水平,并以30例正常女性为对照。结果青春期女性痤疮患者FSH,LH,T/E2增高,E2水平降低;青春期后女性T/E2,PRL增高,E2降低。青春期女性表现以肺胃积热型为主,FSH,LH水平升高,E2降低;青春期后女性以肺胃积热型、脾胃湿热型和肝郁化火型为主,其中肺胃积热型E2水平降低,脾胃湿热型T,T/E2明显增高,肝郁化火型PRL明显升高。结论青春期和青春期后女性痤疮患者,以及不同中医证型患者在黄体期性激素水平存在明显差异。

Objective To study the relationship between the serum level of sex hormones in women with acne and various ages, and typing of Traditional Chinese Medicine （TCM）. Methods The patients were classed adolescent （ 16 - 20 year） and post-adolescent patients （ 21 ~ 45 year） based on age, and Lung-stomach heat retention syndrome, splenogastric hygropyrexia syndrome, heat syndrome due to stagnated liver qi, and heat syndrome due to yin-deficiency based on TCM. The serum lever of follicle-stimulating hormone （FSH）, luteotropic hormone （LH）, prolactin （ PRL）, progesterone （ P）, estradiol （E2） and testosterone （T） were measured with chemiluminescence＇s immunoassay in the luteal phase of menstrual cycle in 118 women with acne, compared with 30 healthy controls. Results It was revealed that the level of FSH, LH, T/E2 were significantly higher,the level of E2 was lower in adolescent patients than those in the control-1. The level of T/E2, PRL were higher, E2 was lower in post-adolescent patients than that of control-2. Majority of adolescent patients were lung-stomach heat retention syndrome, the lower lever of FSH, LH, E2 than controls-1 were observed. Majority of post-adolescent patients attributed to Lung-stomach heat retention syndrome, spleen-stomach damp-heat syndrome and heat syndrome due to stagnated liver qi. It was revealed that the lever of E2 was lower in lungstomach heat retention syndrome patients, T, T/E2 was higher in heat syndrome due to stagnated liver qi patients, PRL was higher in spleen-stomach damp-heat syndrome patients than that of control-2. Conclusion The study indicates that the serum lever of sex hormones were obviously different between adolescent and postadolescent, among phenotypes of differential diagnosis in TCM in the luteal of menstrual cycle in women with acne.