子宫内膜异位症与子宫腺肌病中医证候分布规律的对比研究

Comparative Study on Classification of TCM Syndromes in Endometriosis and Adenomyosis

目的:①揭示子宫内膜异位症和子宫腺肌病中医证候分布规律。②两病不同病况(痛经、月经不调、不孕症)比较。方法:制定"子宫内膜异位症和子宫腺肌病中医证候分布规律调查表",对124例子宫内膜异位症和186例子宫腺肌病患者进行横断面调查,统计学分析其证候特点和分布规律。结果:①子宫内膜异位症患者资料频数分析得出气滞、肾虚、寒凝、痰湿、湿热、气虚、实热、血瘀等8个单一证型;聚类分析后得出气滞血瘀、气滞肾虚血瘀、肾虚血瘀、痰瘀互结、肾虚湿热瘀结、气滞寒凝血瘀等6种临床常见复合证型。子宫腺肌病患者资料频数分析得出肾气虚、肾阳虚、肾阴虚、血瘀、气滞、气虚、寒凝、实热、痰湿、湿热等10个单一证型。聚类分析得出气滞肾虚兼痰湿、肾虚寒凝血瘀、肾虚寒凝气滞、肾虚气滞血瘀和肾虚气滞等5个常见临床复合证型。②子宫内膜异位症和子宫腺肌病不同病况比较,痛经分别为54.03%和88.71%;月经不调分别为18.55%和44.09%;不孕分别为31.45%和18.82%。结论:①子宫内膜异位症和子宫腺肌病证候分布复杂,临床上均以复合证型出现,两种疾病均以气滞肾虚血瘀为常见症候。②子宫腺肌病痛经及月经异常患者发病率明显高于子宫内膜异位症患者,而子宫内膜异位症患者不孕比例较子宫腺肌病患者明显增高。

Objective：（1）To explore regulation of syndromes classification in endometriosis and adenomyosis. （2）Compare the different disease manifestations including dysmenorrhea,irregular menstruation and infertility between endometriosis and adenomy- osis. Methods：The qustioannaire was applied to cross-sectionally analyze the clinical data of 124 patients with endometriosis and 186 patients with adenomyosis. Results ： According to frequency analysis and cluster analysis, there were 8 single types syndromes （ qi stagnation, kidney deficiency, cold congealing, phlegm-dampness, damp-heat, qi deficiency, excess heat and blood stasis） and 6 compound syndromes（ qi stagnation and blood stasis, qi stagnation and kidney deficiency with blood stasis, kidney deficiency and blood stasis, phlegm-stasis complex, phlegm-blood stasis with kidney deficiency, and qi stagnation and cold congealing with blood stasis） in endometriosis. And there were 10 single types syndromes（ kidney qi deficiency,kidney yang deficiency, kidney yin defi- ciency, blood stasis, qi stagnation, qi deficiency, cold congealing, excess heat, phlegm-damp, damp-heat ） and 5 compound syn- dromes（ qi stagnation and kidney deficiency with phlegm-dampness, kidney deficiency with cold congealing and blood stasis, kid- ney deficiency with cold congealing and qi stagnation, kidney deficiency with qi stagnation and blood stasis and kidney deficiency with qi stagnation. The different disease manifestations between endometriosis and adenomyosis was compared, the frequency of dysmenorrhea was 54.03 % and 88.71% respectively, while that of irregular menstruation was 18.55 % and 44.09% , and that of infertility was 31.45% and 18.82%. Conclusion：（~）The regulation syndromes classification in endometriosis and adenomyosis is significantly complicated. The compound syndromes are common in clinic. Syndrome of qi stagnation and kidney deficiency with blood stasis are the most common one in both diseases. （2）Incidence of dysmenorrhea and irregular menstruation in adenomyosis is significantly higher than that in endometriosis. Meanwhile, incidence of infertility in endometriosis is obviously higher than that of adenomyosis.