女性更年期高血压病中医证型与性激素水平相关性研究

Study on Correlation between Sex Hormones and Female Climacteric Hypertension

目的:通过检测性激素在女性更年期高血压病不同证型中的差异性,以期为女性更年期高血压病患者中医辨证分型提供客观化研究依据。方法:对210例女性更年期高血压病患者进行中医辨证分型,分为心脾两虚、肝郁痰结、阴虚内燥、阴阳两虚4个证型,以30例血压正常的更年期女性作为对照组,检测不同中医证型组及对照组血清性激素水平,做统计分析比较。结果:女性更年期高血压病4个中医证型组的血清雌二醇(E2)水平均低于对照组,孕酮(P)及促卵泡激素(FSH)水平高于对照组,阴虚内燥证组的E2、E2/T水平低于其余各证型组及对照组,E2/P水平低于心脾两虚组,4个证型组的FSH水平按阴虚内燥>肝郁痰结>心脾两虚>阴阳两虚组的趋势递减。进一步亚组分析女性更年期高血压病2级患者的血清雌二醇、E2/P、E2/T水平低于更年期高血压病1级组,FSH水平较高血压1级组升高,高血压病1级及2级中阴虚内燥组的E2水平、E2/T水平均显著低于其他3证型组。结论:性激素紊乱在女性更年期高血压病起到一定的作用,随着更年期高血压病的分级水平升高,体内的性激素紊乱情况加重。E2、E2/T水平在女性更年期高血压阴虚内燥证中的变化显著,可以作为阴虚内燥证的客观化指标,而FSH水平在四组中医证型中水平不同,可以作为区分4个证型的特征性指标。

Objective：To detect the sex hormone levels in menopausal women with hypertension in different syndromes, and provide the objective basis for hypertension in female climacteric syndrome type. Methods ：This study collected 210 cases of hyper-tension in menopausal hypertensive patients. 30 cases of selected menopausal women with normal blood pressure were as controls. The menopausal syndrome patients with essential hypertension were divided into both deficiency of heart and spleen group （40 ca- ses ）, liver depression and phlegm accumulation group （36 cases）, Yin deficiency and internal dryness group （98 cases）, both de- ficiency of Yin and Yang group （36 cases）. The serum sex hormone levels of different syndromes and control groups were detected to do the statistical analysis and comparison. Results ： E2 levels in four TCM syndrome types groups were lower than those in the control group. The progesterone （P） and follicle - stimulating hormone （FSH） levels were higher than those in the control group. E2, E2/T level of Yin deficiency and internal dryness group was lower than the rest syndrome groups and control group. E2/P lev-els were lower than both deficiency of heart and spleen group. The FSH level in the four syndromes had an order as follows ： Yin deficiency and internal dryness 〉 liver depression and phlegm accumulation 〉 both deficiency of heart and spleen 〉 both defi-ciency of Yin and Yang group. Further subgroup analyses of female climacteric hypertension ,the serum levels of estradiol, E2/P, E2/T levels of hypertension 2 level group were lower than those of the climacteric hypertension 1 level group. The FSH level was higher than that of 1 level group. E2 and E2/T levels in Yin deficiency and internal dryness syndrome group in hypertension 1 lev- el and 2 level were significantly lower than those of other three type groups. Conclusion：The sex hormone disorder has a certain role in female climacteric hypertension. With elevated levels of climacteric hypertension, the sexual hormone disorder condition can be aggravated. Changes of E2 and E2/T levels in female climacteric hypertension are obvious, which can be used as the objec-tive index of Yin deficiency and internal dryness syndrome, and the levels of FSH in four groups of TCM syndromes in different levels can be used as the index characteristic to distinguish four syndrome types.