应用因子分析法探讨排卵障碍性不孕“病-证-症”关系的研究

Preliminary study on relationship of disease-syndrome-symptom of ovulatory disorder infertility based on factor analysis

目的:探讨排卵障碍性不孕中医证候分布规律,研究排卵障碍性不孕"病-证-症"三者之间的关系,为临床治疗提供参考依据。方法:该研究通过240例排卵障碍性不孕患者的临床资料分析,运用因子分析方法,分析其"病-证-症"分布规律,归纳排卵障碍性不孕"病-证-症"关系。结果:排卵障碍性不孕的疾病分布为:多囊卵巢综合征>卵巢早衰>黄体功能缺陷>黄素化卵泡未破裂综合征>高泌乳素血症>无排卵型功血;中医证候分布为:肾阳虚兼血瘀证>肾阳虚证>肾阴虚兼血瘀证>肾阴虚兼肝气郁结证>肾阳虚兼痰湿壅滞证>肾阴虚证。症状积分较高的症状有临经前少腹疼痛、经色黯、小腹冷、失眠多梦、眼眶黯、面部黯或环唇黯、行经前后乳房胀、胸闷急躁、情志失畅、经行少腹胀痛等。结论:该研究认为多囊卵巢综合征、卵巢早衰在排卵障碍性不孕中最多见,且其发病率呈明显上升趋势。排卵障碍性不孕以肾虚证为主,肾阳虚证较肾阴虚证所占的比重大,血瘀是病机演变过程中的重要因素。排卵障碍性不孕疾病症状分布总体趋势大致相同,同一症状在不同疾病中的轻重程度不同,对临床治疗用药有参考意义。

Objective： In this study, the clinical data of 240 cases of data acquisition on ovulation in patients with anovulatory infertility. Method： Using the method of factor analysis, summed up the distribution situation of various syndromes and the relationship of disease-syndrome-symptom. Result： From the study we found that polycystic ocary syndrome 〉 premature ovarian failure 〉 corpus luteum insufficiency 〉 luteinized unruptured follicle syndrome 〉 hyperprolactinemia 〉 anovulatory dysfunctional uterine bleeding. Using the factor analysis method, the syndromes of anovulatory infertility were divided into six types and the distribution proportion of them is ： kidney Yang deficiency and blood stasis 〉 kidney Yang deficiency 〉 kidney Yin deficiency and blood stasis 〉 kidney Yin deficiency and liver Qi stagnation syndrome 〉 kidney Yang deficiency and phlegm dampness stagnation 〉 kidney Yin deficiency. By means of statistics, the traditional Chinese medicine （TCM） symptoms as abdomen pain before menstrual onset, obfuscation co lour, cold lower abdomen, insomnia, fatigue, eyes dark, face dark or ring lip dark, before and after menstruation breast sweUing, chest tightness, irritable insomnia, depression and lower abdomen pain during menstruation etc contribute high degree in the process. Conclusion： Polycystic ovary syndrome and premature are the main causes of ovulatory disorder infertility and the disease incidence rate assumed the tendency which rose year by year. The treatment of the disease of kidney yang deficiency syndrome scales biggest the disease degree of contribution. Blood stasis is the important factor in the process of pathogenesis evolution. In the study of disease distribution, we found that symptom distribution trend roughly the same and the same symptom severity in different diseases with different, which provides experience for the theory-different diseases with the same therapeutic method. These conclusions provide guidance and reference evidences for clinic practice.