女性性激素水平检测对多囊卵巢综合征中医证型判断的指导价值

Guiding Value of Detecting of Female Sex Hormone Levels in Judging Traditional Chinese Medicine Syndrome Types of Patients with PCOS

目的：研究女性性激素水平检测对多囊卵巢综合征（PCOS）患者中医证型判断的指导价值。方法：将2012年5月~2015年4月就诊的108例确诊PCOS患者按照中医证候辨证分型标准分组,记录其卵泡刺激素（FSH）、雌二醇（E2）、黄体生成激素（LH）、孕酮（P）等性激素水平,分析不同证型患者性激素检测结果差异。结果：此次入组的108例PCOS患者的中医证候辨证分型可分为肾虚证、痰湿证、肝郁证和血瘀证四种;其中痰湿证39例（36.1%）、血瘀证28例（25.9%）、肝郁证22例（20.4%）、肾虚证19例（17.6%）。四种PCOS中医证候类型除FSH水平检测结果对比无统计学意义（P〉0.05）外,剩余三种女性性激素指标检测结果均存在明显差异（P〈0.05）;其中肾虚证LH、E2水平为四组最低,血瘀证LH、E2水平则均为四组最高,肝郁证P水平为四组最高,痰湿证P水平则为四组最低,差异均具有统计学意义（P〈0.05）。结论：不同中医证型的PCOS患者女性性激素水平差异较大,性激素检测对中医证型的判断具有较高的指导价值。

Objective： To study the guiding value of detection of female sex hormone levels in judging TCM syndrome types of patients with polycystic ovary syndrome（ PCOS）. Methods： 108 patients diagnosed with PCOS who were treated between May2012 to April 2015 were divided according to the standard of traditional Chinese medicine（ TCM） syndrome differentiation. The levels of follicle stimulating hormone（ FSH）,estradiol（ E2）,luteinizing hormone（ LH）,progesterone（ P） and other sex hormones were recorded. The difference of sex hormone detection results between patients of different syndrome types were analyzed.Results： The TCM syndrome differentiation types of the 108 cases of patients with PCOS could be divided into kidney deficiency syndrome,phlegm-damp syndrome,liver-Qi stagnation and blood stasis syndrome of four kinds,including 39cases（ 36. 1%） with phlegm-damp syndrome,28cases（ 25. 9%） with blood stasis syndrome,22cases（ 20. 4%） cases with liver-Qi stagnation syndrome and 19cases（ 17. 6%） with kidney deficiency syndrome. Except that there were no statistically significant differences in detection results of FSH levels between the four TCM syndrome types of PCOS（ P〉0. 05）,there were significant differences in the detection results of the remaining three female sex hormones（ P〈0. 05）; LH and E2 levels in patients with kidney deficiency syndrome were the lowest in the four groups while those in patients with blood stasis syndrome were the highest in the four group. P level in the patients with liver-Qi stagnation syndrome was the highest in the four groups while that in patients with phlegm-damp syndrome was the lowest（ P〈0. 05）. Conclusions： The differences of female sex hormone levels in patients with PCOS of different TCM syndrome types are great. Detection of sex hormones has relatively higher value in judging TCM syndrome types.