青春期多囊卵巢综合征肝郁气滞证与促甲状腺激素水平的相关性

Correlation between Gan Depression Qi Stagnation Syndrome and Thyroid Stimulating Hormone Level in Adolescent Polycystic Ovary Syndrome Patients

目的研究青春期多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者肝郁气滞证分布特点,并分析肝郁气滞证型积分与促甲状腺素水平的相关性。方法对2014年11月—2016年7月宁波市中医院妇科门诊确诊为青春期PCOS的患者进行病位及病性证素辨证。对符合肝郁气滞证的110例患者按照证型积分由低到高进行分级,70~100分属Ⅰ级(轻度);101~150分属Ⅱ级(中度);>150分属Ⅲ级(重度),采用Pearson及Partial相关分析研究肝郁气滞证型严重性程度与促甲状腺激素水平的相关性。结果Ⅰ级肝郁气滞证型患者促甲状腺素、睾酮、泌乳素水平最低,Ⅲ级最高,3组间比较,差异有统计学意义(P<0.01);Pearson相关分析表明,肝郁气滞证型积分与促甲状腺素水平存在正相关(r=0.676,P<0.01)。采用Partial偏相关分析,控制体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMR-IR)影响因素后,二者仍呈正相关(r=0.663,P<0.01)。结论青春期PCOS患者伴有明显的肝郁气滞症状时,考虑可能与促甲状腺激素水平升高相关联。

Objective To observe the distribution features of Gan depression qi stagnation syndrome （GDQSS）, and to analyze the correlation between GDQSS scores and thyroid stimulating hormone （TSH） level in adolescent polycystic ovary syndrome （PCOS） patients. Methods Disease location and disease nature were syndrome identified in PCOS outpatients confirmed at Department of Gynecology, Ningbo Municipal Hospital of TCM. Totally 110 patients in line with GDQSS were graded by GDQSS score from low to high. GDQSS score ranging 70 -100 belonged to grade I （mild） ; 101 -150 to grade Ⅱ （moderate） ; 〉 150 to grade Ⅲ （severe）. The correlation between the severity of GDQSS and TSH level was an- alyzed using Pearson and Partia/ correlation analyses. Results Levels of TSH, testosterone （T）, pro- lactin （PRL） were the lowest in grade I GDQSS patients, and they were the highest in grade ]H GDQSS patients （P 〈 0.01 ）. Pearson correlation analysis showed that GDQSS score was positively correlated with TSH level （r =0.676, P 〈0.01 ）. They were still positively correlated by using Partial correlation after controlling body mass index （BMI）, waist hip ratio （WHR）, homeostasis model of assessment-insulin resistance （HOMR-IR） factors （r =0.663, P 〈 0.01 ）. Conclusion Adolescent PCOS patients with obvi- ous GDQSS symptoms might be associated with increased TSH level.