多囊卵巢综合征患者临床病症及血清生殖激素水平与中医证型分布相关性研究

Study on the Relationship Between Clinical Symptoms with Serum Reproductive Hormone Level and TCM Syndromes Distribution in Polycystic Ovary Syndrome Patients

目的:探讨多囊卵巢综合征(PCOS)患者临床病症及血清生殖激素水平与中医证型分布关联性。方法:选取2014年5月~2016年5月四川省妇幼保健院和大庆油田总医院共同收治的PCOS患者共80例,按照中医证候特征分为肾虚血瘀组、脾虚痰湿组和肝经湿热组,测定三组患者的痤疮严重程度评分、多毛及肥胖程度评分、月经疾病及不孕分布情况和生殖激素水平,研究患者临床病症及血清生殖激素水平与中医证型分布关联性。结果:肝经湿热组痤疮程度最严重;脾虚痰湿组和肝经湿热组F-G多毛评分均高于肾虚血瘀组,差异有统计学意义(P<0.05);脾虚痰湿组的BMI值、WHR值均高于肾虚血瘀组和肝经湿热组,差异有统计学意义(P<0.05);三组PCOS患者主要临床表现为月经后期和月经过少,肾虚血瘀组不孕患者占比最高;肝经湿热组患者的PRL水平和T水平均高于肾虚血瘀组和脾虚痰湿组,肾虚血瘀组的PRL水平高于脾虚痰湿组,差异有统计学意义(P<0.05)。结论:PCOS主要中医证型是肾虚血瘀,其主要临床病症为月经不调和不孕;肝经湿热与血清中T和PRL相关,其主要临床病症为多毛和痤疮。

Objective： To investigate the association between clinical symptoms and serum reproductive hormone levels and TCM syndromes in PCOS patients. Methods： A total of 80 patients were diagnosed with PCOS from May 2014 to May 2016. According to the characteristics of traditional Chinese medicine syndrome,the patients were divided into three groups： kidney deficiency and blood stasis group,spleen deficiency phlegm group and liver dampness-heat group. The degree of hairy and obesity,the distribution of menstrual diseases and infertility and the level of reproductive hormones,the relationship between the clinical symptoms and serum reproductive hormone levels and the distribution of TCM syndromes were studied. Results： The degree of acne in the liver was the most severe; The spleen deficiency group and liver heat group F-G hairy scores were higher than that of the kidney deficiency and blood stasis group,the difference was statistically significant（P〈0. 05）; The spleen deficiency group of BMI value and WHR value were higher than that of the kidney deficiency and blood stasis group and the liver heat group,the difference was statistically significant（P〈0. 05）; Three patients in group PCOS were the main clinical symptoms of menstruation late menstruation,the kidney deficiency and blood stasis group of infertile patients with the highest proportion; liver heat in patients with PRL and T higher than the average water level of the kidney deficiency and blood stasis group and the spleen deficiency group,the level of PRL of the kidney deficiency and blood stasis group was higher than that of the spleen deficiency group,the difference was statistically significant（P〈0. 05）. Conclusion： The main TCM syndrome type of PCOS is deficiency of kidney and blood stasis,and the main clinical symptom of the type is irregular menstruation and infertility; Liver dampnessheat is associated with serum T and PRL,major clinical conditions are hirsutism and acne.