彩色多普勒超声检查在PCOS中医辨证分型中的应用研究

Application Study on Color Doppler Ultrasonography in Chinese Medicine Syndrome Differentiation Typing for PCOS

目的:探讨彩色多普勒超声检查在多囊卵巢综合征(PCOS)辨证分型中的应用价值。方法:选取2017年6月-2019年1月本院收治的多囊卵巢综合征患者共130例,对其给予彩色多普勒超声检查,统计患者中医辨证分型情况及不同证型患者卵巢血流动力学指标、卵巢形态学指标的情况。结果:纳入病例中,肾虚肝郁型37例,肾虚血瘀型28例,痰瘀互结型20例,脾虚痰湿型45例。各证型间患者的PI、RI、PSV、EDV值比较,经F检验,差异均有统计学意义(P<0.05)。其中肾虚血瘀型、痰瘀互结型的PI、RI明显高于肾虚肝郁型、脾虚痰湿型(P<0.05);肾虚血瘀型、痰瘀互结型的EDV、PSV明显低于肾虚肝郁型、脾虚痰湿型(P<0.05)。各证型间患者卵巢体积、卵泡数、卵巢面积、髓质面积、面积比值比较,经F检验,差异均有统计学意义(P<0.05)。其中脾虚痰湿型、痰瘀互结型患者卵巢体积明显大于肾虚肝郁型、肾虚血瘀型患者(P<0.05),脾虚痰湿型明显大于痰瘀互结型(P<0.05);脾虚痰湿型、痰瘀互结型患者的卵泡数明显多于肾虚肝郁型、肾虚血瘀型患者(P<0.05),脾虚痰湿型明显多于痰瘀互结型(P<0.05)。结论:应用彩色多普勒超声检测患者卵巢血流动力学及形态学指标,对多囊卵巢综合征的中医辨证分型有一定的指导作用。

Objective:To discuss the application value of color Doppler ultrasonography in syndrome differentiation typing for polycystic ovary syndrome(PCOS).Methods:Selected 130 cases of patients withpolycystic ovary syndrome who were admitted and treated in our hospital during June 2017 to January 2019,and they received examinations viacolor Doppler ultrasonography.Statistically analyzed the condition of Chinese medicine syndrome differentiation typing,and the indexes of ovarian hemodynamics and ovarian morphology in patients with different syndrome types.Results:Among enrolled cases,there occurred 37 cases of kidneydeficiency and liverdepression type,28 cases of kidneydeficiency and bloodstasis type,20 cases of intermingled phlegm and blood stasis type,and 45 cases of spleendeficiency and phlegmdampness type.Comparing the values of PI,RI,PSV and EDVamongpatients ofeach syndrome type,there were significant differences being found after F-test(P<0.05).The values of PI and RI in patients of kidneydeficiency and bloodstasis type and intermingled phlegm and stasis type were significantly higher than those in patients of kidneydeficiency and liverdepression type and spleendeficiency and phlegmdampness type(P<0.05);the values of EDV and PSV in patients ofkidneydeficiency and bloodstasis type and intermingled phlegm and stasis type were significantly lower than those in patients of kidneydeficiency and liverdepression type and spleendeficiency and phlegmdampness type(P<0.05).Comparing ovarian volume,follicular number,ovarian area,medullary area and area ratio among patients ofeach syndrome type,there were significant differences being found after F-test(P<0.05).The ovarian volume in patients of spleendeficiency and phlegmdampness type and intermingled phlegm and stasis type was significantly larger than that in patients of kidneydeficiency and liverdepression type and kidneydeficiency and bloodstasis type(P<0.05);the ovarian volume in patients of spleendeficiency and phlegmdampness type was significantly larger than that in patients of intermingled phlegm and stasis type(P<0.05).The follicular number in patients of spleendeficiency and phlegmdampness type and intermingled phlegm and stasis type was significantly higher than that in patients of kidneydeficiency and liverdepression type and kidneydeficiency and bloodstasis type(P<0.05);the follicular number in patients ofspleendeficiency and phlegmdampness type was significantly higher than that in patients of intermingled phlegm and stasis type(P<0.05).Conclusion:The detection of indexes in ovarian hemodynamics and morphology via color Doppler ultrasonography can provide guidance for Chinese medicine syndrome differentiation typing for polycystic ovary syndrome.