女性卵巢储备功能下降的危害因素及中医体质类型分布

Study on the risk factors of ovarian reserve decline in women and the distribution of traditional Chinese medicine constitution types

目的研究女性卵巢储备功能下降(DOR)的危害因素及中医体质类型分布。方法选取2019年3月-2020年3月湖州市妇幼保健院收治的150例DOR患者为观察组,同期体检健康的150例女性志愿者为对照组。患者及志愿者入院后参照《中医体质分类量表》及《中医体质分类判定标准》调查中医体质类型分布(包括平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质及特禀质9种体质),同时收集两组的基础资料信息(包括年龄、体质指数、居住地、工作情况、文化程度、经济收入、睡眠质量、流产次数、月经情况、妇科手术史、吸烟史、饮酒史及家庭关系)。对比两组基础资料信息,并将两组有差异信息纳入多因素Logistic回归分析模型行量化赋值,明确发生DOR的危险因素。结果观察组患者阳虚质、气郁质占比分别为38.67%、24.00%,显著高于对照组女性的16.67%、6.67%,平和质占比9.33%显著低于对照组的20.67%(P<0.05)。观察组年龄、体质指数显著高于对照组,初中文化程度、家庭月收入<5000元、睡眠质量差、流产次数≥3次、月经不规律、有妇科手术史及家庭关系不满意患者占比显著高于对照组(P<0.05)。多因素Logistic回归分析证实年龄≥30岁、体质指数异常、初中文化程度、家庭月收入<5000元、睡眠质量差、流产次数≥3次、月经不规律、有妇科手术史及家庭关系不满意是发生DOR的危险因素(P<0.05)。结论DOR患者中医体质类型以阳虚质、气郁质为主,且DOR的发病与年龄、体质指数、文化程度、经济收入、睡眠质量、流产次数、月经情况、妇科手术史及家庭关系关系密切,值得临床医师关注。

Objective To study the risk factors of decreased ovarian reserve function(DOR)in women and the distribution of traditional Chinese medicine constitution types.Methods From March 2019 to March 2020,150 patients with DOR treated in Huzhou Municipal Maternal and Child Health Care Hospital were selected as observation group,150 healthy female volunteers after physical examination were selected as control group.After admission to hospital,the distributions of traditional Chinese medicine constitution types were surveyed in the two groups according to traditional Chinese medicine constitution classification scale and Chinese medicine constitution classification criterion of physical distribution,including Yin-Yang harmony constitution,Qi-insufficiency constitution,Yang-insufficiency constitution,Yin-insufficiency constitution,phlegm-dampness constitution,damp-heat constitution,blood stasis constitution,Qi-stagnation constitution,and allergic constitution.The basic information data were collected and compared between the two groups,including age,body mass index,place of residence,working condition,educational level,economic income,sleep quality,the number of abortion,menstruation situation,history of gynecological surgery,smoking history,drinking history,and family relationship,the factors with significant difference were included in multivariate Logistic regression analysis to determine the risk factors of DOR.Results In observation group,the proportions of Yang-insufficiency constitution and Qi-stagnation constitution were 38.67%and 24.00%,respectively,which were statistically significantly higher than those in control group(16.67%and 6.67%),the proportion of Yin-Yang harmony constitution in observation group was 9.33%,which was statistically significantly lower than that in control group(20.67%)(P<0.05).Age and body mass index in observation group were statistically significantly higher than those in control group,the proportions of patients with junior middle school education,economic income<5000 RMB,poor sleep quality,the number of abortion≥3 times,irregular menstruation,history of gynecological surgery,and unsatisfactory family relationship were statistically significantly higher than those in control group(P<0.05).Multivariate Logistic regression analysis showed that age≥30 years old,abnormal body mass index,middle school education,economic income<5000 RMB,poor sleep quality,the number of abortion≥3 times,irregular menstruation,gynecological surgery history,and unsatisfactory family relationship were risk factors of DOR(P<0.05).Conclusion The types of traditional Chinese medicine constitution of DOR patients are mainly Yang-insufficiency constitution and Qi-stagnation constitution,and the onset of DOR is closely related to age,body mass index,educational level,economic income,sleep quality,number of abortion,menstrual status,gynecological surgery history,and family relationship,which deserve clinicians’attention.