痰湿证多囊卵巢综合征伴糖尿病前期患者的临床特征分析

Clinical characteristics analysis of phlegm-dampness syndrome polycystic ovary syndrome with prediabetes

目的:探究痰湿证多囊卵巢综合征(PCOS)伴糖尿病前期(PDM)患者的临床特征。方法:筛选黑龙江中医药大学附属第一医院妇科科研门诊临床科研信息一体化系统中符合PCOS诊断标准的患者,并根据PDM和证型判定标准进行分组,统计分析痰湿证PCOS伴PDM患者临床特征的差异性和相关性。结果:共纳入1682例PCOS患者,PDM患者610例,占比36.3%。其中痰湿证型254例(41.6%),非痰湿证型356例(58.4%)。痰湿证和非痰湿证PCOS伴PDM患者在平和质、气虚质、血瘀质、气郁质、湿热质、阴虚质和阳虚质的分布中差异具有统计学意义(P<0.05,P<0.01)。痰湿证PCOS伴PDM患者的收缩压、体重、身体质量指数(BMI)、腰围、臀围、腰臀比(WHR)、腰高比(WHtR)、黑棘皮评分和脂质蓄积指数(LAP)值均显著高于非痰湿证组(P<0.05,P<0.01),性激素结合球蛋白(SHBG)值显著低于非痰湿证组(P<0.01)。Logistic回归分析中发现,PCOS伴PDM患者与湿热质、收缩压、黑棘皮评分和LAP值间存在统计学意义的相关性(P<0.05,P<0.01),其回归系数依次为0.944、0.036、0.518和0.967,使PCOS伴PDM患者发生的风险倍数上升依次为2.570倍、1.036倍、1.679倍和2.630倍。结论:应该关注PCOS伴PDM患者的存在,重视痰湿证患者其可能伴有的更严重的代谢紊乱程度,合理的施以辨证调体,降低PCOS患者发生2型糖尿病的风险和进程,更好地缓解PCOS相关代谢并发症的发生。

Objective:To explore the clinical characteristics of phlegm-dampness syndrome polycystic ovary syndrome(PCOS)with prediabetes.Methods:Patients who met PCOS diagnostic criteria in the integrated system of clinical scientific research information in the department of gynecology scientific research outpatient department were screened and grouped according to PDM and syndrome type criteria.The difference and correlation of clinical characteristics of phlegm-dampness syndrome PCOS patients with PDM were statistically analyzed.Results:A total of 1682 patients with PCOS and 610 patients with PDM were included in this statistics,accounting for 36.3%.Among them,there were 254 cases(41.6%)of phlegm-dampness syndrome,and 356 cases(58.4%)of non-phlegm-dampness syndrome.In patients with phlegm-dampness syndrome and nonphlegm-dampness syndrome PCOS with PDM,there was statistical significance in the distribution of calm quality,qi deficiency quality,blood stasis quality,qi stagnation quality,damp-heat quality,yin deficiency quality and yang deficiency quality(P<0.05,P<0.01).Systolic blood pressure,body weight,BMI,waist circumference,hip circumference,WHR,WHtR,acanthosis nigricans score and LAP value in PCOS patients with PDM were higher than those in the non-phlegm-dampness syndrome group(P<0.05,P<0.01),while SHBG value was lower than that in the non-phlegm-dampness syndrome group(P<0.01).Logistic regression analysis showed that there was a statistically significant correlation between PCOS patients with PDM and phlegm-dampness syndrome,systolic blood pressure,acanthosis nigricans score and LAP value(P<0.05,P<0.01),and the regression coefficients were 0.944,0.036,0.518 and 0.967,respectively.The risk multiple of PCOS patients with PDM increased by 2.570 times,1.036 times,1.679 times and 2.630 times respectively.Conclusion:Attention should be paid to the existence of PCOS patients with PDM,and to the more serious metabolic disorders that may be associated with patients with phlegm-dampness syndrome.Syndrome differentiation adjustment should be reasonably implemented to reduce the risk and progression of T2DM in PCOS patients and better alleviate the occurrence of metabolic complications related to them.