482例女性中医体质、阴道微生态状况与围绝经期综合征发病相关性研究

Correlations of TCM Constitution and Vaginal Microecology with Perimenopausal Syndrome in 482 Women

目的了解天津地区围绝经期综合征发病与中医体质、阴道微生态状况的相关性。方法采用病例对照研究设计,通过改良版Kupperman量表评分将482例围绝经期女性分为对照组(得分<6分)和观察组(得分≥6分),所有观察对象进行中医体质量表评价以确定中医体质类型,取阴道分泌物进行阴道微生态检测及评价。结果观察组阴道微生态失调率为70.05%,高于对照组(38.25%,P<0.01),中医体质平和质占比8.12%,低于对照组(23.51%,P<0.01)。观察组阴道PH值异常率61.73%、菌群密集度异常率57.87%、菌群多样性异常率40.61%、优势菌异常率28.43%及微生物感染率26.40%,均高于对照组(P<0.01);分别对九种不同中医体质观察对象阴道微生态状况进行统计学分析,对照组与观察组在平和质、阳虚质、血瘀质、气郁质4种中医体质分型中存在差异(P<0.05,P<0.01),在阴虚质、气虚质、痰湿质、湿热质与特禀质5种中医体质分型中差异无统计学意义(P>0.05)。结论围绝经期综合征女性阴道微生态状况、中医体质分布与围绝经期健康女性存在差异,改善围绝经期症状的同时应该关注患者中医体质与阴道微生态情况。

Objective To understand the correlations of the incidence of perimenopausal syndrome with traditional Chinese medicine(TCM)constitution and vaginal microecology in Tianjin.Methods With a case-control study design,482 perimenopausal women were divided into a control group(score<6 points)and an observation group(score≥6 points)by using an improved Kupperman scale.All study subjects were evaluated using the TCM constitution scale to determine the type of TCM constitution,and vaginal secretions were taken for testing and evaluating vaginal microecology.Results The rate of vaginal microecological imbalance in the observation group was 70.05%,which was higher than that in the control group(38.25%,P<0.01).The proportion of balanced constitution was 8.12%in the observation group,which was significantly lower than that in the control group(23.51%,P<0.01).The abnormal rates of vaginal pH,bacterial density,bacterial diversity,and dominant bacteria and microbial infection in the observation group were 61.73%,57.87%,40.61%,28.43%,and 26.40%,respectively,higher than those in the control group(P<0.01).A statistical analysis was conducted on the vaginal microecological status of research subjects with nine different TCM constitutions.There were significant differences(P<0.05,P<0.01)between the control group and the observation group in the four types of TCM constitution:balanced constitution,yang-deficiency constitution,blood stasis constitution,and qi depression constitution.There was no significant difference(P>0.05)in the five types of TCM constitution:yin-deficiency constitution,qideficiency constitution,phlegm-dampness constitution,dampness-heat constitution,and inherited special constitution.Conclusion There are differences in the vaginal microecological status and distribution of TCM constitution between women with perimenopausal syndrome and healthy women during perimenopause.While perimenopausal symptoms are improved,attention should be paid to the patients’TCM constitution and vaginal microecological status.