女性原发性骨质疏松肾虚三证与性激素变化关系的临床研究

Clinical Study on Relationship between Sexual Hormones and Three Types of Kidney Deficiency in Female Patients with Primary Osteoporosis

目的 :探讨女性原发性骨质疏松 (primaryosteoporosis,POP)肾虚三证与性激素变化的关系为临床辨证施治提供客观诊断依据。资料与方法 :选择 116例有肾虚见证的老年女性为研究对象 ,平均年龄 5 8 33± 5 8(5 1～ 70岁 ) ,其中肾气虚 5 2例 ,肾阴虚 36例 ,肾阳虚 2 8例 ,另选正常对照组 5 0例 ,平均年龄 5 9 4 9岁 (5 0～ 70岁 ) ,同步检测血清E2 、T、 5 /E2 并进行统计学分析。结果 :与对照组相比 ,肾虚三型T、T/E2 显著上升 (P <0 0 5或 0 0 1) ,肾阳虚T值较肾气虚亦有显著差异 (P <0 0 5 ) ,肾虚三型E2 较对照组显著下降 (P <0 0 1) ,但组间无显著性差异 (P >0 0 5 ) ,逐步判别分析结果表明 :情激素水平可作为POP肾虚三证的客观诊断指标。结论 :①女性POP患者性激素T、T/E2 的变化按肾气虚、肾阴虚、肾阳虚逐渐升高 ,E2 则逐渐降低 ;②女性POP患者性激素水平变化与肾虚三证关系密切 ,其变化依肾气虚、肾阴虚、肾阳虚逐渐明显 ;

Objective:In order to provide clinical TCM differentiation with objective diagnotic basis by researching on the relationship between the changes of sexual hormones and three types of kidney deficiencles in females patients with primary osteoporosis(POP).Methods:One hundred and sixteen females patients with kidney deficiency(aged 51-70 years,mean 58 33±5 8 years)were objected,among those,kidney-qi deficiency 52 cases,kidney-ying deficiency 36 cases,and kidney-Yang deficiency 28 cases.Normal females 50 cases with no kidney deficiency(aged 50-70 years,mean 59 49 years)were taken as control group.The levels of serum T?E 2?T/E 2 were determined simultaneously and treated by statisticed methods.Results:Compared with the control group,The serum T?T/E 2 of the three types of kidney deficiences was significantly different( P <0 05 or 0 01),the serum E 2 of the three types was markedly decreased( P <0 01),but not remaakable differences btween groups,the T value of kidney-Yang deficiency is higher than that of kidney-qi deficiencies( P <0 05).Discriminant shows:sexual hormones might be taken as objective diagnostic index to determine the three types of kidney deficiency.Conclusions:①The serum T?T/E 2 change of female patients with POP were increased gradually,but the E 2 were decreased.②The changes of serum sexual hormones in female patients with POP were closely related with the three type of kidney deficiencies,and the changes were obvious following gradually from kidney-qi deficiency to kidney-yang deficiency,and③The study suggested:the change of the sexual hormones levels might be taken as an objective diagnostic basis to determine the three types of kidney deficiences in female POP patients.