痰湿证PCOS患者伴高雄激素血症268例分析
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摘要
目的通过比较不同水平雄激素状态下痰湿证PCOS患者的临床及生化特征,探索出痰湿证PCOS伴HA患者的临床特征,为疾病的个性化治疗和远期并发症的预防提供依据。方法收集2014年12月~2017年8月黑龙江中医药大学附属第一医院临床科研信息一体化系统中436例痰湿证PCOS患者,分为高雄组268例及非高雄组168例,对照组83例,分析并比较3组的临床特征及生化指标。结果痰湿证PCOS+HA组的多毛、黑棘皮及溢脂发生率显著高于痰湿证PCOS+non-HA组(P<0.05);与痰湿证PCOS+non-HA组相比,痰湿证PCOS+HA组的FSH及SHBG显著降低、LH及LH/FSH显著升高,差异有统计学意义(P<0.05);痰湿证PCOS+HA组的TC、TG、LDL值显著高于痰湿证PCOS+non-HA组和对照组(P<0.05);痰湿证PCOS+HA组的FPG、FINS、HOMA-IR值均显著高于痰湿证PCOS+non-HA组及对照组(P<0.05)。结论痰湿证PCOS合并HA患者多毛、黑棘皮及溢脂发生率较高;痰湿证PCOS合并HA患者性激素代谢异常较重;痰湿证PCOS合并HA患者糖脂代谢紊乱较重。
Objective Through the collection and analysis of clinical features and biochemical indices data got from 436 women who were diagnosed as phlegm-dampness syndrome of PCOS,in order to provide the reference for the personalized treatment for disease and prevention of long-term complication.Methods We collected 436 cases of patients diagnosed with phlegm-dampness syndrome of PCOS and 62 cases of control group from December 2014 to August 2017.We analysied and compared of three groups of clinical and biochemical indicators.Results The incidence of hirsutism,acanthosis nigricans and excessive fat of phlegm-dampness syndrome of PCOS + HA subgroup were higher than phlegm-dampness syndrome of PCOS + non-HA subgroup(P < 0.05).The LH and LH/FSH of of phlegm-dampness syndrome of PCOS + HA subgroup were higher.The level of FSH and SHBG was lower than phlegm-dampness syndrome of PCOS + non-HA subgroup and the control group(P < 0.05).The TC,TG and LDL of phlegm-dampness syndrome of PCOS +HA subgroup were higher than phlegm-dampness syndrome of PCOS + non-HA subgroup and the control group(P < 0.05).The FPG,FINS and HOMA-IR of phlegm-dampness syndrome of PCOS + HA subgroup is higher than phlegm-dampness syndrome of PCOS +non-HA subgroup and the control group(P < 0.05).Conclusion The patients with phlegm-dampness syndrome of PCOS + HA have higher incidence of hirsutism,acanthosis nigricans and excessive fat.The patients with phlegm-dampness syndrome of PCOS + HA have serious sex hormone metabolic disorders.The patients with phlegm-dampness syndrome of PCOS + HA have serious glucolipid metabolic disorders.
Objective Through the collection and analysis of clinical features and biochemical indices data got from 436 women who were diagnosed as phlegm-dampness syndrome of PCOS,in order to provide the reference for the personalized treatment for disease and prevention of long-term complication.Methods We collected 436 cases of patients diagnosed with phlegm-dampness syndrome of PCOS and 62 cases of control group from December 2014 to August 2017.We analysied and compared of three groups of clinical and biochemical indicators.Results The incidence of hirsutism,acanthosis nigricans and excessive fat of phlegm-dampness syndrome of PCOS + HA subgroup were higher than phlegm-dampness syndrome of PCOS + non-HA subgroup(P < 0.05).The LH and LH/FSH of of phlegm-dampness syndrome of PCOS + HA subgroup were higher.The level of FSH and SHBG was lower than phlegm-dampness syndrome of PCOS + non-HA subgroup and the control group(P < 0.05).The TC,TG and LDL of phlegm-dampness syndrome of PCOS +HA subgroup were higher than phlegm-dampness syndrome of PCOS + non-HA subgroup and the control group(P < 0.05).The FPG,FINS and HOMA-IR of phlegm-dampness syndrome of PCOS + HA subgroup is higher than phlegm-dampness syndrome of PCOS +non-HA subgroup and the control group(P < 0.05).Conclusion The patients with phlegm-dampness syndrome of PCOS + HA have higher incidence of hirsutism,acanthosis nigricans and excessive fat.The patients with phlegm-dampness syndrome of PCOS + HA have serious sex hormone metabolic disorders.The patients with phlegm-dampness syndrome of PCOS + HA have serious glucolipid metabolic disorders.
引文
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4 高金金.痰湿型与非痰湿型多囊卵巢综合征患者糖代谢的比较研究[D].黑龙江:黑龙江中医药大学,2013
5 史梅莹.多囊卵巢综合征证候要素的分布特点及其与相关理化指标关系的探讨[D].北京:北京中医药大学,2015
6 国家中医药管理局医政司.24个专业105个病种中医临床路径(试行)[M].北京:国家中医药管理局,2012:532-533
7 Azziz R,Carmina E,Dewailly D,et al.The Androgen Excess and PCOS Society criteria forthe polycystic ovary syndrome:the complete task force report[J].Fertil Steril,2009,91(2):456-488
8 李艳琼.四种雄激素指标对诊断多囊卵巢综合征的临床意义[J].黑龙江医学,2015,39(12):1346-1348
9 仲万霞,郑大伟,曲中玉,等.汉族多囊卵巢综合征患者各雄激素指标的临床意义分析[J].生殖与避孕,2014,34(10):830-837
10 李慧蓉,魏兆莲,曹云霞.体重指数对多囊卵巢综合征患者IVF结局的影响[J].安徽医科大学学报,2010,45(1):109-112
11 邢小燕,杨文英,杨兆军.胰岛素抵抗指数在不同糖耐量人群中诊断代谢综合征的作用[J].中国糖尿病杂志,2004,12(3):182-186
12 Wild RA,Rizzo M,Clifton S,et al.Lipid levels in polycystic ovary syndrome:systematic review and meta-analysis[J].Fertil Steril,2011,95(3):1073-7079
2 廖彩韵,梁晓燕.多囊卵巢综合征的病理生理[J].广东医学,2013,34(1):9-11
3 常久,李晓君.多囊卵巢综合征中医证型分布特点的现代文献研究[J].中医性科学,2014,23(3):60-63
4 高金金.痰湿型与非痰湿型多囊卵巢综合征患者糖代谢的比较研究[D].黑龙江:黑龙江中医药大学,2013
5 史梅莹.多囊卵巢综合征证候要素的分布特点及其与相关理化指标关系的探讨[D].北京:北京中医药大学,2015
6 国家中医药管理局医政司.24个专业105个病种中医临床路径(试行)[M].北京:国家中医药管理局,2012:532-533
7 Azziz R,Carmina E,Dewailly D,et al.The Androgen Excess and PCOS Society criteria forthe polycystic ovary syndrome:the complete task force report[J].Fertil Steril,2009,91(2):456-488
8 李艳琼.四种雄激素指标对诊断多囊卵巢综合征的临床意义[J].黑龙江医学,2015,39(12):1346-1348
9 仲万霞,郑大伟,曲中玉,等.汉族多囊卵巢综合征患者各雄激素指标的临床意义分析[J].生殖与避孕,2014,34(10):830-837
10 李慧蓉,魏兆莲,曹云霞.体重指数对多囊卵巢综合征患者IVF结局的影响[J].安徽医科大学学报,2010,45(1):109-112
11 邢小燕,杨文英,杨兆军.胰岛素抵抗指数在不同糖耐量人群中诊断代谢综合征的作用[J].中国糖尿病杂志,2004,12(3):182-186
12 Wild RA,Rizzo M,Clifton S,et al.Lipid levels in polycystic ovary syndrome:systematic review and meta-analysis[J].Fertil Steril,2011,95(3):1073-7079