基于数据挖掘技术探析多囊卵巢综合征多毛的经络辨证规律
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摘要
目的:分析多囊卵巢综合征(polycystic ovarian syndrome,PCOS)多毛的分布特点及其经络辨证规律。方法:针对PCOS患者,采用改良的多毛评分(modified Ferriman-Gallwey score,m F-G评分)评价其体毛分布情况,运用clementine数据挖掘软件,分析多毛的分布部位及其与经络的关联性。结果:141例PCOS患者参与了本研究。其最常见的多毛部位是上唇(50.35%)和下腹(34.04%);两部位同时出现多毛表现频率较高的是上唇-下腹(24.82%)、上唇-胸部(12.06%)、上唇–大腿(11.35%);分析上唇、下腹、胸部与其他多毛部位的关联性发现,一般距离相近的部位同时出现多毛的提升度大;按照经络循行路线统计,多毛发生频次由高到低依次为任脉(63.12%)、冲脉(61.70%)、足厥阴肝经(58.16%)、足阳明胃经(57.45%);按《灵枢·阴阳二十五人》归类,由于阳明经脉气血变化造成多毛的发生率高(59.57%)。结论:血在毫毛生长中起重要作用,从部位的阴阳属性分析,属阴的部位多毛的发生频率高于属阳的部位;多毛的发生与经络气血变化密切相关,冲任脉、足厥阴肝经、阳明经在本病发生中有重要作用。
Objective To analyze the distribution characteristics of hirsutism and the law of meridian differentiation in polycystic ovarian syndrome(PCOS). Methods For the patients of PCOS, the modified Ferriman-Gallwey score(m F-G score)was adopted to evaluate the hirsutism distribution. The clementine data mining software was used to analyze the distribution region of hirsutism and the correlation with meridian. Results A total of 141 patients of PCOS participated in the study. The most common regions of hirsutism were in the upper lip(50.35%) and the lower abdomen(34.04%). The higher frequencies of hirsutism at two regions were at the upper lip and lower abdomen(24.82%), the upper lip and chest(12.06%) and the upper lip and thigh(11.35%). In the analysis on the correlation of the upper lip, lower abdomen and chest with other regions, hirsutism was more common in the nearby regions. In reference to the running course of meridian, the frequencies of hirsutism from high to low were the conception vessel(63.12%), the thoroughfare vessel(61.70%), the liver meridian of foot-jueyin(58.16%) and the stomach meridian of foot-yangming(57.45%). According to Miraculous Pivot: Yinyang Twenty-Five Persons, the high incidence of hirsutism(59.57%) resulted from the change of qi and blood in yangming meridian. Conclusion Blood plays the important role in the growth of body hair. Regarding the yinyang attribution, the incidence of hirsutism at the yin regions is higher than the yang regions. The occurrence of hirsutism is closely related to qi and blood changes in meridians. The conception vessel, the thoroughfare vessel, the liver meridian of foot-jueyin and yangming meridian act highly on the disease.
Objective To analyze the distribution characteristics of hirsutism and the law of meridian differentiation in polycystic ovarian syndrome(PCOS). Methods For the patients of PCOS, the modified Ferriman-Gallwey score(m F-G score)was adopted to evaluate the hirsutism distribution. The clementine data mining software was used to analyze the distribution region of hirsutism and the correlation with meridian. Results A total of 141 patients of PCOS participated in the study. The most common regions of hirsutism were in the upper lip(50.35%) and the lower abdomen(34.04%). The higher frequencies of hirsutism at two regions were at the upper lip and lower abdomen(24.82%), the upper lip and chest(12.06%) and the upper lip and thigh(11.35%). In the analysis on the correlation of the upper lip, lower abdomen and chest with other regions, hirsutism was more common in the nearby regions. In reference to the running course of meridian, the frequencies of hirsutism from high to low were the conception vessel(63.12%), the thoroughfare vessel(61.70%), the liver meridian of foot-jueyin(58.16%) and the stomach meridian of foot-yangming(57.45%). According to Miraculous Pivot: Yinyang Twenty-Five Persons, the high incidence of hirsutism(59.57%) resulted from the change of qi and blood in yangming meridian. Conclusion Blood plays the important role in the growth of body hair. Regarding the yinyang attribution, the incidence of hirsutism at the yin regions is higher than the yang regions. The occurrence of hirsutism is closely related to qi and blood changes in meridians. The conception vessel, the thoroughfare vessel, the liver meridian of foot-jueyin and yangming meridian act highly on the disease.
引文
[1]LI R,ZHANG Q,YANG D,et al.Prevalence of polycystic ovary syndrome in women in China:a large community-based study[J].Hum Reprod,2013,28(9):2562-2569.
[2]王泽,石玉华,陈子江.多囊卵巢综合征诊断和治疗中存在的问题[J].实用妇产科杂志,2016,32(6):423-426.
[3]Hohl A,Ronsoni MF,Oliveira M.Hirsutism:diagnosis and treatment[J].Arq Bras Endocrinol Metabol,2014,58(2):97-107.
[4]赵君利,陈子江,石玉华,等.育龄期妇女体毛状况调查及其在多囊卵巢综合征诊断中的初步应用[J].中华妇产科杂志,2007,42(9):590-594.
[5]Geisthovel F.A comment on the European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine consensus of the polycystic ovarian syndrome[J].Reprod Biomed Online,2003,7(6):602-605.
[6]Glintborg D,Andersen M.An update on the pathogenesis,inflammation,and metabolism in hirsutism and polycystic ovary syndrome[J].Gynecol Endocrinol,2010,26(4):281-296.
[7]Yildiz BO,Bolour S,Woods K,et al.Visually scoring hirsutism[J].Hum Reprod Update,2010,16(1):51-64.
[8]杨尊求,周青.督脉循行考[J].云南中医中药杂志,2016,37(9):19-21.
[9]李磊,尤传香.冲脉循行考[J].中华中医药杂志,2013,28(1):190-192.
[10]任玉兰,梁繁荣.基于数据挖掘的经穴效应特异性文献评价思路[J].针刺研究,2009,34(3):199-201.
[11]许林玲,徐天舒,张建斌.基于数据挖掘技术探讨古代针灸治疗消渴病的腧穴配伍规律[J].中国针灸,2015,35(8):841-843.
[12]朱学亮,檀占娜,李伯英,等.基于数据挖掘的不同灸法临床应用病种的比较研究*[J].中国针灸,2014,34(9):879-883.
[13]李玲,周学平.数据挖掘技术在中医药传承中的研究进展[J].江苏中医药,2011,43(11):92-93.
[14]任玉兰,梁繁荣,吴曦,等.基于数据挖掘的针灸临床循证决策支持系统研究[J].中华中医药杂志,2011,26(4):795-797.
[15]戚秀中,刘栋,顾瞻,等.何为“经络”[J].辽宁中医药大学学报,2015,17(1):171-173.
[16]刘斌,尤海燕.血管区理论对《素问·皮部论篇》解读的启示[J].北京中医药大学学报,2016,39(10):802-806.
[17]杨新鸣,吴效科.冲任阻滞与多囊卵巢综合征[J].世界中西医结合杂志,2010,5(8):645-648.
[18]金春兰,庞然,徐立鹏,等.针灸治疗多囊卵巢综合征临床选穴组方规律[J].中国针灸,2015,35(6):625-630.
[19]谢静,李宜为,温川飙.针灸治疗多囊卵巢综合征用穴规律研究[J].亚太传统医药,2016,12(24):89-91.
[20]纪珺,孙颖,王卫.针刺治疗多囊卵巢综合征选穴规律探析[J].中医外治杂志,2015,24(1):61-62.
[21]徐晓航,陈圆辉,王倩,等.多囊卵巢综合征诊治新进展[J].国际生殖健康/计划生育杂志,2015,34(2):160-164.
[22]Demir B,Pasa S,Demir S,et al.Hirsutism score and the severity of hyperandrogenism associated with polycystic ovary syndrome in the southeastern region of Turkey[J].J Int Med Res,2011,39(4):1529-1535.
[23]Fabbri E,An Y,Gonzalez-Freire M,et al.Bioavailable testosterone linearly declines over a wide age spectrum in men and women from the baltimore longitudinal study of aging[J].J Gerontol A Biol Sci Med Sci,2016,71(9):1202-1209.
[24]滕香宇.中国上海女性中m-FG评分法多毛适宜切点值的探索[C]//中华医学会第十一次全国内分泌学学术会议论文集,2012.
[25]赵晓苗,倪仁敏,黄佳,等.改良Ferriman-Gallwey评分系统用于广东省育龄期汉族妇女体毛评价的分析[J].中华妇产科杂志,2013,48(6):427-431.
[26]LI R,QIAO J,YANG D,et al.Epidemiology of hirsutism among women of reproductive age in the community:a simplified scoring system[J].Eur J Obstet Gynecol Reprod Biol,2012,163(2):165-169.
[27]Wong M,Zhao X,Hong Y,et al.Semiquantitative assessment of hirsutism in 850 PCOS patients and 2,988 controls in China[J].Endokrynol Pol,2014,65(5):365-370.
[28]李娜,秦淑芳.从冲脉论治妇科病之体会[J].长春中医药大学学报,2012,28(5):815-816.
[29]王清,曹俊岩.贵阳地区多囊卵巢综合征痤疮、多毛与中医证型的相关性研究[J].贵阳中医学院学报,2013,35(3):147-148.
[30]蔡宝宏,顾宇.论“二阳之病发心脾”之闭经因机证治[J].辽宁中医药大学学报,2016,18(3):135-137.
[2]王泽,石玉华,陈子江.多囊卵巢综合征诊断和治疗中存在的问题[J].实用妇产科杂志,2016,32(6):423-426.
[3]Hohl A,Ronsoni MF,Oliveira M.Hirsutism:diagnosis and treatment[J].Arq Bras Endocrinol Metabol,2014,58(2):97-107.
[4]赵君利,陈子江,石玉华,等.育龄期妇女体毛状况调查及其在多囊卵巢综合征诊断中的初步应用[J].中华妇产科杂志,2007,42(9):590-594.
[5]Geisthovel F.A comment on the European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine consensus of the polycystic ovarian syndrome[J].Reprod Biomed Online,2003,7(6):602-605.
[6]Glintborg D,Andersen M.An update on the pathogenesis,inflammation,and metabolism in hirsutism and polycystic ovary syndrome[J].Gynecol Endocrinol,2010,26(4):281-296.
[7]Yildiz BO,Bolour S,Woods K,et al.Visually scoring hirsutism[J].Hum Reprod Update,2010,16(1):51-64.
[8]杨尊求,周青.督脉循行考[J].云南中医中药杂志,2016,37(9):19-21.
[9]李磊,尤传香.冲脉循行考[J].中华中医药杂志,2013,28(1):190-192.
[10]任玉兰,梁繁荣.基于数据挖掘的经穴效应特异性文献评价思路[J].针刺研究,2009,34(3):199-201.
[11]许林玲,徐天舒,张建斌.基于数据挖掘技术探讨古代针灸治疗消渴病的腧穴配伍规律[J].中国针灸,2015,35(8):841-843.
[12]朱学亮,檀占娜,李伯英,等.基于数据挖掘的不同灸法临床应用病种的比较研究*[J].中国针灸,2014,34(9):879-883.
[13]李玲,周学平.数据挖掘技术在中医药传承中的研究进展[J].江苏中医药,2011,43(11):92-93.
[14]任玉兰,梁繁荣,吴曦,等.基于数据挖掘的针灸临床循证决策支持系统研究[J].中华中医药杂志,2011,26(4):795-797.
[15]戚秀中,刘栋,顾瞻,等.何为“经络”[J].辽宁中医药大学学报,2015,17(1):171-173.
[16]刘斌,尤海燕.血管区理论对《素问·皮部论篇》解读的启示[J].北京中医药大学学报,2016,39(10):802-806.
[17]杨新鸣,吴效科.冲任阻滞与多囊卵巢综合征[J].世界中西医结合杂志,2010,5(8):645-648.
[18]金春兰,庞然,徐立鹏,等.针灸治疗多囊卵巢综合征临床选穴组方规律[J].中国针灸,2015,35(6):625-630.
[19]谢静,李宜为,温川飙.针灸治疗多囊卵巢综合征用穴规律研究[J].亚太传统医药,2016,12(24):89-91.
[20]纪珺,孙颖,王卫.针刺治疗多囊卵巢综合征选穴规律探析[J].中医外治杂志,2015,24(1):61-62.
[21]徐晓航,陈圆辉,王倩,等.多囊卵巢综合征诊治新进展[J].国际生殖健康/计划生育杂志,2015,34(2):160-164.
[22]Demir B,Pasa S,Demir S,et al.Hirsutism score and the severity of hyperandrogenism associated with polycystic ovary syndrome in the southeastern region of Turkey[J].J Int Med Res,2011,39(4):1529-1535.
[23]Fabbri E,An Y,Gonzalez-Freire M,et al.Bioavailable testosterone linearly declines over a wide age spectrum in men and women from the baltimore longitudinal study of aging[J].J Gerontol A Biol Sci Med Sci,2016,71(9):1202-1209.
[24]滕香宇.中国上海女性中m-FG评分法多毛适宜切点值的探索[C]//中华医学会第十一次全国内分泌学学术会议论文集,2012.
[25]赵晓苗,倪仁敏,黄佳,等.改良Ferriman-Gallwey评分系统用于广东省育龄期汉族妇女体毛评价的分析[J].中华妇产科杂志,2013,48(6):427-431.
[26]LI R,QIAO J,YANG D,et al.Epidemiology of hirsutism among women of reproductive age in the community:a simplified scoring system[J].Eur J Obstet Gynecol Reprod Biol,2012,163(2):165-169.
[27]Wong M,Zhao X,Hong Y,et al.Semiquantitative assessment of hirsutism in 850 PCOS patients and 2,988 controls in China[J].Endokrynol Pol,2014,65(5):365-370.
[28]李娜,秦淑芳.从冲脉论治妇科病之体会[J].长春中医药大学学报,2012,28(5):815-816.
[29]王清,曹俊岩.贵阳地区多囊卵巢综合征痤疮、多毛与中医证型的相关性研究[J].贵阳中医学院学报,2013,35(3):147-148.
[30]蔡宝宏,顾宇.论“二阳之病发心脾”之闭经因机证治[J].辽宁中医药大学学报,2016,18(3):135-137.