摘要
目的探讨多囊卵巢综合征(PCOS)痰湿证患者临床特征与生化水平,并分析其与痰湿证的相关性。方法 463例PCOS患者分为痰湿证组和非痰湿证组,记录PCOS患者年龄、身高、体重、腰围、臀围及多毛、痤疮、黑棘皮评分;于自然月经周期或孕激素撤退出血的第3~5天空腹采血,测定性激素、血脂、空腹血糖及空腹胰岛素水平。结果痰湿证PCOS患者284例,占65. 14%,非痰湿证PCOS患者152例,占34. 86%。痰湿证PCOS患者体重、BMI、腰围、臀围、腰臀比(WHR)和痤疮、多毛、黑棘皮评分均高于非痰湿证PCOS患者(P <0. 05);痰湿证PCOS患者促黄体生成素(LH)、促卵泡生成素(FSH)、性激素结合球蛋白(SHBG)、高密度脂蛋白(HDL)和载脂蛋白(ApoA1)低于非痰湿证组,甘油三脂(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、空腹血糖(FPG)、空腹胰岛素(FINS)稳态模型胰岛素抵抗指数(IR)高于非痰湿证组(P <0. 05); Logistic二项回归分析,体重(OR=1. 550,P=0. 042)、BMI (OR=14. 360,P=0. 001)、痤疮(OR=1. 185,P=0. 000)、黑棘皮(OR=9. 272,P=0. 007)、TG (OR=1. 939,P=0. 013)和FPG (OR=9. 966,P=0. 000)与痰湿证呈正相关,而LH(OR=0. 457,P=0. 000)、FSH(OR=0. 261,P=0. 000)、SHBG(OR=0. 973,P=0. 000)、HDL(OR=0. 389,P=0. 038)和ApoA1(OR=0. 309,P=0. 004)与痰湿证呈负相关。结论痰湿证较非痰湿证PCOS患者有明显临床及生化水平紊乱,其中,体重、BMI、痤疮、黑棘皮、TG和FPG为痰湿证的危险因素,而LH、FSH、SHBG、HDL和ApoA1为痰湿证的保护因素。
Objective To investigate the clinical characteristics and biochemical level in patients with polycystic ovary syndrome( PCOS) of phlegm-damp syndrome,and to analyze the correlation between clinical characteristics and biochemical factor and phlegm-damp syndrome. Methods 463 patients with PCOS were divided into phlegm-damp syndrome group and non-phlegm-damp syndrome group. The age,height,weight,waist circumference,hip circumference,hairy,acne and acanthosis nigricans score wererecorded,and in natural menstrual cycle or progesterone withdrawal bleeding 3-5 days,determination sex hormones,blood lipids,fasting blood glucose and fasting insulin. Results PCOS of phlegm-damp syndrome have 284 cases,accounting for 65. 14%,non-phlegm-damp syndrome PCOS patients 152 cases,accounting for 34. 86%. The body weight,BMI,waist circumference,hip circumference,WHR and acne,hairy,and acanthosis nigricans score of phlegm-damp syndrome PCOS patients are higher than those of non-phlegm-damp syndrome( P < 0. 05). LH,FSH,SHBG,HDL and ApoA1 in patients of PCOS with phlegm-damp syndrome are lower than those of non-phlegm-damp syndrome group. legm-damp syndrome group( P < 0. 05). Logistic regression analysis,weight( OR = 1. 550,P = 0. 042),BMI( OR= 14. 360,P = 0. 001),acne( OR = 1. 185,P = 0. 000),acanthosis nigricans( OR = 9. 272,P =0. 007),TG( OR = 1. 939,P = 0. 000) and FPG( OR = 0. 261,P = 0. 000) are positively correlated with phlegm-damp syndrome. And LH( OR = 0. 457,P = 0. 000),FSH( OR = 0. 261,P = 0. 000),SHBG( OR = 0. 973,P = 0. 000),HDL( OR = 0. 389,P = 0. 038) and ApoA1( OR = 0. 309,P = 0. 004)are negatively correlated with phlegm-damp-syndrome. Conclusion Phlegm-damp syndrome has obvious clinical and biochemical disorders than non-phlegm-damp syndrome patients,of which weight,BMI,acne,acanthosis nigricans,TG and FPG are the risk factors of phlegm-damp syndrome. LH,FSH,SHBG,HDL and ApoA1 are the protective factors of phlegm-damp syndrome.
引文
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