| 徐 芳,侯丽辉,刘颖华,王梦思,丁春丽,牛静云.不同证型多囊卵巢综合征患者的临床和生化特征研究[J].,2018,(8):1527-1531 |
| 不同证型多囊卵巢综合征患者的临床和生化特征研究 |
| A Study on the Clinical and Biochemical Characteristics of Patients with Different Syndromes of Polycystic Ovary Syndrome |
| 投稿时间：2017-11-09 修订日期：2017-12-08 |
| DOI：10.13241/j.cnki.pmb.2018.08.026 |
| 中文关键词: 多囊卵巢综合征 中医证型 临床研究 |
| 英文关键词: Polycystic ovary syndrome TCM syndrome Clinical research |
| 基金项目:国家自然科学基金青年基金项目（81503610）；国家中医药管理局中医药标准化项目（SATCM2015BZ〔046〕）；黑龙江省中医药管理局课题(ZHY16-029) |
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| 中文摘要: |
| 摘要 目的：探讨"痰湿证"和"非痰湿证"多囊卵巢综合征（Polycystic ovary syndrome，PCOS）患者的临床和生化特征。方法：纳入PCOS患者89例(其中痰湿证42例、非痰湿证47例)及正常对照52例(其中痰湿证对照组21例、非痰湿证对照组31例)，采集和比较其临床资料及血清糖脂代谢指标、性激素水平的差异。结果：PCOS患者月经初潮年龄明显晚于正常对照组，两种证型PCOS患者均存在临床表现、性激素、糖代谢、脂代谢的异常，表现在多毛评分、黑棘皮、皮肤溢脂、痤疮发生率明显高于对照组；黄体生成素（(Luteinizing hormone，LH)、黄体生成素/促卵泡激素(Follicle stimulating hormone，FSH)、雌二醇(Estradiol，E2)、睾酮(Testosterone，T)、游离雄激素指数(Free androgen index，FAI)、空腹葡萄糖(Fast blood glucose，FBG)、甘油三酯(Triglyceride，TG)水平明显高于对照组；高密度脂蛋白(High density lipoprotein，HDL)水平显著低于对照组(P＜0.05)。而"痰湿型"PCOS以体重指数（Body mass index，BMI）、腰臀比（Waist hip ratio，WHR）、收缩压、黑棘皮和皮肤溢脂发生率、FAI、FBG、空腹胰岛素（Fast Insuline，FINS）、稳态模型胰岛素抵抗指数（Homeostasis model insulin resistance index，HOMA-IR）水平增高为主；而"非痰湿型"PCOS以LH/FSH、LH水平增高为主；与"非痰湿"对照组相比，"痰湿"对照组BMI、WHR、收缩压、FBG、TG、低密度脂蛋白(Low density lipoprotein，LDL)、HOMA-IR明显升高。结论： "痰湿证"PCOS患者以糖脂代谢异常和胰岛素抵抗为主，而 "非痰湿证" PCOS患者以性腺轴紊乱和高雄激素血症为主，将PCOS患者分为"痰湿证"和"非痰湿证"，能反映疾病不同证型的基本特点，对远期并发症的防治有指导意义。 |
| 英文摘要: |
| ABSTRACT Objective: To study the clinical and biochemical characteristics of patients with polycystic ovary syndrome with different syndromes. Methods: The samples of 89 cases of PCOS patients (42 cases of phlegm dampness type and 47 cases of nonphlegm dampness type) and 52 cases of normal control groups(21 cases of phlegm dampness type and 31 cases of nonphlegm dampness type) were studied. The clinical data and the serum glycolipid metabolism index and sex hormone level were collected and compared. Results: The age of menarche of patients with phlegm dampness type and nonphlegm dampness type were later than those oif the normal control groups, the F-G score and the incidence of skin excessive fat, acne, acan-thosis nigricans in phlegm dampness type and nonphlegm dampness type were significantly increased than those of the control group with phlegm dampness type and nonphlegm dampness type, the LH, LH/FSH, E2, T, FAI, FGS, TG levels were significantly higher than those in the control group; the level of HDL was lower than that of the control group(P<0.05). The BMI, WHR, systolic blood pressure, the incidence of acanthosis nigricans and skin excessive fat, FAI, FGS, FINS, HOMA-IR levels in the phlegm dampness type were significantly increased; and the LH, LH/FSH, HDL levels in nonphlegm dampness type were signifycantly increased; between phlegm dampness type and nonphlegm dampness type in the control group. Conclusion:＂Phlegm-damp-Ness＂PCOS is mainly characterized with abnormal glucose and lipid metabolism and insulin resistance, and＂non-phlegm dampness＂PCOS is mainly characterized with disorders of gonadal axis and hyperandrogenism. As PCOS patients were divided into＂phlegm-dampness＂and＂non-phlegm dampness＂, it can reflect the basic characteristics and the severity of disease and guide for prevention and treatment of long-term complications. |
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