250例糖尿病家族史多囊卵巢综合征中医证型的特征研究

Clinical characteristics of Chinese medicine syndrome of polycystic ovary syndrome from diabetes family history

关键词:  多囊卵巢综合征  糖尿病家族史  中医证型  临床特征

Key words:  polycystic ovary syndrome  diabetes family history  Chinese medicine syndrome  clinical characteristic

摘要:

[目的] 探讨糖尿病家族史多囊卵巢综合征（PCOS）中医证型分布规律及血清性激素、糖脂代谢特征。[方法] 回顾性分析250例糖尿病家族史PCOS患者的一般情况、血清性激素及糖脂代谢水平，包括年龄、初潮年龄、体质量、体重指数（BMI）、腰围（WC）、臀围（HC）、腰臀比（WHR）、收缩压、舒张压、促卵泡生成素（FSH）、促黄体生成素（LH）、泌乳素（PRL）、雌二醇（E₂）、睾酮（T）、硫酸脱氢表雄酮（DHEAS）、雄烯二酮（AND）、性激素结合球蛋白（SHBG）、空腹血糖（FPG）、空腹胰岛素水平（FINS）、稳态模式胰岛素抵抗指数（HOMA-IR）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）。[结果] 250例糖尿病家族史PCOS患者根据中医证候诊断标准分为肾虚肝郁证、肾虚血瘀证、脾虚痰湿证和痰瘀互结证4个证型，其中痰瘀互结证占38%；脾虚痰湿证占28.4%；肾虚肝郁证占20.8%；肾虚血瘀证占12.8%。脾虚痰湿证组和痰瘀互结证组的体质量、BMI、WC、HC、WHR、收缩压、舒张压、T、DHEAS、AND、GS、FINS、IR、TG、TC、LDL-C均高于肾虚肝郁证组和肾虚血瘀证组，差异具有统计学意义（P<0.05），且4组的腰臀比均>0.8，而SHBG、HDL-C低于肾虚肝郁证组和肾虚血瘀证组，差异有统计学意义（P<0.05）。[结论] 糖尿病家族史多囊卵巢综合征不同证型间具有其内在的特征，表现出更明显的代谢异常问题。

Abstract:

[Objective] To explore Chinese medicine syndrome distribution and characteristics of sexual hormones and glycolipid metabolism of polycystic ovarian syndrome from diabetes family history.[Methods] It was made a retrospective analysis of 250 cases of patients with PCOS from diabetes family history general situation, sexual hormones and glycolipid metabolism,including age, menarche age, body weight, BMI, WC, HC, WHR, systolic blood pressure, diastolic blood pressure, follicle stimulating prime(FSH), luteinizing prime(LH), prolactin prime(PRL), estradiol(E₂), testosterone(T), dehydroepiandrosterone(DHEAS), and rostene dione(ADN), sex hormone binding globulin(SHBG), fasting plasma glucose(FPG), fasting insulin(FINS), homeostasis model insulin resistance index(HOMA-IR), triglycerides(TG), total cholesterol(TC), high density lipoprotein(HDL-C) and low-density lipoprotein(LDL-C).[Results] The 250 patients with PCOS from diabetes family history were divided into the syndrome differentiation phlegm and blood stasis syndrome, spleen deficiency and phleg dampness syndrome, of kidney deficiency and liver qistagnation, kidney deficiency and blood stasis syndrome, respectively accounting for 38%, 28.4%, 20.8%,12.8%. Body weight, BMI, WC, HC, WHR, ystolic blood pressure, diastolic blood pressure, T, DHEAS, AND, GS, FINS, IR, TG, TC, LDL-C of PCOS patients with spleen deficiency and phlegm dampness syndrome,phlegm and blood stasis syndrome was significantly higher than that of the kidney deficiency and liver qistagnation,kidney deficiency and blood stasis syndrome(P<0.05),SHBG, HDL-C was lower than that of kidney deficiency and liver qistagnation, kidney deficiency and blood stasis syndrome(P<0.05).[Conclusion] Different syndrome types of PCOS from diabetes family history patients showed characteristics differences.