多囊卵巢综合征中医病因病机临床分析

Clinical analysis of TCM etiology and pathogenesis of polycystic ovarian syndrome

关键词:  多囊卵巢综合征  证素  病位  病性  病因病机

Key words:  polycystic ovarian syndrome  syndrome element  disease location  nature of disease  etiology and pathogenesis

摘要:

[目的] 探讨多囊卵巢综合征（PCOS）中医发病机制。[方法] 运用证素辨证方法，对101例PCOS患者进行中医证素辨证，分析其病位证素、病性证素的频数、积分情况，探讨PCOS中医发病机制。[结果] 101例PCOS患者中，病位证素积分由高到低依次为胞宫、肾、肝、脾、心神、大肠，胞宫、肾与其他证素相比，差异有统计学意义（P<0.01），肝、脾与其他证素相比，差异有统计学意义（P<0.05）；在虚证证素中，气虚积分最高，依次大于阴虚、阳虚、血虚、精亏，差异有统计学意义（P<0.01），阴虚、阳虚与其他证素相比，差异有统计学意义（P<0.05）；在实证证素中，积分由高到低为气滞、血瘀、痰、湿、寒，气滞积分最高，与其他证素相比，差异有统计学意义（P<0.01），血瘀、痰、湿与其他证素相比，差异有统计学意义（P<0.05）。[结论] PCOS的病变脏腑主要在胞宫、肾，肾虚为本，兼夹气滞、血瘀、痰湿等，本虚标实，为其发病机制。

Abstract:

[Objective] Discuss the TCM etiology and pathogenesis of polycystic ovarian syndrome (PCOS). [Methods] One hundred and one cases of patients with PCOS were selected, and the method of differentiation of symptoms and signs based on symptom factors differentiation was adopted to analyze these cases. The frequency and integration of syndrome elements of disease location and nature were studied. [Results] In these cases, the integration value of syndrome elements in different disease locations ranked from great to small as follows: uterus, kidney, liver, spleen, mind and large intestine. Especially, the values for uterus and kidney had significant difference comparing with other syndrome elements (P<0.01). Also, the values for liver and spleen had significant difference comparing with other syndrome elements (P<0.05). In the asthenia syndrome, the integration value of Qi-deficiency was highest, which had a significant difference (P<0.01) comparing with other syndromes (the values of these syndromes ranked for great to small as follows: yin-deficiency, yang-deficiency, blood-insufficiency and kidney-jing deficiency). Moreover, the values for yin-deficiency and yang-deficiency had a significant difference (P<0.05) comparing with other syndromes. In the excess syndrome, the integration values ranked from great to small as follows: Qi stagnation, blood-stasis, phlegm, dampness and cold. Difference between Qi stagnation and other syndromes had statistical significance (P<0.01). In addition, the values for blood-stasis, phlegm and dampness were also different with other syndromes, which had statistical significance (P<0.05). [Conclusion] The pathological viscera of PCOS are mainly uterus and kidney, and its pathogenesis comes down to kidney deficiency accompanied with Qi stagnation, blood-stasis and phlegm-damp etc., and is essential empty and out solid.