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[多囊卵巢综合征证型分布规律及性激素水平与糖代谢特征]

[Distribution Laws of PCOS Syndrome Types and Features of Sex Hormone Levels and Glucose Metabolism].

作者信息

Tang Pei-Pei, Tan Yong

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Jul;36(7):801-805.

Abstract

OBJECTIVE

To analyze distribution laws of polycystic ovary syndrome PCOS) syndrome types and features of sex hormone levels and glucose metabolism, providing evidence for clinical syndrome typing, diagnosis and treatment.

METHODS

Totally 237 PCOS patient were recruited. Their basic information and clinical data were collected and syndrome typed as Shen yin deficiency type, Shen yang deficiency type, Gan depression type, phlegm dampness type, blood stasis type. Data were analyzed by using SPSS21. 0 Software package. Basic features, hormone levels, and glucose metabolism were observed in patients with different syndrome types.

RESULTS

(1) The laws of syndrome distribution: Shen yin deficiency type in 46 cases (19. 41%), Shen yang deficiency type in 61 cases (25. 74%), Gan depression type in 48 cases (20. 25%), phlegm dampness type in 46 cases (19. 41%), blood stasis type in 36 cases (15.19%). (2) The levels of sex hormones: Compared with patients with Shen yin deficiency type, luteinizing hormone (LH) was higher in patients with Shen yang deficiency type (P <0. 01 , P <0. 05) ; LH was lower in patients with Gan depression type and phlegm dampness type (P <0. 01 , P <0. 05) ; follicle stimulating hormone (FSH) was lower in patients with phlegm dampness type (P <0.05); LH/FSH ratio was higher in patients with Shen yang deficiency type (P <0. 01); testosterone (T) level was lower in patients with Gan depression type and blood stasis type (P <0. 05, P <0. 01) ; prolactin (PRL) level was higher in patients with blood stasis type and phlegm dampness type (P <0. 05, P <0. 01). Compared with patients with Shen yang deficiency type, LH level and LH/FSH ratio were lower in patients with Gan depression type, phlegm dampness type, and blood stasis type (P <0. 01) ; FSH was lower in patients with phlegm dampness type (P<0.05); T was also lower in patients with Gan depression type and blood stasis type (P <0.05, P < 0.01); PRL was higher in patients with Gan depression type and phlegm dampness type (P <0.01, P < 0. 05). Compared with patients with Gan depression type, PRL was lower in patients with phlegm dampness type and blood stasis type (P <0. 01). Ddehydroepiandrosterone sulfate (DHEAS) level was the lowest in patients with blood stasis type (P <0. 05, P <0. 01). There was no statistical difference in estradiol (E₂) among all groups (P>0.05). (3) The characteristics of glucose metabolism: Compared with patients with phlegm dampness type, fasting insulin (FINS), 2 h insulin (INS 2 h) , 3 h insulin (INS 3 h) , insulin/glucose (I/G), homeostatic model for insulin resistance (HOMA-IR) were lower in patients with Shen yin deficiency type, Shen yang deficiency type, Gan depression type, blood stasis type (P <0. 01) ; islet β-cell function index (HOMA-β) was lower in patients with Shen yang deficiency type, Gan depression type, blood stasis type (all P <0. 01); 2 h glucose (GLU 2 h) was lower in patients with Shen yin deficiency type, Shen yang deficiency type, blood stasis type (P <0. 05, P <0. 01); 3 h glucose (GLU 3 h) was lower in patients with Shen yin deficiency type (P <0. 05). Compared with patients with Gan depression type, INS 2 h and GLU 2 h were also lower patients with Shen yin deficiency type (P <0. 05, P <0. 01).

CONCLUSIONS

There exists certain distribution laws of syndrome types in PCOS patients. Besides, different syndrome types had certain relevance with sex hormone and glucose metabolism features.

摘要

目的

分析多囊卵巢综合征(PCOS)的证型分布规律及性激素水平和糖代谢特点,为临床辨证分型、诊断及治疗提供依据。

方法

选取237例PCOS患者,收集其基本信息和临床资料,并辨证分为肾阴虚型、肾阳虚型、肝郁型、痰湿型、血瘀型。采用SPSS 21.0软件包进行数据分析,观察不同证型患者的基本特征、激素水平及糖代谢情况。

结果

(1)证型分布规律:肾阴虚型46例(19.41%),肾阳虚型61例(25.74%),肝郁型48例(20.25%),痰湿型46例(19.41%),血瘀型36例(15.19%)。(2)性激素水平:与肾阴虚型患者相比,肾阳虚型患者促黄体生成素(LH)水平较高(P<0.01,P<0.05);肝郁型和痰湿型患者LH水平较低(P<0.01,P<0.05);痰湿型患者促卵泡生成素(FSH)水平较低(P<0.05);肾阳虚型患者LH/FSH比值较高(P<0.01);肝郁型和血瘀型患者睾酮(T)水平较低(P<0.05,P<0.01);血瘀型和痰湿型患者催乳素(PRL)水平较高(P<0.05,P<0.01)。与肾阳虚型患者相比,肝郁型、痰湿型和血瘀型患者LH水平及LH/FSH比值较低(P<0.01);痰湿型患者FSH水平较低(P<0.05);肝郁型和血瘀型患者T水平也较低(P<0.05,P<0.01);肝郁型和痰湿型患者PRL水平较高(P<0.01,P<0.05)。与肝郁型患者相比,痰湿型和血瘀型患者PRL水平较低(P<0.01)。血瘀型患者硫酸脱氢表雄酮(DHEAS)水平最低(P<0.05,P<0.01)。各证型间雌二醇(E₂)水平差异无统计学意义(P>0.05)。(3)糖代谢特点:与痰湿型患者相比,肾阴虚型、肾阳虚型、肝郁型、血瘀型患者空腹胰岛素(FINS)、餐后2小时胰岛素(INS 2 h)、餐后3小时胰岛素(INS 3 h)、胰岛素/血糖(I/G)、胰岛素抵抗稳态模型评估(HOMA-IR)较低(P<0.01);肾阳虚型、肝郁型、血瘀型患者胰岛β细胞功能指数(HOMA-β)较低(均P<0.01);肾阴虚型、肾阳虚型、血瘀型患者餐后2小时血糖(GLU 2 h)较低(P<0.05,P<0.01);肾阴虚型患者餐后3小时血糖(GLU 3 h)较低(P<0.05)。与肝郁型患者相比,肾阴虚型患者INS 2 h和GLU 2 h也较低(P<0.05,P<0.01)。

结论

PCOS患者存在一定的证型分布规律,且不同证型与性激素及糖代谢特点存在一定相关性。

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