多囊卵巢综合征伴胰岛素抵抗的中医证候分布规律与内分泌指标的相关性探讨

发布时间：2017-12-30 21:52

本文关键词：多囊卵巢综合征伴胰岛素抵抗的中医证候分布规律与内分泌指标的相关性探讨　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：探讨多囊卵巢综合征伴胰岛素抵抗(PCOS-IR)患者的中医证候分布规律与相关内分泌指标的关系,试图为临床辨证施治提供一些客观依据。方法：(1)对诊断为PCOS-IR患者进行问卷调查,采集中医四诊资料及相关病历资料；(2)建立数据库,将中医四诊资料进行聚类分析、频数分析,得出中医证候分布规律；(3)运用方差分析、非参数检验的方法分析PCOS-IR的各证型组间内分泌指标(BMI、PRL、FSH、LH、LH/FSH、E2、FT、DHEAS、INSO、INS1h、 INS2h、INS3h)的差异,探讨PCOS-IR的中医证候分布规律与内分泌指标的相关性。结果：(1)PCOS-IR的中医证候分布情况为肾虚肝郁证30例(18.6%),脾虚湿蕴证34例(21.1%),肾虚血瘀证31例(19.3%),痰瘀互结证41例(25.5%),气滞血瘀证25例(15.5%),以痰瘀互结证为主。(2)PCOS-IR的各证型组间比较示痰瘀互结组与其它证型组BMI均具有差异(P0.05),且痰瘀互结组的BMI均高于其它证型组；其余证型组之间比较BMI均无差异(P0.05)。(3)PCOS-IR的中医各证型组间比较基础性激素水平(PRL、FSH、LH、 LH/FSH、E2、FT、DHEAS均无差异(P0.05)。(4)痰瘀互结证组与其它证型组比较INSO、INS1h均有差异(P0.05),且INSO、INS1h高于其它证型组；痰瘀互结证组、脾虚湿蕴证组与其它证型组比较INS2h有差异(P0.05),但二者比较并无差异(P0.05),且二者INS2h高于其它证型组；肾虚血瘀组与其它证型组比较INS3h有差异(P0.05),与肾虚肝郁组比较无差异(P0.05),且二者INS3h低于其它证型组。结论：(1)PCOS-IR患者的证候分布为肾虚肝郁证、脾虚湿蕴证、肾虚血瘀证、痰瘀互结证、气滞血瘀证,以痰瘀互结证型为主。(2)痰瘀互结证可能与PCOS-IR肥胖的发生关系密切。(3)痰瘀互结证可能与IR的发生关系密切。(4)痰瘀互结证的PCOS-IR可能病情更重,脾虚湿蕴证次之,其余证型相对较轻。(5)涤痰逐瘀法可能是PCOS-IR的重要治法。
[Abstract]:Objective: to investigate the relationship between the distribution of TCM syndromes and related endocrine indexes in patients with polycystic ovary syndrome (PCOS) with insulin resistance (PCOS-IRR). This paper attempts to provide some objective basis for clinical treatment based on syndrome differentiation. Methods: 1) questionnaire survey was carried out on the patients diagnosed as PCOS-IR, and the data of four diagnoses of TCM and related medical records were collected. 2) establishing database, clustering analysis and frequency analysis of the data of four diagnoses of TCM, and obtaining the distribution law of TCM syndromes; (3) Analysis of variance and nonparametric test were used to analyze the endocrine index of BMI-PRLL / FSHLH / FSHE2FT in PCOS-IR. DHEASA INSOS1h, INS2hS3h). To explore the relationship between the distribution of TCM syndromes and endocrine indexes of PCOS-IR. Results the distribution of TCM syndromes of PCOS-IR was 30 cases of kidney deficiency and liver stagnation syndrome. There were 34 cases with spleen deficiency and dampness accumulation, 31 cases with kidney deficiency and blood stasis, 41 cases with phlegm and blood stasis, 41 cases with phlegm and blood stasis, 25 cases with Qi stagnation and blood stasis. The comparison of PCOS-IR with phlegm and blood stasis syndrome showed that there was significant difference in BMI between phlegm and blood stasis group and other syndrome groups (P0.05). The BMI of phlegm and blood stasis group was higher than that of other syndromes. There was no difference in BMI between the other syndromes groups. There was no difference in the levels of basic sex hormones and the levels of basic sex hormones among the different syndrome groups of traditional Chinese medicine (P0.05A, PCOS-IR, P 0.05, P 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05). There was no difference in DHEAS between LH / FSHE 2 and FTN DHEAS (P 0.05, P 0.05). There was significant difference between the phlegm and blood stasis syndromes group and other syndrome groups (P 0.05). The INS1h of INSOL was higher than that of other syndromes. Compared with other syndrome groups, INS2h of phlegm and blood stasis syndrome group, spleen deficiency dampness accumulation syndrome group and other syndrome type group were different (P 0.05), but there was no difference between them (P 0.05), and the INS2h of both groups was higher than other syndrome type group. Compared with other syndrome groups, INS3h in kidney deficiency and blood stasis group was different (P 0.05), but no difference was found in kidney deficiency and liver stagnation group (P 0.05). The INS3h of both groups was lower than that of other syndromes. Conclusion the syndromes of PCOS-IR were kidney deficiency and liver depression, spleen deficiency and dampness accumulation, kidney deficiency and blood stasis, phlegm and blood stasis, qi stagnation and blood stasis. Phlegm and blood stasis syndromes were the main type. (2) phlegm and blood stasis syndromes were probably closely related to the occurrence of obesity in PCOS-IR. (3) phlegm and blood stasis syndromes might be closely related to the occurrence of IR. The PCOS-IR of phlegm and blood stasis syndrome may be more serious. The syndrome of spleen deficiency and dampness accumulation was the second, and the other syndrome types were relatively light. 5) the method of removing phlegm and removing blood stasis might be an important treatment for PCOS-IR.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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