世界中医药
文章摘要
引用本文:李娟1,吴婉婷2,宋金龙1,赖毛华1,刘华1,马红霞1,夏阳1.多囊卵巢综合征合并胰岛素抵抗的中医证型特征研究[J].世界中医药,2017,(07):.  
多囊卵巢综合征合并胰岛素抵抗的中医证型特征研究
Study on Characteristics of Traditional Chinese Medicine Syndromes in Patients with Polycystic Ovary Syndrome with Insulin Resistance
投稿时间:2017-02-15  
DOI:10.3969/j.issn.1673-7202.2017.07.051
中文关键词:  多囊卵巢综合征  胰岛素抵抗  中医证型  特征
English Keywords:Polycystic ovarian syndrome  Insulin resistance  Characteristics  Traditional chinese medicine syndrome
基金项目:广州市医药卫生科技项目(20152A011018)——针刺对多囊卵巢综合征合并胰岛素抵抗患者胰岛素敏感性作用的前瞻性观察研究
作者单位
李娟1,吴婉婷2,宋金龙1,赖毛华1,刘华1,马红霞1,夏阳1 1 广州医科大学附属第一医院,广州,510120
2 广州中医药大学,广州,510006 
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中文摘要:
      目的:探讨多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)合并胰岛素抵抗(Insulin Resistance,IR)各中医证型的分布规律及临床内分泌和糖脂代谢的特点。方法:选取2014年1月至2016年1月广州医科大学附属第一医院收治的PCOS合并IR患者78例并根据中医四诊分型,并选取同龄健康女性26例为对照,观察其一般情况及临床内分泌、代谢指标,包括年龄、身高、体重、腰围、臀围、空腹血糖、空腹胰岛素、总胆固醇(Cholesterol,CHOL)、三酰甘油(Triglyceride,TG)、高密度脂蛋白(High Density Lipoproteins,HDL)、低密度脂蛋白(Low Density Lipoprotein,LDL)、载脂蛋白A1(Apolipoprotein A-1,ApoA-1)、载脂蛋白B(Apolipoprotein B,ApoB)、卵泡刺激激素(Follicle-stimulating Hormone,FSH)、黄体生成素(Luteinizing Hormone,LH)、泌乳素(Prolactin,PRL)、睾酮(Testosterone,T),比较各项指标的组间差异。 结果:78例PCOS患者脾虚痰湿证52.56%,肾虚证23.08%,肝郁证24.36%。脾虚痰湿组的体质指数(Body Mass Index,BMI)、腰臀比(Waist-to-hip Ratio,WHR)、胰岛素稳态模型指数(Homeostasis Model of Assessment for Insulin Resistance Index,HOMA-IR)、LH、LH/FSH、T、CHOL、TG、HDL、LDL、APOA-1及APOB均显著高于正常对照组(P<0.05),肝郁气滞组WHR、HOMA-IR、LH、LH/FSH以及T均显著高于正常对照组(P<0.05),肾虚组HOMA-IR、LH、LH/FSH以及TG均显著高于正常对照组(P<0.05)。肾虚组和肝郁气滞组的BMI和WHR,以及肝郁气滞组的TG均显著低于脾虚痰湿组(P<0.05)。结论:PCOS脾虚痰湿证IR发生率高于肝郁气滞证和肾虚证,且脾虚痰湿证具有更明显的肥胖、内分泌及脂代谢紊乱。
English Summary:
      To investigate the distribution rules of TCM Syndromes in polycystic ovary syndrome (PCOS) with insulin resistance and the characteristics of clinical endocrinology and glycolipid metabolism. Methods:A total of 78 PCOS patients with insulin resistance were grouped according to TCM syndrome type and 26 cases of healthy women of the same age were selected as control subjects. The general body condition, clinical endocrine and metabolic indices, including age, height, weight, waist circumference, hip circumference, fasting blood glucose, fasting insulin, total cholesterol (CHOL), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), apolipoprotein A-1 (ApoA-1), apolipoprotein B (ApoB), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and the testosterone (T) were observed and the differences of the parameters were compared between the groups. Results:The syndromes of patients with spleen deficiency and phlegm dampness, kidney deficiency, and liver qi stagnation accounted for 52.56%, 23.08%, and 24.36% respectively in the 78 cases of PCOS patients. Body mass index (BMI), waist-to-hip ratio (WHR), homeostasis model of assessment for insulin resistance index (HOMA-IR), LH, LH/FSH, T, CHOL, TG, HDL, LDL, APOA-1, and APOB of the spleen deficiency and phlegm dampness group were significantly higher than those of the normal control group (P<0.05). WHR, HOMA-IR, LH, LH/FSH, and T of liver qi stagnation group were significantly higher than those of the normal control group (P<0.05). HOMA-IR, LH, LH/FSH, and TG of kidney deficiency were significantly higher than those of the normal control group (P<0.05). BMI and WHR of the kidney deficiency and liver qi stagnation group, and TG of liver qi stagnation group were significantly lower than those of the spleen deficiency and phlegm dampness group (P<0.05). Conclusion:The incidence of IR in spleen deficiency and phlegm dampness syndrome was higher than in the syndromes of kidney deficiency and liver qi stagnation for PCOS patients. Obesity and endocrine and lipid metabolism disorder in spleen deficiency and phlegm dampness syndrome were more obvious.
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