多囊卵巢综合征中医证型与血清激素水平、胰岛素抵抗的相关性研究

目的探讨多囊卵巢综合征(PCOS)中医证候分布规律及其与性激素、胰岛素抵抗的相关性。方法选择PCOS患者120例,健康对照组36例。月经周期第22天检测性激素水平、空腹血糖(FPG)、空腹胰岛素水平(FINS),计算胰岛素抵抗指数(HOMA-IR),并按中医辨证分型。结果患者中肾阳虚比例高于其他证型(P<0.05);各证型E2、P均显著低于对照组(P<0.05或P<0.01),T显著高于对照组(P<0.05或P<0.01);肾阴虚组、肝郁组、血瘀组LH显著高于对照组(P<0.01);肝郁组PRL显著高于对照组(P<0.05);肾阳虚组、肾阴虚组及痰湿组患者胰岛素抵抗的发生率显著高于对照组(P<0.01)。结论多囊卵巢综合征证型与性激素变化及胰岛素抵抗状态有相关性,肾阳虚是PCOS的基本证候和原发病机。

Correlativity Between Chinese Medical Syndromes and Sexual Hormones and Insulin Resistance of Polycystic Ovarian Syndrome

Objective To probe into the correlativity of the syndrome law of polycystic ovarian syndrome and its correlativity with sexual hormones and insulin resistance. Methods 120 cases of polycystic ovarian syndrome and 36 healthy women were selected, measure their sexual hormones and fasting plasma glucose and fasting insulin on the twenty-second day of menstruate cycle, and calculate insulin resistance homa model (HOMA-IR),then decide TCM syndrome. Results Kidney-yang-deficiency syndrome had the highest proportion in polycystic ovarian syndrome (P < 0.05); estradiol(E2) level and progesterone(P) level were significantly lower in various syndrome groups of PCOS than in the control group(P < 0.05, P < 0.01), while testosterone(T) level was significantly higher than the control group(P < 0.05, P < 0.01); luteinizing hormone level(LH) was significantly higher in kidney-yin-deficiency group and the group of stagnation of liver-qi and the blood-stasis group than in the control group (P < 0.01); the prolactim level(PRL) was significantly higher in the group of stagnation of liver-qi than in the control group(P < 0.05); the insulin resistance ratio was significantly higher in kidney-yang-deficiency group and kidney-yin-deficiency group and phlegm-dampness group than in the control group (P < 0.01). Conclusion TCM syndrome of PCOS is related with sexual hormones and insulin resistance, and kidney-yang-deficiency is the basic syndrome and primary pathogenesis.