多囊卵巢综合征中医分类与性激素及胰岛素水平相关性研究

目的找出多囊卵巢综合征（PCOS）患者中医证类与性激素及胰岛素的相关性。方法将100例多囊卵巢综合征患者利用中医四诊分类,观察治疗前后卵泡早期血清胰岛素及性激素水平,测定血清促黄体生成素（LH）、促卵泡生成素（FSH）、泌乳素（PRL）、雌二醇（E2）、孕酮（P）、睾酮（T）、硫酸脱氢表雄酮（DHEAS）以及雄烯二酮（A）。结果将就诊的100例PCOS患者中,脾虚痰湿证47.73%,肾虚肝郁证31.82%,肾虚血瘀证11.36%,痰瘀互结证9.09%。LH、FSH水平、LH/FSH比值以及E2、P水平各证组间比较,差异无统计学意义;肾虚血瘀组T水平与脾虚痰湿组比较,差异有统计学意义（P〈0.05）;肾虚肝郁组与其他证型相比,PRL水平显著升高（P〈0.05）;脾虚痰湿组胰岛素、HOMA-IR水平较肾虚肝郁组显著增高（P〈0.05）。结论PCOS肾阴虚与T水平升高有相关性;痰湿阻滞与PCOS胰岛素抵抗有一定的相关性。

Classification of Polycystic Ovary Syndrome in Chinese Medicine and its Correlation with Sex Hormone and Insulin Level

Objective To find out the correlation of the differentiation of polycystic ovary syndrome（PCOS）in Chinese medicine with sex hormone and insulin level.Methods 100 cases of PCOS were divided into different types based on the four diagnostic methods of Chinese medicine.Follicule insulin level of the early stage and sex hormone level in serum were observed before and after treatment.Luteinizing hormone（LH）,follicule-stimulating hormone（FSH）,prolactin（PRL）,estradiol（E2）,progesterone（P）,testosterone（T）,dehydroepiandrosterone sulfate（DHEAS）and androstendione（A）in serum were detected.Results 100 cases of PCOS were differentiated as spleen deficiency and phlegm damp pattern（47.73%）,kidney deficiency and liver stagnation pattern（31.82%）,kidney deficiency and blood stasis pattern（11.36%）and inter-action of phlegm and stasis（9.09%）.There were not significant differences in LH and FSH levels,LH/FSH and E2 and P levels among groups in statistics.The difference in T level was significant between kidney deficiency and blood stasis pattern group and spleen deficiency and phlegm damp pattern group in statistics（P0.05）.As compared with other patterns,PRL level increased significantly in kidney deficiency and liver stagnation pattern group（P0.05）.In spleen deficiency and phlegm damp pattern group,insulin and HOMA-IR levels were higher significantly than those in kidney deficiency and liver stagnation pattern group（P0.05）.Conclusion PCOS of kidney yin deficiency is correlative with the increase of T level.Stagnation of phlegm and damp is correlative with insulin resistance in PCOS to a certain extent.