功能失调性子宫出血中医辨证规律及雌激素水平分析

目的分析功能失调性子宫出血患者的中医辨证规律及雌激素水平的影响。方法将我院2015年3月-2018年3月门诊收治的功能失调性子宫出血患者作为观察组(508例),同期选择月经正常健康女性作为对照组(300例)。观察患者年龄和中医疾病与中医证型分布情况、孕激素受体(PR)、雌激素受体(ER)和血管内皮生长因子(VEGF)的差异。结果青春期功血患者的中医证型以肾阴虚为主,约占52.3%(23/44),育龄期功血患者的中医证型以气滞血瘀为主,约占24.3%(87/358),围绝经期功血患者的中医证型以脾虚为主,约占25.5%(27/106);功血患者各年龄段总人数与中医证型分布差异变化显著,具有统计学意义(χ^2=207.224,P=0.005)。崩漏266例,主要证型以阴虚血热为主,约占25.9%(69/266);经期延长156例,肾阴虚为主要证型,约占25.0%(39/156);月经先期30例,以气滞血瘀证型为主,约占50.0%(15/30);经间期出血7例,以气滞血瘀和湿热证型为主,均占30.4%(7/23);月经过多15例,气血两虚兼血瘀证型最多,约为46.7%(7/15)。各中医证型分布人数差异变化具有统计学意义(χ^2=212.357,P=0.004)。观察组的PR、ER表达指标显著高于对照组,而VEGF表达指标则明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论采用客观的方法分析年龄、中医疾病与功血中医证候的分布规律及雌激素水平变化,可为临床提供参考依据。

Analysis of TCM Syndrome Differentiation and Estrogen Levels in Patients with Dysfunctional Uterine Bleeding

Objective To study TCM syndrome differentiation and estrogen levels in patients with dysfunctional uterine bleeding. Methods A total of 508 cases of dysfunctional uterine bleeding were used as the observation group and 300 cases with normal menstrual women were served as the control group from March 2015 to March 2018. The age,the distribution of TCM syndromes, PR, ER and VEGF of patients were compared. Results The traditional Chinese medicine syndrome in adolescent uterine bleeding patients was mainly kidney Yin deficiency,accounting for 52.3%(23/44). The sydnrome of uterine bleeding patients at childbearing age was mainly Qi stagnation,accounting for about 24.3%(87/358). The sydnrome of uterine bleeding patients in perimenopausal period was mainly spleen deficiency,accounting about 25.5%(27/106). The difference between the cases in each age group of TCD and TCM syndromes varied significantly. The difference was statistically significant(χ^2=207.224,P=0.005). The main sydrnome of 266 cases of uterine bleeding was Yin deficiency and blood heat,accounting for about 25.9%(69/266). The main sydnrome of 156 cases of extended period was kidney Yin deficiency,accounting for about 25.0%(39/156). The main sydrnome of 30 cases of advanced menstruation was Qi stagnation and blood stasis,accounting for about 50.0%(15/30). The main sydnrome of 7 cases of intervene bleeding was Qi stagnation and damp-heat,accounting for about 30.4%(7/23), respectively. The main sydnrome of 15 cases of menorrhagia was blood deficiency and blood stasis,accounting for about 46.7%(7/15). The distribution of TCM syndromes was statistically difference(χ^2=212.357,P=0.004). PR and ER of the observation group were significantly rather than those of the control group while VEGF of the observation group was significantly lower than that of the control group. The difference was statistically significant(P<0.05). Conclusion The use of objective methods to analyze the distribution of TCM syndromes in age, TCM disease and uterine bleeding and changes in estrogen levels can provide a reference for clinical practice.