原发性不孕症中医辨证分型与性激素水平的相关性研究

目的:探讨不孕症证候规律及其与性激素的相关性.方法:选择原发性不孕症患者70例,健康对照者19例,以辨证分型、证候积分、性激素检测为指标.结果:不孕症以兼夹证多见,其中肝郁证、肾虚证所占比例为高(P＜0.01).月经周期第10天,各证型组雌二醇(E2)均显著高于对照组(P＜0.05或P＜0.01);肝郁组、肾虚组孕酮(P)显著高于对照组(P＜0.01);肝郁组、痰湿组、血瘀组泌乳素(PRL)均显著高于对照组(P＜0.05或P＜0.01).月经周期第20天,肝郁组、肾虚组、痰湿组P显著低于对照组(P＜0.01);不同证型组P/E2均显著低于对照组(P＜0.05或P＜0.01);痰湿组E2显著高于对照组(P＜0.01).结论:不孕症证候与性激素变化具有相关性,肝郁和肾虚是不孕症的基本证候和原发病机.

Study on Correlativity of TCM Syndrome Types of Primary Infertility with Levels of Sexual Hormones

Objective:To probe into correlativity of the syndrome law of infertility and its correlativity with sexual hormones.Methods: Seventy cases of primary infertility and 19 healthy women were selected,and TCM syndrome types,cumulative score of syndrome,sexual hormone levels were used as indexes.Results:Intermingling syndromes were commonly seen for infertility, among them,stagnation of the liver-Qi and kidney-deficiency syndromes had higher proportion(P<0.01).At the tenth day of menstrual cycle,estradiol(E_2)level in various syndrome types group was significantly higher than that of the control group(P<0. 05 or P<0.01);progesterone(P)level in the group of stagnation of liver-Qi and the kidney deficiency group was significantly higher than that of the control group(P<0.01),and prolactin(PRL)level in the group of stagnation of liver-Qi,the phlegm- dampness group and the blood stasis group was higher than that in the control group(P<0.05 or P<0.01).At the 20th day of menstrual cycle,P level in the group of stagnation of liver-Qi,the kidney deficiency group and the phlegm-dampness group was significantly lower than that in the control group(P<0.01);P/E_2 ratio in the different types groups was significantly lower than that in the control group(P<0.05 or P<0.01);E_2 level in the phlegm-dampness group was significantly higher than that in the control group(P<0.05).Conclusion:Syndromes of infertility are related with changes of sexual hormones,and stagnation of liver-Qi and kidney deficiency are basic syndromes and primary pathogenesis.