中医辨证分型论治多囊卵巢综合征的疗效及其影响因素分析

目的探讨中医辨证分型论治多囊卵巢综合征(PCOS)的疗效,并分析影响PCOS的相关因素。方法选取2017年5月—2019年5月就诊的PCOS患者198例,其中西药组50例,采用炔雌醇环丙孕酮片(达英-35)进行治疗,中医辨证分型组148例,其中肾亏血瘀型55例,痰凝肾虚型54例,肝火郁热型39例。各证型在西药组治疗基础上,采用中医辨证分型治疗。同期选择健康育龄期体检女性150例为对照组。比较西药组及中医辨证分型组治疗后疗效,治疗前后性激素水平变化。采用单因素分析和多元Logistic回归模型分析影响PCOS的因素。结果治疗后,中医辨证分型组中肾亏血瘀型整体有效率、痰凝肾虚型整体有效率、肝火郁热型整体有效率均高于西药组整体有效率(P<0.05)。治疗后,中医辨证分型组中各证型和西药组睾酮(TSHO)、黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH值均低于本组治疗前,雌二醇(E2)水平均高于本组治疗前,且中医辨证分型组中各证型TSHO、LH、FSH、LH/FSH和E2水平均优于西药组(P<0.05)。单因素分析表明,体质量指数是否正常、是否缺乏锻炼、心理压力是否过大、是否规律作息、有无合并基础疾病、有无PCOS遗传史均是影响患者PCOS的相关因素(P<0.05)。多因素Logistic分析显示,体质量指数是否正常、是否缺乏锻炼、是否心理压力过大、有无合并基础疾病、有无PCOS遗传史均是影响患者PCOS的独立影响因素。结论中医辨证施治PCOS疗效显著,可有效调节性激素水平,而保持科学合理的生活习惯、调节心理情绪、拥有良好的心态,有助于降低PCOS的患病风险。

Efficacy of TCM Syndrome Differentiation Treatment in treating Polycystic Ovary Syndrome and Analysis of Influencing Factors

Objective To investigate the efficacy of traditional chinese medicine(TCM)syndrome differentiation in the treatment of polycystic ovary syndrome(PCOS),and to analyze the influencing factors of PCOS.Methods A total of 198 PCOS patients in our hospital from May 2017 to May 2019 were selected as the observation group.Among them,50 patients in the western medicine group were treated with ethinyl estradiol and cyproterone tablets(Diane-35).There were 148 cases of TCM syndrome differentiation,55 cases of kidney deficiency and blood stasis,54 cases of phlegm and kidney deficiency,and 39 cases of liver-fire-stagnation-heat type.On the basis of western medicine group treatment,each syndrome group adopts TCM syndrome differentiation treatment.During the same period,150 healthy women of childbearing age were selected as the control group.The effect of the observation group after treatment and the changes in sex hormone levels before and after treatment were compared.Single factor analysis and multiple logistic regression model were used to analyze the factors affecting PCOS.Results After treatment,the overall effective rate of kidney deficiency and blood stasis type,phlegm coagulation and kidney deficiency type,and liver-fire stagnation-heat type were all higher than those of the western medicine group(P<0.05).After treatment,the testosterone(TSHO),luteinizing hormone(LH),follicle stimulating hormone(FSH)and LH/FSH values of each syndrome group and western medicine group were lower than before treatment,and estradiol(E2)levels were higher than treatment Before,and the levels of sex hormones in each syndrome group were better than those in the western medicine group(P<0.05).Univariate analysis showed that whether the body mass index is normal,lack of exercise,excessive psychological pressure,regular work and rest,with or without underlying diseases,and with or without a genetic history of PCOS are all related factors that affect the patient′s PCOS(P<0.05).Multivariate logistic analysis showed that whether the body mass index is normal,lack of exercise,excessive psychological stress,combined with underlying diseases,and whether there is a genetic history of PCOS are all independent factors affecting PCOS.Conclusion TCM treatment of PCOS has significant effect on regulating the levels of sex hormones.Maintaining scientific and reasonable life habit and regulate psychological mood is helpful to reduce the risk of PCOS.