摘要
目的:比较不同中医证候多囊卵巢综合征(PCOS)患者门诊促排加指导同房的临床特征和妊娠结局。方法:回顾性分析2016年12月-2017年12月于门诊促排加指导同房助孕治疗的216例PCOS不孕患者,通过系统聚类分析法,探索PCOS不孕患者的证候特征规律,并统计各证候患者的BMI、性激素水平、糖代谢情况、促排卵结局及临床妊娠结局。结果:利用系统聚类分析法,结合科室专业知识,且经过专家讨论后,最终确定5类符合临床的证型,即脾虚痰湿型(102例,47.22%)、痰瘀互结型(46例,21.30%)、脾虚肝郁型(35例,16.20%)、肾虚血瘀型(22例,10.19%)和其他型(11例,5.09%),脾虚痰湿型、痰瘀互结型患者肥胖程度较脾虚肝郁、肾虚血瘀型、其他型患者重(P<0.01),肾虚血瘀型PCOS不孕患者的LH、LH/FSH、T水平显著高于其他各证型脾(P<0.05),脾虚肝郁型PCOS不孕患者PRL的水平显著高于其他各证型患者(P<0.05),不同证型PCOS不孕患者间FSH、E2的水平均无明显差异(P>0.05),脾虚痰湿型、痰瘀互结型患者血糖异常情况明显高于其他各证型患者(P<0.05),其妊娠率亦较其他证型高(P<0.05);不同证型的PCOS不孕患者卵泡生长速度、内膜厚度及直径≥16 mm的卵泡个数无差异(P>0.05);各证型流产发生率较高,其中肾虚血瘀型患者流产率高于其他证型患者,但差异无统计学意义(P>0.05)。结论:各证型PCOS不孕患者BMI、基础性激素(LH、LH/FSH、T、PRL)、糖代谢情况以及妊娠率存在差异。各证型促排卵后卵泡和内膜情况无明显差异。各证型均有较高流产率,但证型间无明显差异。
Objective:To compare the clinical characteristics andpregnancy outcomesof infertilepatients with polycystic ovary syndrome(PCOS) of different traditional Chinese Medicine(TCM)syndromes. Methods:A total of 216 infertile patients with PCOS were retrospectively analyzed from September 2016 to December 2017. The syndrome characteristics were investigated by systematic cluster analysis. The BMI, glucose metabolism, sex hormone level, outcome of ovulation inductionand clinical pregnancy outcomewere analyzed. Results:The five types of syndromes,including spleen deficiency and phlegm dampness syndrome(102 cases, 47.22%), phlegm and stasis syndrome(46 cases, 21.30%), spleen deficiency and liver depression syndrome(35 cases, 16.20%), kidney deficiency and blood stasis syndrome(22 cases, 10.19%) and othersyndromes(11 cases, 5.09%) were determined by systematic cluster analysis and expert discussion. The patients with spleen deficiency and phlegm dampness syndrome and phlegm stasis syndrome were more obese than spleen deficiency and liver depressionsyndrome, kidney deficiency and blood stasissyndromeand other syndromes(P<0.01). The levels ofLH, LH/FSH and T in patients with kidney deficiency and blood stasis syndromewere significantly higher than those of the other syndrome types(P<0.05). The level of PRL in spleen deficiency and liver depression syndromewas significantly higher than that of other syndromes(P<0.05). There were no significant differences in the levels of FSH or E2 among different syndrometypes of PCOS infertility(P>0.05). The abnormal blood glucose in the patients with spleen deficiency and phlegm dampness syndrome and phlegm stasissyndrome was significantly higher than that in other syndrome typespatients(P<0.05)and their pregnancy rates were higher than that of other syndrome types(P<0.05). There were no differences in follicle growth rate, endometrium thicknessorthe number of follicle which diameterwas more than 16 mm among different syndrome typespatients(P>0.05). The abortion rates of different typeswere
作者
方群英
吴丽敏
孙秀英
刘芬
方朝晖
FANG Qunying;WU Limin;SUN Xiuying;LIU Fen;FANG Zhaohui(Reproductive Center,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui,China;Postgraduate School of Anhui University of TCM,Hefei 230038,Anhui,China;Department of Endocrinology,the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230001,Anhui,China;Anhui Institute of Traditional Chinese Medicine Diabetes Prevention and Treatment,Hefei 230037,Anhui,China)
出处
《中华中医药学刊》
CAS
北大核心
2019年第11期2662-2666,共5页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81373671)
国家自然科学基金青年科学基金项目(81000237)
关键词
多囊卵巢综合征不孕症中医证候
临床特征
妊娠结局
polycystic ovary syndrome
infertility
traditional Chinese medicine(TCM)syndromes
clinical characteristics
pregnancy outcomes
