脾肾两虚阳明浊热证多囊卵巢综合征-胰岛素抵抗患者超声学及血清学特征分析OA
Ultrasound and serological characteristics analysis of PCOS-IR patients with spleen-kidney deficiency plus yangming turbid heat
目的 探讨脾肾两虚阳明浊热证多囊卵巢综合征-胰岛素抵抗(polycystic ovary syndrome in-sulin resistance,PCOS-IR)患者在超声学与血清学方面的特征.方法 将PCOS-IR患者分为阳明浊热组及非阳明浊热组,每组各60 例,另收集健康组 30 名.观察患者一般情况,对 2 组PCOS-IR患者病程及月经周期进行比较,对3 组进行超声学特征及血清激素比较.结果 阳明浊热组、非阳明浊热组比健康组初潮年龄延迟,体质量指数(body mass index,BMI)高(P<0.05),非阳明浊热组BMI比健康组高(P<0.05).阳明浊热组的月经周期比非阳明浊热组长,差异有统计学意义(P<0.05).阳明浊热组子宫动脉及子宫螺旋动脉血流阻力指数(resistance index,RI)、搏动指数(pul-satility index,PI)、收缩期峰值速度(peak systolic velocity,PSV)/舒张末期速度(end-diastolic veloci-ty,EDV)(S/D)比非阳明浊热组、健康组高(P<0.05);非阳明浊热组子宫动脉RI、PI、S/D及子宫螺旋动脉RI、S/D比健康组高(P<0.05).阳明浊热组、非阳明浊热组与健康组比较A型子宫内膜比例低,C型子宫内膜比例高(P<0.05),阳明浊热组与非阳明浊热组比较,B型子宫内膜比例低,C型子宫内膜比例高(P<0.05).阳明浊热组胰岛素抵抗指数(insulin resistance index,HOMA-IR)、睾酮(testosterone,T)比非阳明浊热组、健康组高,非阳明浊热组HOMA-IR、T比健康组高,差异均有统计学意义(P<0.05);阳明浊热组、非阳明浊热组抗苗勒管激素(anti-mullerian hormone,AMH)、促黄体生成素(luteinizing hormone,LH)、LH/促卵泡生成素(follicle-stimulating hormone,FSH)比健康组高(P<0.05).结论 脾肾两虚阳明浊热证PCOS-IR患者在月经周期、超声学以及血清学中有特征性改变,可为中医临床治疗提供评判疗效依据.
Objective Exploring the ultrasonic and serological characteristics of polycystic ovary syndrome insulin resistance(PCOS-IR)patients with spleen-kidney deficiency plus yangming turbid heat pattern.Methods PCOS-IR patients were divided into yangming turbid heat pattern(YTH)group and non yangming turbid heat pattern(non-YTH)group,with 60 cases in each,and another 30 cases healthy individuals were recruited as the control.Their general conditions were observed,the course of illness and menstrual cycle between two groups of PCOS-IR patients were compared,and the ultrasound characteristics and serum hormones among the three groups were compared.Results The YTH group and non-YTH group had a delayed onset of menarche and a higher BMI than the healthy group(P<0.05),while the non-YTH group had a higher BMI than the healthy group(P<0.05).The menstrual cycle of the YTH group was significantly longer than that of the non-YTH group(P<0.05).The RI,PI,and S/D of the uterine artery and spiral artery in the YTH group were higher than those in the non-YTH group and healthy group(P<0.05);The RI,PI,S/D of the uterine artery and the RI,S/D of the uterine spiral artery in the non-YTH group were higher than those in the healthy group(P<0.05).Compared with the healthy group,the YTH group and non-YTH group had a lower proportion of type A endometrium and a higher proportion of type C endometrium(P<0.05).Compared with the non-YTH group,the YTH had a lower proportion of type B endometrium and a higher proportion of type C endometrium(P<0.05).The HOMA-IR and T of the YTH group were higher than those of the non-YTH and the healthy group.The HOMA-IR and T of the non-YTH group were higher than those of the healthy group,and the differences were statistically significant(P<0.05);The AMH,LH,and LH/FSH levels in the YTH group and non-YTH group were higher than those in the healthy group(P<0.05).Conclusions PCOS-IR patients with spleen-kidney deficiency plus yangming turbid heat have characteristic changes in menstrual cycle,ultrasound,and serology,which can provide a basis for evaluating the efficacy of TCM clinical treatment.
张雅冬;许昕;刘雁峰
北京中医药大学东直门医院 北京 100700||首都医科大学附属北京中医医院首都医科大学附属北京中医医院北京中医药大学东直门医院 北京 100700
医药卫生
多囊卵巢综合征-胰岛素抵抗脾肾两虚阳明浊热证子宫动脉子宫螺旋动脉性激素
polycystic ovary syndrome with insulin resistancespleen-kidney deficiency plus yangming turbid heatuterine arteryuterine spiral arterysex hormones
《现代中医临床》 2026 (1)
15-20,6
国家自然科学基金资助项目(No.82274567,No.82074480)北京市属医院科研培育项目(No.PZ2023018)国家中医药管理局全国名老中医药专家传承工作室建设项目(2022)
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