摘要
目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)的不同中医证型及其内分泌代谢特征,提高中西医结合诊治水平。方法根据中医理论对510例PCOS患者辨证分型,回顾性分析入组患者的糖耐量试验(OGTT)、胰岛素释放试验、体重指数(BMI)等内分泌代谢指标,计算稳态模型胰岛素抵抗指数(HOMA-IR)、空腹胰岛素/空腹血糖(I/G)。结果肾阳虚组192例(37.7%)、脾阳虚组167例(32.8%)、肝郁化热组84例(16.4%)、肾阴虚组67例(13.1%),肾阳虚、脾阳虚患者较多(P<0.01);PCOS患者中44%糖耐量异常,4个证型组糖耐量异常率差异无统计学意义。PCOS患者胰岛素抵抗者占62.7%,脾阳虚组胰岛素抵抗较其他三个证型组高(P<0.01)。HOMA-IR、I/G诊断胰岛素抵抗的敏感性分别为89.4%、87.5%,差异无统计学意义(P>0.05);HOMA-IR、I/G诊断胰岛素抵抗的特异性分别为94%、75%,HOMA-IR的特异性较强(P<0.01)。结论 PCOS以肾阳虚证、脾阳虚证较常见,PCOS患者代谢异常的主要特征为胰岛素抵抗,HOMA-IR诊断胰岛素抵抗的特异性较好。
Objective To explore the characteristics of different patterns/syndromes in traditional Chinese medicine and endocrinal metabolism in polycystic ovary syndrome （PCOS） and improve the level of the diagnosis and treatment with integrated Chinese and western medicine. Methods Five hundred and ten cases of PCOS were differentiated in terms of the theory of traditional Chinese medicine. The endoerinal meta bolic indexes such as OGTT, insulin release test and BMI were analyzed retrospectively for the patients en rolled. HOMA - IR and I/G were calculated. Results There were 192 cases （ 37.7 % ） in kidney yang defi ciency group,167 cases（32.8% ）in spleen yang deficiency group, 84 cases （16.4%）in liver qi stagnation transforming heat group and 67 cases（ 13.1% ）in kidney yin deficiency group. Most of patients were differen- tiated as kidney yang and spleen yang deficiency（ P 〈 0.01 ）. 44% of PCOS patients presented abnormal glu cose tolerance. The difference in glucose tolerance abnormality rate was not significant statistically in compari son among four patterns/syndromes. 62.7% of PCOS patients presented insulin resistance. The level of insu lin resistance in spleen yang deficiency group was higher than the other three pattern groups （P 〈 0.01 ）. The sensitivity in HOMA -IR and I/G diagnosis was 89.4% and 87.5% respectively, without significant differ ence （P 〉 0.05 ）. The specificity in HOMA - IR and I/G diagnosis was 94% and 75% respectively. The spe cificity of HOMA - IR was stronger（ P 〈 0.01 ）. Conclusion PCOS is commonly differentiated as kidney yang deficiency and spleen yang deficiency. The metabolic abnormality in PCOS patients is characterized as insulin resistance. HOMA - IR presents the better specificity in the diagnosis of insulin resistance.
出处
《世界中西医结合杂志》
2013年第7期689-692,共4页
World Journal of Integrated Traditional and Western Medicine
基金
重庆市卫生局中医药科技项目(2012-2-131)
关键词
多囊卵巢综合征
中医证型
糖耐量异常
胰岛素抵抗
Polyeystie Ovary Syndrome
Pattern of Traditional Chinese Medicine
Abnormality ofsulin Resistance Glucose Tolerance
Insulin Resistance
