| 程冉;赵宏利;方晓红;杨柳青;邢佳;朱颖;章勤.多囊卵巢综合征患者昼夜节律、睡眠质量与性激素水平、肝阴虚证相关性研究[J].,2024,44(1):19-24 |
| 多囊卵巢综合征患者昼夜节律、睡眠质量与性激素水平、肝阴虚证相关性研究 |
| Associations Study of Circadian Rhythm/Sleep Quality with Sex Hormone Levels/Gan Yin Deficiency Syndrome in Patients with Polycystic Ovary Syndrome |
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| DOI：10.7661/j.cjim.20231010.332 |
| 中文关键词: 多囊卵巢综合征 昼夜节律 睡眠时型 睡眠质量 肝阴虚证 中西医结合 |
| 英文关键词:polycystic ovary syndrome circadian rhythm sleep chronotype sleep quality Gan yin deficiency syndrome integrative medicine |
| 基金项目:浙江省中医药科技计划项目（No.2022ZB249）;杭州市医药卫生科技项目（No.A20231224）;中医药治疗妇科内分泌与代谢性疾病创新团队项目（No.2022SJCXTD） |
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| 中文摘要: |
| 目的 探索多囊卵巢综合征（PCOS）患者昼夜节律、睡眠质量与性激素水平、肝阴虚证的相关性。方法 90例均为2022年4—11月在浙江省杭州市中医院妇科门诊就诊的PCOS患者，符合纳入标准74例，另选择月经规律的健康女性30名为对照组。同时测定两组患者血清中促卵泡生成素（FSH）、促黄体生成素（LH）、催乳素（PRL）、雌二醇（E2）、孕酮（P）、总睾酮（T）的水平。并使用早-晚问卷-5（MEQ-5）、匹兹堡睡眠质量指数问卷（PSQI）、中医证候评分表评估PCOS患者睡眠时型、睡眠质量和肝阴虚证程度，并分析MEQ-5评分、PSQI评分与性激素水平、肝阴虚证评分的相关性。结果 74例PCOS患者中，睡眠时型属夜晚型者12例（16.22%），中间型者56例（75.68%），清晨型者6例（8.10%），组间比较，显示昼夜节律紊乱越重者，LH、LH/FSH水平及肝阴虚证评分均越高（P＜0.05）；睡眠质量差者（PSQI7分）共48例（64.86%），睡眠质量佳者（PSQI＜7分）共26例（35.14%），组间比较显示睡眠质量差者LH、LH/FSH水平及肝阴虚证评分均显著升高（P＜0.05）。相关性分析显示MEQ-5评分与LH、LH/FSH水平呈负相关（r = -0.278，P=0.022；r = -0.244，P=0.043），PSQI评分与LH、LH/FSH水平呈正相关（r = 0.306，P=0.008；r = 0.251，P=0.031），肝阴虚证评分与LH水平呈正相关（r = 0.264，P=0.029）；肝阴虚证评分与MEQ-5评分呈负相关（r = -0.502，P=0.000），肝阴虚证评分与PSQI评分呈正相关（r = 0.692，P=0.000）。结论 PCOS患者昼夜节律紊乱、睡眠质量差与血清LH、LH/FSH升高相关，临床上针对此类患者可从肝阴虚证入手治疗以降低血清LH，纠正性激素紊乱，恢复自发排卵。 |
| 英文摘要: |
| Objective To study the associations of circadian rhythm/sleep quality with sex hormone levels/Gan yin deficiency syndrome in patients with polycystic ovary syndrome （PCOS）. Methods A total of 90 patients with PCOS were included in this study from April to November 2022 at Department of Gynecology， Hangzhou TCM Hospital. Totally 74 patients were in line with inclusion criteria， and 30 healthy women with regular menstruation were included as the control group. The serum levels of follicle stimulating hormone （FSH）， luteinizing hormone （LH）， prolactin （PRL）， estradiol （E2）， progesterone （P）， and total testosterone （T） were measured. The morningness-eveningness questionnaire-5 （MEQ-5）， Pittsburgh Sleep Quality Index （PSQI）， and TCM syndrome scoring table were used to assess the sleep chronotype， the sleep quality， and the degree of Gan yin deficiency syndrome， respectively. And the correlations between MEQ-5 score， PSQI score， and the levels of sex hormone， the scores of Gan yin deficiency syndrome were analyzed. Results Among the 74 patients， the MEQ-5 score of night type was 12 cases （16.22%）， intermediate type 56 cases （75.68%）， and morning type 6 cases （8.10%）. The inter-group comparison showed that the more serious the circadian rhythm disorder was， the higher the LH， LH/FSH levels， and Gan yin deficiency syndrome score were （P＜0.05）. There were 48 cases （64.86%） with poor sleep quality （PSQI7 points） and 26 cases （35.14%） with good sleep quality （PSQI＜7 points）. The inter-group comparison showed that the poorer the sleep quality was， the higher the LH， LH/FSH levels， and Gan yin deficiency syndrome score were （P＜0.05）. Correlation analysis showed that MEQ-5 score was negatively correlated with LH and LH/FSH levels （r =-0.278， P=0.022； r =-0.244， P=0.043）. PSQI score was positively correlated with LH and LH/FSH levels （r =0.306， P=0.008； r =0.251， P=0.031）， and Gan yin deficiency syndrome score was positively correlated with LH levels （r =0.264， P=0.029）. The score of Gan yin deficiency syndrome was negatively correlated with MEQ-5 score （r =-0.502， P=0.000） and positively correlated with PSQI score （r =0.692， P=0.000）. Conclusions Circadian rhythm disruption and poor sleep quality of PCOS patients were correlated to increased serum levels of LH and LH/FSH. Clinically for such patients， treatment can be started from Gan yin deficiency to lower serum LH， correct sexual hormone disorder， and restore voluntary ovulation. |
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