摘要
目的:探讨肾虚型多囊卵巢综合征(PCOS)患者的因-症关系,并研究针灸治疗前后T淋巴细胞亚群的变化。方法:选取2020年1月至2023年7月于河北省中医院就诊的120例肾虚型PCOS患者,采用随机数字表法将患者分为观察组(n=60)和对照组(n=60)。对照组采用口服枸橼酸氯米芬胶囊治疗,观察组采用顺应月经周期分期针刺治疗。应用Apriori算法分析患者因-症关系,对比两组患者中医证候积分、临床症状及体征评分以及T淋巴细胞亚群的变化,比较不同治疗方案的疗效。采用广义估计方程模型评价两组患者T淋巴细胞亚群的改善情况,以及患者预后的影响因素。结果:肾虚型PCOS患者病因主要包括饮食不节、情志不遂、湿热郁滞和人流不当,与畏寒肢冷、形体消瘦、脉沉细、失眠健忘、脉细数、烦躁易怒、胸闷不舒、乳房胀痛、性欲减退、腰膝酸软、头晕耳鸣、舌淡高度相关。治疗不同时间后,观察组患者中医症候积分、症状和体征评分较对照组显著降低(P<0.05)。组内比较结果显示,两组患者治疗不同时间后中医症候积分、症状和体征评分较治疗前均有不同程度降低(P<0.05)。治疗后不同时间,观察组患者CD3^(+)T细胞和CD8^(+)T细胞较对照组显著升高,CD4^(+)T细胞和CD4^(+)T/CD8^(+)T较对照组显著降低(P<0.05)。广义估计方程显示,观察组对CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)T/CD8^(+)T的改善情况均优于对照组(P<0.05)。FSH、T、CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)T/CD8^(+)T、治疗方法均显著影响肾虚型PCOS患者预后(P<0.05)。结论:肾虚型PCOS患者因-症关系符合阴阳互根理论。补肾疏肝针刺治疗可有效缓解肾虚型PCOS患者的临床症状,调节患者机体内T淋巴细胞亚群水平,改善患者体内的免疫抑制状态。
Objective:To explore the etiology-symptom correlation in patients with polycystic ovary syndrome(PCOS)of kidney deficiency type and investigate the changes in T lymphocyte subsets before and after acupuncture treatment.Methods:A total of 120 patients with kidney deficiency type PCOS who visited Hebei Hospital of Traditional Chinese Medicine from January 2020 to July 2023 were selected and randomly divided into observation group(n=60)and control group(n=60)using a random number table method.Control group was treated with oral chloramphenicol citrate capsules,while observation group was treated with acupuncture in accordance with the menstrual cycle staging.Apriori algorithm was applied to analyze the etiology-symptom correlation of the patients,traditional Chinese medicine syndrome scores,clinical symptoms and signs scores,changes in T lymphocyte subsets between two groups of patients were compared,so as to compare the efficacy of different treatment plans.Generalized estimation equation model was used to evaluate the improvement of T lymphocyte subsets in two groups of patients,as well as the influencing factors of patient prognosis.Results:Main causes of PCOS patients with kidney deficiency included improper diet,emotional distress,dampness and heat stagnation,and improper abortion which was highly related to fear of cold limbs,emaciation,thin pulse,insomnia and forgetfulness,thin pulse,irritability,chest tightness,breast swelling and pain,decreased libido,weak waist and knees,dizziness and tinnitus,and a dull tongue.At different times after treatment,traditional Chinese medicine symptom scores,symptom,and sign scores of observation group patients were significantly lower than those of control group(P<0.05).Comparison results within the group showed that traditional Chinese medicine symptom scores,symptoms,and signs of two groups of patients decreased to varying degrees at different times after treatment compared to before treatment(P<0.05).At different times after treatment,CD3^(+)T cells and CD8^(+)T cells in observation group were sig‐nificantly increased compared to control group,while CD4^(+)T cells and CD4^(+)T/CD8^(+)T cells were significantly reduced compared to control group(P<0.05).Generalized estimation equation showed that the improvement of CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,and CD4^(+)T/CD8^(+)T cells in observation group was better than that in control group(P<0.05).FSH,T,CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,CD4^(+)T/CD8^(+)T cells,and treatment methods were all significantly affect the prognosis of patients with kidney deficiency type PCOS(P<0.05).Conclusion:Etiology-symptom correlation in patients with kidney deficiency-type PCOS is consistent with the theoretical state of interdependence of yin and yang.Acupuncture therapy for tonifying the kidney and soothing the liver can effectively alleviate the clinical symptoms of patients with kidney deficiency-type PCOS,regulate the levels of T lymphocyte subsets in the body,and ameliorate the immune suppression status in such patients.
作者
杨丹丹
李艳青
林晓华
卢利霞
王倩男
YANG Dandan;LI Yanqing;LIN Xiaohua;LU Lixia;WANG Qiannan(Department of Gynecology,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)
出处
《中国免疫学杂志》
北大核心
2026年第2期424-430,共7页
Chinese Journal of Immunology
基金
河北省中医药管理局科研计划项目(2022033)。
关键词
多囊卵巢综合征
因-症关系
肾虚型
T淋巴细胞亚群
Polycystic ovary syndrome
Etiology-symptom correlation
Kidney deficiency type
T lymphocyte subsets
