主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

北京中医药大学学报 ›› 2018, Vol. 41 ›› Issue (8): 689-695.doi: 10.3969/j.issn.1006-2157.2018.08.012

• 临床研究 • 上一篇    下一篇

多囊卵巢综合征肝经湿热证患者炎症微环境状态及补肾清肝法的改善作用*

俞瑾, 刘璐茜, 翟东霞, 张丹英, 程雯, 白玲玲, 姚睿嫔, 孙帅, 俞超芹#   

  1. 海军军医大学附属长海医院中医妇科 上海 200433
  • 收稿日期:2018-01-05 出版日期:2018-08-30 发布日期:2018-08-30
  • 通讯作者: 俞超芹,女,博士,教授,博士生导师,研究方向:妇科疾病的中医药治疗,E-mail: chqy81@163.com
  • 作者简介:俞瑾,女,博士,住院医师
  • 基金资助:
    国家自然科学基金青年科学基金项目(No. 81603646)

The inflammatory microenvironment of patients with polycystic ovary syndrome and pattern of “dampness heat in the liver meridian” and effects of kidney-tonifying liver-clearing method*

Yu Jin, Liu Luxi, Zhai Dongxia, Zhang Danying, Cheng Wen, Bai Lingling, Yao Ruipin, Sun Shuai, Yu Chaoqin#   

  1. Department of TCM Gynecology, Changhai Hospital, Navy Medical University, Shanghai 200433, China
  • Received:2018-01-05 Online:2018-08-30 Published:2018-08-30
  • Supported by:
    National Natural Science Foundation Youth Fund Project(No. 81603646)

摘要: 目的 探讨多囊卵巢综合征(PCOS)肝经湿热证患者的炎症微环境状态以及补肾清肝法的改善作用。方法 招募健康育龄女性及PCOS肝经湿热证患者,采用蛋白芯片及ELISA技术分析血清内炎症因子的差异。予PCOS肝经湿热证患者补肾清肝药物连续治疗3个月并随访3个月,统计患者的妊娠及排卵情况,观察患者治疗前后各项临床症状、内分泌水平及差异炎症因子变化情况,分析各有效指标间的相关性。结果 与健康育龄女性相比,PCOS肝经湿热证患者血清黑素瘤生长刺激因子/生长调节致癌基因α(CXCL1/GROα)、人白细胞介素1受体拮抗剂(IL-1ra/IL-1F3)、人白细胞介素8(IL-8)、人白细胞介素16(IL-16)、人白细胞介素18(IL-18/IL-1F4)水平增加(P<0.05)。补肾清肝法可有效促进患者排卵,有利于妊娠;改善患者月经不调、痤疮、经前乳胀、心烦易怒、口干口苦症状(P<0.05);降低患者血清促黄体生成素(LH),睾酮(T),游离睾酮(FT),胰岛素(INS)60、120 min,胰岛素抵抗指数(HOMA-IR)以及血清差异炎症因子IL-1ra/IL-1F3、IL-18/IL-1F4水平(P<0.05);且IL-1ra/IL-1F3、IL-18/IL-1F4均与FT成显著正相关(P<0.01,P<0.05)。结论 PCOS肝经湿热证患者存在炎症微环境状态;补肾清肝法具有明显的治疗效果,其作用效应可能与降低患者雄激素及炎症因子水平、改善患者炎症微环境状态相关。

关键词: 多囊卵巢综合征, 肝经湿热证, 炎症微环境, 补肾清肝法

Abstract: Objective To study the inflammatory microenvironment of polycystic ovary syndrome (PCOS) with dampness heat in the liver meridian and effects of Bushen Qinggan (BQ, kidney-tonifying liver-clearing)method. Methods PCOS patients with the pattern of dampness heat in the liver meridian were recruited as the subjects while healthy women of reproductive at childbearing age as controls. PCOS patients were treated with BQ medication for three consecutive months and followed for another three months Serum characteristic inflammatory cytokines were measured with protein microarray technology and ELISA. Pregnancy and ovulation in patients were evaluated. Clinical symptoms, hormones and inflammatory cytokines of PCOS patients were compared before and after the treatment. Besides, the correlation between parameters was also explored. Results Compared with healthy reproductive women, the serum levels of inflammatory factor CXCL1/GROα, IL-1ra/IL-1F3, IL-16, IL-8, IL-18/IL-1F4 in PCOS patients with dampness heat in the liver meridian were significantly increased (P<0.05). BQF could promote ovulation and pregnancy of the patients. Besides, BQF could significantly relieve symptoms of menstrual irregularities, acne, premenstrual breast tenderness, mood swings, dry mouth or bitter sensation in the mouth(P<0.05); In addition, BQF reduce the serum level of luteinizing hormone (LH), testosterone (T), free testosterone (FT), insulin (INS) at 60min and 120min, Homeostasis model assessment of insulin resistance (HOMA-IR) and IL-1ra/IL-1F3, IL-18/IL-1F4 (P<0.05). IL-1ra/IL-1F3 and IL-18/IL-1F4 had positive correlations with FT (P<0.01, P<0.05). Conclusion An inflammatory microenvironment was present in PCOS patients with dampness heat in liver meridian; the therapeutic effects of BQF might be related to downregulating of androgen and inflammatory cytokines.

Key words: Polycystic ovary syndrome, dampness heat of liver channel, inflammatory microenvironment, Bushen Qinggan method

中图分类号: 

  • R271.1