【摘要】 目的 探讨痰湿证与非痰湿证多囊卵巢综合征(polycystic ovarian syndrome, PCOS)患者游离睾酮指数(free testosterone index, FAI)与不同临床特征的差异及相关性。方法 基于临床科研信息一体化平台收集病例资料，回顾性纳入2019年9月～2021年1月黑龙江中医药大学第一附属医院收治的1041例PCOS患者。按中医诊断标准分为痰湿组(n=658)和非痰湿组(n=383),记录各项指标并统计分析各项指标与FAI的相关性，以分析不同中医证型FAI的影响因素。结果 痰湿组PCOS患者FAI、体重、腰围、臀围、腰臀比(waist-to-hip ratio, WHR)、空腹血糖(fasting plasma glucose, FPG)、30min葡萄糖、空腹胰岛素(fasting insulin, FINS)、30min胰岛素、胰岛素抵抗指数(insulin resistance of homeostasis model assessment, HOMA-IR)、甘油三酯(triglyceride, TG)、总胆固醇(total cholesterol, TC)、低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol, LDL-C)、载脂蛋白B(apolipoprotein B, ApoB)、ApoB/ApoA等临床指标值高于非痰湿组(P<0.05)。在痰湿组PCOS患者中，FAI与卵泡生成素(follicle-producing hormone, FSH)、泌乳素(prolactin, PRL)、性激素结合球蛋白(sex hormone-binding globulin, SHBG)、高密度脂蛋白胆固醇(high-density lipoprotein-cholesterol, HDL-C)、载脂蛋白A(apolipoprotein A, ApoA)呈负相关，与收缩压、舒张压、体重、体重指数(body mass index, BMI)、腰围、臀围、WHR、睾酮(testosterone, T)、雄烯二酮(androstenedione, AND)、60min葡萄糖、120min葡萄糖、FINS、30min胰岛素、60min胰岛素、120min胰岛素、180min胰岛素、HOMA-IR指数、TG、ApoB/ApoA呈正相关(P<0.05)。在非痰湿组PCOS患者中，FAI与PRL、SHBG呈负相关，与舒张压、体重、BMI、腰围、T、硫酸脱氢表雄酮(dehydroepiandrosterone sulfate, DHEAS)、AND、60min葡萄糖、120min葡萄糖、FINS、60min胰岛素、120min胰岛素、180min胰岛素、ApoB、HOMA-IR指数呈正相关(P<0.05)。结论 痰湿组与非痰湿组PCOS患者的FAI等研究指标水平存在显著差异，痰湿组PCOS患者的FAI水平高于非痰湿组。痰湿组PCOS患者FAI水平与肥胖、糖脂代谢水平等具有明显的相关性，其因果关系需进一步探究。更多还原

【Abstract】 Objective To investigate the difference and correlation between free testosterone index(FAI) and different clinical characteristics in patients with polycystic ovary syndrome(PCOS) with phlegm-dampness syndrome and non-phlegm-dampness syndrome. Methods Based on the case data collected from the clinical research information integration platform, 1041 PCOS patients who visited the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from September 2019 to January 2021 were retrospectively included. According to the diagnostic criteria of traditional Chinese medicine(TCM), they were divided into phlegm-dampness syndrome group(n=658) and non-phlegm-dampness syndrome group(n=383). All the indicators were recorded and the correlation between each indicator and FAI was statistically analyzed to analyze the influencing factors of FAI of different TCM syndrome types. Results The values of FAI, body weight, waist circumference, hip circumference, waist-to-hip ratio(WHR), fasting plasma glucose(FPG), 30-minute glucose, fasting insulin(FINS), 30-minute insulin, insulin resistance of homeostasis model assessment(HOMA-IR), triglyceride(TG), total cholesterol(TC), low-density lipoprotein-cholesterol(LDL-C), apolipoprotein B(ApoB), ApoB/ApoA in PCOS patients with phlegm-dampness syndrome were higher than those in non-phlegm-dampness syndrome group(P<0.05). In PCOS patients in the phlegm-dampness syndrome group, FAI was negatively correlated with follicle-producing hormone(FSH), prolactin(PRL), sex hormone-binding globulin(SHBG), high-density lipoprotein-cholesterol(HDL-C) and apolipoprotein A(ApoA); FAI was positively correlated with systolic blood pressure, diastolic blood pressure, body weight, body mass index(BMI), waist circumference, hip circumference, WHR, testosterone(T), androstenedione(AND), 60-minute glucose, 120-minute-glucose, FINS, 30-minute insulin, 60-minute insulin, 120-minute insulin, 180-minute insulin, HOMA-IR index, TG, ApoB/ApoA(P<0.05). In PCOS patients in the non-phlegm-dampness syndrome group, FAI was negatively correlated with PRL and SHBG. FAI was positively correlated with diastolic blood pressure, body weight, BMI, waist circumference, T, dehydroepiandrosterone sulfate(DHEAS), AND, 60-minute glucose, 120-minute glucose, FINS, 60-minute insulin, 120-minute insulin, 180-minute insulin, ApoB, HOMA-IR index(P<0.05). Conclusion There are significant differences in the levels of FAI and other research indicators in PCOS patients between phlegm-dampness syndrome and the non-phlegm-dampness syndrome. The FAI level of PCOS patients with phlegm-dampness syndrome is higher than that of the non-phlegm-dampness syndrome. The level of FAI in PCOS patients with phlegm-dampness syndrome is significantly correlated with obesity, glucose and lipid metabolism, and its causality needs to be further explored.更多还原