1.广州中医药大学第二临床医学院,广东省广州市白云区机场路12号,510405
2.河南中医药大学中医学院仲景书院
3.广州中医药大学第二附属医院/广东省中医院
guangningnie@gzucm.edu.cn
收稿:2023-11-20,
修回:2024-03-29,
纸质出版:2024-07-02
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梁婉诗,廖怡茹,付靖涵等.1221例女性基础性激素水平及抗苗勒管激素水平不同年龄段变化特征——女子“以七为期”的生殖衰老规律回顾性研究[J].中医杂志,2024,65(13):1369-1374.
LIANG Wanshi,LIAO Yiru,FU Jinghan,et al.Characteristics of Basal Sex Hormone Levels and Anti-müllerian Hormone Levels in 1221 Women of Different Ages:A Retrospective Study on the Law of Women Reproductive Aging in the "Seven-year Period" Theory[J].Journal of Traditional Chinese Medicine,2024,65(13):1369-1374.
梁婉诗,廖怡茹,付靖涵等.1221例女性基础性激素水平及抗苗勒管激素水平不同年龄段变化特征——女子“以七为期”的生殖衰老规律回顾性研究[J].中医杂志,2024,65(13):1369-1374. DOI: 10.13288/j.11-2166/r.2024.13.011.
LIANG Wanshi,LIAO Yiru,FU Jinghan,et al.Characteristics of Basal Sex Hormone Levels and Anti-müllerian Hormone Levels in 1221 Women of Different Ages:A Retrospective Study on the Law of Women Reproductive Aging in the "Seven-year Period" Theory[J].Journal of Traditional Chinese Medicine,2024,65(13):1369-1374. DOI: 10.13288/j.11-2166/r.2024.13.011.
目的
2
从基础性激素水平及抗苗勒管激素水平不同年龄段变化特征探析中医理论中女子“以七为期”的生殖衰老规律。
方法
2
回顾性收集2018年1月至2022年12月于广东省中医院就诊并行基础性激素及抗苗勒管激素水平检测的女性就诊者数据资料,根据不同年龄段分为一七/二七组(21岁以下)、三七组(21~27岁)、四七组(28~34岁)、五七组(35~41岁)、六七组(42~48岁)及七七及以后组(49岁及以上)。收集就诊者年龄、平均月经周期(近3个月),基础性激素[包括卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E
2
)、睾酮(T)]水平及FSH/LH值,抗苗勒管激素(AMH)水平,比较各组数据资料中各指标的变化情况。
结果
2
共纳入数据资料1221份。各组总体上FSH、LH、FSH/LH值、E
2
、T、AMH水平及平均月经周期差异均有统计学意义(
P
<0.05或
P
<0.01)。三七组的AMH出现峰值。与三七组相比,四七组FSH/LH值升高,LH、AMH和T水平下降,月经周期缩短(
P
<0.01)。五七组FSH/LH值继续升高,LH、AMH、T水平继续下降,月经周期继续缩短,FSH和E
2
水平开始升高(
P
<0.05或
P
<0.01)。与五七组比较,六七组FSH、LH、E
2
水平均升高,AMH、T水平继续降低(
P
<0.05或
P
<0.01)。与六七组比较,七七及以后组FSH、LH水平继续升高,AMH、E
2
水平下降(
P
<0.01)。
结论
2
女子“以七为期”的生殖衰老规律与不同年龄段基础性激素水平及抗苗勒管激素水平变化特征基本相符,其中“三七”阶段生殖能力达到峰值,“四七”阶段开始逐渐走向生殖衰老。
Objective
2
To explore the law of women reproductive aging based on theory of "seven-year period" in traditional Chinese medicine(TCM) through analyzing the characteristics of basic sex hormone levels and anti-müllerian hormone levels in women of different ages.
Methods
2
The data of female who visited Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2018 to December 2022 and accepted basic hormone and anti-müllerian hormone determination were collected retrospectively. According to the age of subjects, they were divided into the "1
-
2 seven" group (under 21 years old), "3 seven" group (21
-
27 years old), "4 seven" group (28
-
34 years old), "5 seven" group (35
-
41 years old), "6 seven" group (42
-
48 years old) and "7 seven" and older group (49 years old and above). The age, a
verage menstrual cycle in the past 3 months, basic hormone levels including follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E
2
), testosterone (T) and FSH/LH value, and anti-müllerian hormone (AMH) levels were collected and compared.
Results
2
A total of 1221 cases were included. The differences in FSH, LH, FSH/LH values, E
2
, T, AMH levels and average menstrual cycle among the groups were statistically significant (
P
<0.05 or
P
<0.01). AMH peaked in the "3 seven" group. Compared to those in the "3 seven" group, the FSH/LH value in the "4 seven" group increased, while the LH, AMH and T levels decreased, and the menstrual cycle was shortened (
P
<0.01). The FSH/LH, LH, AMH, T and menstrual cycle in the "5 seven" group were consistent with the changing trend of those in the "4 seven" group, while the FSH and E
2
levels in the "5 seven" group were significantly higher (
P
<0.05 or
P
<0.01). Compared to those in the "5 seven" group, the FSH, LH and E
2
levels of the "6 seven" group increased, and the AMH and T levels continued to decrease (
P
<0.05 or
P
<0.01). Compared to those in the "6 seven" group, the FSH and LH levels of the "7 seven" and older group continued to increase, and the AMH and E
2
levels decreased (
P
<0.01).
Conclusion
2
The law of women reproductive aging in the "seven-year period" theory is basically consistent with the characteristics of basic sex hormone levels and anti-müllerian hormone levels in women of different ages. The reproductive capacity reaches its peak in the "three-seven-year period" and gradually moves towards reproductive aging in the "four-seven-year period".
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