基于复合体质视角的成都地区育龄女性自然流产特征及风险因素分析

陈苇; 刘杨春; 周从容; 赖繁; 李晓红; 罗尔丹

doi:10.16766/j.cnki.issn.1674-4152.003163

基于复合体质视角的成都地区育龄女性自然流产特征及风险因素分析

doi: 10.16766/j.cnki.issn.1674-4152.003163

1.
电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院中医科，四川成都 611731
2.
电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院产科
3.
电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院GCP机构

基金项目:

四川省科技计划重点研发项目 2023YFG0277

四川省名中医工作室建设项目川中医药办函〔2022〕36号

四川省中医药管理局科学技术研究专项课题 2021MS283

成都市医学重点学科建设项目 2022-043

四川省医院协会医务管理分会专项项目 SCYW012

详细信息

通讯作者:
罗尔丹，E-mail: luoerdan@sina.cn

中图分类号: R714.21 R271.4
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出版历程
- 收稿日期: 2022-06-21

Analysis on the characteristics and risk factors of spontaneous abortion of childbearing age women in Chengdu from the perspective of compound constitution

1.
Traditional Chinese Medicine Department of Chengdu Women' s and Children' s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China

摘要

摘要: 目的了解自然流产(spontaneous abortion, SA)患者的复合体质特点, 探索育龄女性发生SA的风险因素, 为SA的预防提供参考。方法收集2016年1月-2021年12月在成都市妇女儿童中心医院中医科就诊的育龄女性妊娠和中医体质信息, 辨识复合体质。采用单因素分析比较SA患者与非SA人群的主体质和兼夹体质的差异, 构建logistic回归模型探索SA的风险因素。结果纳入2 878例育龄女性信息, 其中759例具有SA史, 平均年龄32.34岁, 平和质仅占11.86%, 少于非SA人群(χ²=4.059, P=0.044)。SA患者主体质为特禀质的比例多于非SA人群(χ²=8.542, P=0.003), 且复合体质中含气虚质(χ²=5.113, P=0.024)和阳虚质(χ²=5.724, P=0.017)比例均高于非SA人群。SA患者偏颇体质存在聚集性。年龄增长、阳虚体质和特禀体质均是SA发生的风险因素。结论 SA患者复合体质中气虚质和阳虚质的比例高于非SA人群, 且阳虚、气郁和气虚质显示出聚集性, 年龄、阳虚质和特禀质是SA的风险因素, 提示临床实践中对于有备孕需求的阳虚质和特禀质女性应及早进行体质调整, 预防自然流产。
- 自然流产 /
- 中医体质 /
- 复合体质 /
- 育龄女性 /
- 风险因素
Abstract: Objective To understand the compound constitution characteristics of patients with spontaneous abortion (SA), to explore the risk factors of SA in women of childbearing age, and to provide reference for the prevention of SA. Methods The information of pregnancy and traditional Chinese Medicine (TCM) constitution of childbearing age women who visited the TCM Department of Chengdu Women's and Children's Central Hospital in January 2016 to December 2021 were collected, and their compound constitutions were identified.Univariate analysis was used to compare the differences of major and concurrent constitutions between SA patients and non-SA people, and logistic regression model was established to explore the risk factors of SA. Results A total of 2 878 childbearing age women were included, and 759 of them had a history of SA, with an average age of 32.34, and only 11.86% of them were of balanced constitution, which was less than that of non-SA people (χ²=4.059, P=0.044).The proportion of SA patients with special intrinsic constitution was higher than that of non-SA people (χ²=8.542, P=0.003), and the compound constitutions containing Qi-deficiency (χ²=5.113, P=0.024) and Yang-deficiency constitution (χ²=5.724, P=0.017) were higher than non-SA population.The biased constitutions of SA patients were aggregative.Age growth, Yang-deficiency and Special Intrinsic constitutions were the risk factors of SA. Conclusion The proportions of Qi-deficiency and Yang-deficiency as compound constitutions in SA patients are higher than those in non-SA population, and Yang-deficiency, Qi-depression and Qi-deficiency show aggregation.Age, Yang-deficiency and special intrinsic constitutions are the risk factors of spontaneous abortion.It is suggested in clinical practice to adjust the constitution of preparing pregnant women when with Yang-deficiency and special intrinsic constitutions as soon as possible to prevent spontaneous abortion.
- Spontaneous abortion /
- Traditional Chinese medicine constitution /
- Compound constitution /
- Childbearing age women /
- Risk factor
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图 1 非SA人群主体质与兼夹体质组合分布

Figure 1. Combined distribution of major and concurrent constitutions in non-SA population

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图 2 SA患者主体质与兼夹体质组合分布

Figure 2. Combined distribution of major and concurrent constitutions in SA patients

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图 3 非SA人群复合体质中各体质的聚类

Figure 3. Cluster analysis of various constitutions of compound constitutions in non-SA population

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图 4 SA患者复合体质中各体质的聚类

Figure 4. Cluster analysis of various constitutions of compound constitutions iin SA patients

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表 1 SA患者与非SA人群主体质分布[例(%)]

Table 1. Distribution of major constitutions between SA patients and non-SA population[cases(%)]

主体质	非SA人群 (n=2 119)	SA患者 (n=759)	χ²值	P值
平和质	314(14.82)	90(11.86)	4.059	0.044
气虚质	97(4.58)	38(5.01)	0.135	0.713
阳虚质	569(26.85)	226(29.78)	1.518	0.218
阴虚质	135(6.37)	50(6.59)	0.006	0.937
痰湿质	137(6.47)	53(6.98)	0.129	0.719
湿热质	283(13.36)	97(12.78)	0.350	0.554
血瘀质	189(8.92)	54(7.11)	2.810	0.094
气郁质	373(17.60)	132(17.39)	0.017	0.896
特禀质	22(1.04)	19(2.50)	8.542	0.003

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表 2 SA患者与非SA人群复合体质分布[例(%)]

Table 2. Distribution of compound constitutions between SA patients and non-SA population[cases(%)]

复合体质	非SA人群 (n=2 119)	SA患者 (n=759)	χ²值	P值
平和质	314(14.82)	90(11.86)	4.059	0.044
气虚质	608(28.69)	251(33.07)	5.113	0.024
阳虚质	1 057(49.88)	417(54.94)	5.724	0.017
阴虚质	519(24.49)	190(25.03)	0.088	0.767
痰湿质	578(27.28)	228(30.04)	2.115	0.146
湿热质	868(40.96)	285(37.55)	2.877	0.090
血瘀质	715(33.74)	243(32.02)	0.750	0.386
气郁质	1 027(48.47)	368(48.49)	< 0.001	0.993
特禀质	108(5.10)	46(6.06)	1.025	0.311

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表 3 自然流产影响因素的logistic回归分析

Table 3. Logistic regression analysis of influencing factors of spontaneous abortion[cases(%)]

变量	B	SE	Wald χ²	P值	OR(95% CI)
年龄	0.050	0.010	27.281	< 0.001	1.052(1.032~1.072)
BMI	< 0.001	0.015	< 0.001	0.993	1.000(0.972~1.029)
体质			16.183	0.040
气虚质	0.342	0.227	2.264	0.132	1.407(0.902~2.196)
阳虚质	0.332	0.144	5.302	0.021	1.394(1.051~1.849)
阴虚质	0.311	0.206	2.287	0.130	1.365(0.912~2.041)
痰湿质	0.301	0.202	2.217	0.137	1.351(0.909~2.009)
湿热质	0.223	0.169	1.744	0.187	1.250(0.898~1.741)
血瘀质	0.004	0.196	< 0.001	0.983	1.004(0.684~1.475)
气郁质	0.251	0.158	2.538	0.111	1.286(0.944~1.752)
特禀质	1.128	0.337	11.188	0.001	3.089(1.595~5.980)

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