杨燕婷 张韬

摘要：目的 探討初级中学女生痛经与中医体质类型的相关性，分析痛经的影响因素，为预防痛经提供参考。方法 2015年12月-2016年1月，采用整群抽样，对上海市城郊地区初级中学女生进行问卷调查，包括一般情况调查表、中医体质分类与判定自测表及COX痛经症状量表，分析痛经与中医体质类型相关性及其影响因素。结果 上海城郊地区初级中学女生痛经发生率为29.52%（93/315）。痛经与无痛经者身高、初潮年龄比较差异有统计学意义（P<0.05）。痛经与平和质的秩相关系数（rs）=-0.130（P=0.021）；除特禀质外，痛经与7种偏颇体质的rs均大于0（P<0.05）。经血有无血块、有无痛经遗传史、不同睡眠质量、不同学习压力、不同情绪状态和不同体育锻炼者痛经情况比较，差异有统计学意义（P<0.05）。Logistic回归分析显示，痛经影响因素主要为痛经遗传史、学习压力和阴虚体质。结论 偏颇体质是初级中学女生发生痛经的易感体质。阴虚体质、痛经遗传史、学习压力大均使痛经发生率增高，建议通过疏导、调理以改善阴虚体质，预防痛经发生。

关键词：痛经；中医体质；相关性；影响因素；青春期

DOI：10.3969/j.issn.1005-5304.2017.08.007

中图分类号：R271.113 文献标识码：A 文章编号：1005-5304（2017）08-0027-05

Analysis on Correlation between Dysmenorrhea and TCM Constructions among Junior High School Girls of Shanghai Suburb YANG Yan-ting， ZHANG Tao （Huinan Community Health Service Center of Pudong District of Shanghai， Shanghai 201300， China）

Abstract： Objective To discuss the correlation between the dysmenorrhea and TCM constitutions among the junior high school girls of Shanghai suburb； To analyze the influencing factors； To provide references for the prevention of dysmenorrhea. Methods By using cluster sampling during December 2015 to January 2016， the questionnaire surveys which included the general situation， the classification and determination of TCM constitution self-test and COX Menstrual Symptom Scale were used for the junior high school girls from the suburb area of Shanghai to analyze the relationship between dysmenorrhea and TCM constitutions and the influencing factors. Results The incidence rate of dysmenorrhea was 29.52% （93/315） in junior high school girls from the suburb area of Shanghai. There was statistical significance in body height and menarche age among girls with and without dysmenorrhea （P<0.05）. The rank correlation coefficient of dysmenorrhea and gentleness type was -0.130 （P=0.021）. The rank correlation coefficients of dysmenorrhea and pathological constitution （except for special diathesis type） were all greater than 0 （P<0.05）. Univariate analysis showed that there was statistical significance in the incidence of different coagula in menses， different inheritance of dysmenorrhea， different sleep quality， different learning pressure， different emotional state and different physical exercises （P<0.05）. Logistic regression analysis showed that influence factors of dysmenorrhea were inheritance of dysmenorrhea， learning pressure and yin-deficiency constitution. Conclusion The pathological constitution is the susceptible constitution of dysmenorrhea of junior high school girls. Yin-deficiency constitution， inheritance of dysmenorrhea and learning pressure can increase the incidence of dysmenorrhea. It is suggested that the corresponding preventive measures should be taken to achieve the purpose of prevention dysmenorrhea by regulating and improving yin-deficiency constitution.

Key words： dysmenorrhea； TCM constitutions； correlation； influencing factors； adolescaria

基金项目：上海市卫生和计划生育委员会科研课题（201540006）

通讯作者：张韬，E-mail：hnsqzhangtao@126.com

原发性痛经是青春期少女的常见疾病，在一定程度上影响其学习与生活，患者常伴有烦躁焦虑、消沉等不良情绪。体质指个体在先天禀赋和后天获得的基础上所形成的形态结构、生理功能和心理状态方面综合的、相对稳定的固有特质，分为平和体质和偏颇体质，其中偏颇体质又包括气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质和特禀质等8种体质类型[1]。研究发现，体质类型差异与个体对疾病的敏感性和发病倾向性有关[2-4]。有研究指出，偏颇体质或复合体质易引起痛经，但偏颇体质类型不一：汪素卿等[3]认为特禀质或气郁质与痛经发生有关，而王晓娜等[4]阐述了气虚质、阳虚质、气郁质等偏颇体质对痛经有一定影响。

基于此，本研究对上海市城郊地区初级中学女生进行横断面研究，了解初级中学女生痛经现状及体质类型分布，研究初级中学女生痛经与中医体质类型的相关性，分析痛经发生的因素，为初级中学女生预防痛经提供参考。……