多囊卵巢综合征患者症状网络分析及护理启示

doi:10.3761/j.issn.0254-1769.2026.11.010

摘要/Abstract

摘要：

目的调查多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者的症状发生状况，构建同期症状网络，识别症状群和核心症状，旨在为制订针对性的症状管理策略提供依据。方法采用便利抽样法，于2024年11月—2025年5月，选取来自国内不同地区的400例PCOS患者作为调查对象，使用自行编制的一般资料调查表和PCOS患者常见症状问卷进行调查。通过探索性因子分析提取症状群并应用R软件构建网络模型，计算中心性指标，确定核心症状及桥梁症状。结果最终纳入378例PCOS患者。共提取高雄激素性皮肤表现症状群、排卵及月经异常症状群、代谢紊乱症状群、情绪障碍伴疲劳症状群、经前期综合征症状群5个症状群，累计方差贡献率为56.1%；月经周期异常（97.9%）是PCOS患者最常见的症状。在症状网络中，感到痛苦（r_S=8.19）和感到悲伤（r_S=8.16）是最核心的症状；易激惹（r_bs=4.78）是桥梁强度最大的症状。结论 PCOS患者常表现多种症状及症状群。医护人员可基于网络分析识别出的核心症状，制订精准、有效的干预措施，从而改善患者治疗期间的生活质量。

关键词: 多囊卵巢综合征, 核心症状, 症状群, 网络分析, 症状管理, 护理

Abstract:

Objective To investigate the occurrence of symptoms in patients with polycystic ovary syndrome （PCOS），construct a contemporaneous symptom network，and identify symptom clusters and core symptoms，in order to provide a basis for developing targeted symptom management strategies. Methods A convenience sampling method was used to survey 400 patients with PCOS from different regions of China between November 2024 and May 2025. Data were collected using a self-designed general information questionnaire and a PCOS common symptoms questionnaire. Exploratory factor analysis was employed to identify symptom clusters，and a network model was constructed using R software. Centrality indices were calculated to determine core and bridge symptoms. Results A total of 378 subjects were ultimately included in the study. A total of 5 symptom clusters were extracted，including hyperandrogenic skin manifestations，ovulatory and menstrual dysfunction，metabolic disorders，mood disorders with fatigue，and premenstrual syndrome，with a cumulative variance contribution rate of 56.1%. The most prevalent symptom among PCOS patients was irregular menstrual cycles（97.9%）. Within the symptom network，“feeling distressed”（r_S=8.19） and “feeling sad”（r_S=8.16） were identified as the most central symptoms. Irritability（r_bs=4.78） exhibited the highest bridge strength. Conclusion PCOS patients often present with a diverse range of symptoms and symptom clusters. Healthcare providers can use the core symptoms identified through network analysis to develop precise and effective interventions，thereby enhancing patients’ quality of life during treatment.

Key words: Polycystic Ovary Syndrome, Core Symptoms, Symptom Clusters, Network Analysis, Symptom Management, Nursing Care

刘京辉, 刘芳丽, 李思媛, 徐文琪, 张露文, 田清蜜, 杜李百合, 章明阳. 多囊卵巢综合征患者症状网络分析及护理启示[J]. 中华护理杂志, 2026, 61(11): 1512-1519.

LIU Jing-hui, LIU Fangli, LI Siyuan, XU Wenqi, ZHANG Luwen, TIAN Qingmi, DU Libaihe, ZHANG Mingyang. Symptom network analysis and nursing implications in patients with polycystic ovary syndrome[J]. Chinese Journal of Nursing, 2026, 61(11): 1512-1519.

图/表 3

表1 调查对象的一般资料（n=378）

Table 1 Participant characteristics（n=378）

表2 多囊卵巢综合征患者症状发生频率、严重程度和困扰程度评分（n=378）

Table 2 Frequency， severity， and distress of symptoms in patients with polycystic ovary syndrome（n=378）

表3 多囊卵巢综合征患者症状群的探索性因子分析结果（n=378）

Table 3 Exploratory factor analysis of symptom clusters in patients with polycystic ovary syndrome（n=378）

参考文献 31

[1]	Kulkarni S, Gupta K, Ratre P, et al. Polycystic ovary syndrome:current scenario and future insights[J]. Drug Discov Today, 2023, 28(12):103821.
[2]	Wu Q, Gao J, Bai DX, et al. The prevalence of polycystic ova-rian syndrome in Chinese women:a meta-analysis[J]. Ann Pal-liat Med, 2021, 10(1):74-87.
[3]	中国医疗保健国际交流促进会围产与营养代谢学分会. 多囊卵巢综合征患者孕前、孕期及产后管理中国专家共识(2023年版)[J]. 中国实用妇科与产科杂志, 2023, 39(11):1106-1113.
	Peripartum and Nutritional Metabolism Society of China Inter-national Exchange and Promotive Association for Medical and Health Care. Chinese expert consensus on the management of patients with polycystic ovary syndrome before and during pregnancy and after delivery(2023 edition)[J]. Chin J Pract Gynecol Obstet, 2023, 39(11):1106-1113.
[4]	Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome[J]. Eur J Endo-crinol, 2023, 189(2):G43-G64.
[5]	中国中西医结合学会妇产科专业委员会. 多囊卵巢综合征中西医结合诊治指南[J]. 中国中西医结合杂志, 2024, 44(1):5-18.
	Chinese Society of Integrated Traditional and Western Medi-cine Gynecology Professional Committee. Diagnosis and treat-ment of polycystic ovary syndrome by integrative medicine[J]. Chin J Integr Tradit West Med, 2024, 44(1):5-18.
[6]	Dybciak P, Humeniuk E, Raczkiewicz D, et al. Anxiety and de-pression in women with polycystic ovary syndrome[J]. Medicina(Kaunas), 2022, 58(7):942.
[7]	Alur-Gupta S, Dokras A, Cooney LG. Management of polycystic ovary syndrome must include assessment and treatment of mental health symptoms[J]. Fertil Steril, 2024, 121(3):384-399.
[8]	杨丛品, 李爱民, 李静, 等. 多学科健康管理对多囊卵巢综合征患者体外受精-胚胎移植结局的影响[J]. 护理学杂志, 2025, 40(14):35-38.
	Yang CP, Li AM, Li J, et al. Effectiveness of multidisciplinary health management on in vitro fertilization and embryo tran-sfer outcomes in women with polycystic ovary syndrome[J]. J Nurs Sci, 2025, 40(14):35-38.
[9]	Diakosavvas M, Oyebode O, Bhide P. Weight management stra-tegies to reduce metabolic morbidity in women with polycystic ovary syndrome[J]. Curr Obes Rep, 2025, 14(1):22.
[10]	朱政, 胡天天, 金依霖, 等. 症状网络的基本概念及其在症状管理中的应用[J]. 护士进修杂志, 2023, 38(24):2214-2218, 2224.
	Zhu Z, Hu TT, Jin YL, et al. Basic concepts of symptom net-works and its implementation in symptom management[J]. J Nu-rses Train, 2023, 38(24):2214-2218,2224.
[11]	Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS)[J]. Hum Reprod, 2004, 19(1):41-47.
[12]	Epskamp S, Borsboom D, Fried EI. Estimating psychological net-works and their accuracy:a tutorial paper[J]. Behav Res Me-thods, 2018, 50(1):195-212.
[13]	Papachristou N, Barnaghi P, Cooper B, et al. Network analysis of the multidimensional symptom experience of oncology[J]. Sci Rep, 2019, 9(1):2258.
[14]	石丹, 李铮, 杨坚, 等. 老年脑卒中病人症状负担与生活质量相关性研究[J]. 护理研究, 2019, 33(6):925-929.
	Shi D, Li Z, Yang J, et al. Relationship research on symptom burden and quality of life elderly stroke patients[J]. Chin Nurs Res, 2019, 33(6):925-929.
[15]	刘美子, 安然, 吴子童, 等. 头颈部肿瘤患者核心症状及症状群的网络分析与护理对策[J]. 中华护理杂志, 2024, 59(7):828-834.
	Liu MZ, An R, Wu ZT, et al. A network analysis and nursing implications of core symptoms and symptom clusters in head and neck cancer patients[J]. Chin J Nurs, 2024, 59(7):828-834.
[16]	余骏雯, 朱政, 胡天天, 等. 症状网络的特异性指标[J]. 护士进修杂志, 2023, 38(24):2229-2234,2245.
	Yu JW, Zhu Z, Hu TT, et al. Specificity indices of symptom network[J]. J Nurses Train, 2023, 38(24):2229-2234,2245.
[17]	孙诚鑫, 王钰莹, 杨庆红, 等. 肝癌患者术后核心症状的动态网络分析及护理启示[J]. 中华护理杂志, 2025, 60(15):1857-1863.
	Sun CX, Wang YY, Yang QH, et al. Dynamic network analysis of postoperative core symptoms in hepatocellular carcinoma patients and nursing insights[J]. Chin J Nurs, 2025, 60(15):1857-1863.
[18]	傅若金, 顾卓伟, 路瑶, 等. 不同月经模式多囊卵巢综合征患者性激素及代谢水平差异的研究[J]. 实用妇产科杂志, 2020, 36(1):48-52.
	Fu RJ, Gu ZW, Lu Y, et al. Differences in sexual hormones and levels of metabolism in polycystic ovary syndrome patients with different menstrual patterns[J]. J Pract Obstet Gynecol, 2020, 36(1):48-52.
[19]	中华预防医学会生育力保护分会生殖内分泌生育保护学组. 多囊卵巢综合征合并胰岛素抵抗诊治专家共识[J]. 生殖医学杂志, 2024, 33(9):1133-1140.
	Reproductive Endocrinology & Fertility Preservation Section of Chinese Society on Fertility Preservation under Chinese Preventive Medicine Association. Consensus on the diagnosis and management of polycystic ovary syndrome with insulin resistance[J]. J Reprod Med, 2024, 33(9):1133-1140.
[20]	童一希. 多囊卵巢综合征患者月经周期异常与糖脂代谢及胰岛功能相关性[J]. 中国计划生育学杂志, 2021, 29(9):1902-1906.
	Tong YX. Correlation between different menstrual cycles of patients with polycystic ovary syndrome and their glucose and lipid metabolism and islet function[J]. Chin J Fam Plan, 2021, 29(9):1902-1906.
[21]	Niu JL, Lu MY, Liu B. Association between insulin resistance and abnormal menstrual cycle in Chinese patients with polycystic ovary syndrome[J]. J Ovarian Res, 2023, 16(1):45.
[22]	周惠芳, 洪艳丽, 刁飞扬, 等. 多囊卵巢综合征中西医结合诊疗指南(2024年版)[J]. 中医杂志, 2025, 66(6):649-656.
	Zhou HF, Hong YL, Diao FY, et al. Guidelines for the dia-gnosis and treatment of polycystic ovary syndrome with inte-grated traditional Chinese and western medicine(2024 edition)[J]. J Tradit Chin Med, 2025, 66(6):649-656.
[23]	高征, 李梦元, 李博, 等. 中药复方干预肥胖型多囊卵巢综合征糖脂代谢异常的Meta分析[J]. 国际生殖健康/计划生育杂志, 2024, 43(5):368-377,394.
	Gao Z, Li MY, Li B, et al. Efficacy of Chinese medicine com-pound on abnormal glucose and lipid metabolism in patients with obese polycystic ovary syndrome:a Meta analysis[J]. J Int Reprod Health/Family Plan, 2024, 43(5):368-377,394.
[24]	李慧敏, 毛东伟, 胡桂华, 等. 中药周期疗法联合促排卵方案治疗多囊卵巢综合征不孕症Meta分析[J]. 新中医, 2024, 56(22):181-188.
	Li HM, Mao DW, Hu GH, et al. Meta analysis of Chinese medicine periodic therapy combined with ovulation induction protocol for treatment of infertility caused by polycystic ovary syndrome[J]. New Chin Med, 2024, 56(22):181-188.
[25]	Hofmann K, Decrinis C, Bitterlich N, et al. Body image and mental health in women with polycystic ovary syndrome:a cross-sectional study[J]. Arch Gynecol Obstet, 2025, 312(1):177-190.
[26]	宋丹妮, 胡双, 蒲丛珊, 等. 辅助生殖技术受孕孕妇心理症状群变化轨迹的影响因素分析及护理启示[J]. 中华护理杂志, 2025, 60(10):1209-1216.
	Song DN, Hu S, Pu CS, et al. Analysis of influencing factors on the trajectories of psychological symptom clusters in pregnant women with assisted reproductive technology and nursing revelation[J]. Chin J Nurs, 2025, 60(10):1209-1216.
[27]	仇茜, 施金凤, 冒文盈, 等. 不孕症女性生育压力与病耻感、归因方式调查及相关性分析[J]. 中国计划生育学杂志, 2023, 31(12):2788-2792,2798.
	Qiu Q, Shi JF, Mao WY, et al. Investigation of fertility stress,stigma,and attribution style of infertile women and their correlation analysis[J]. Chin J Fam Plan, 2023, 31(12):2788-2792,2798.
[28]	王凡, 张正红, 肖开转, 等. 下丘脑-垂体-肾上腺轴和下丘脑-垂体-卵巢轴在多囊卵巢综合征神经内分泌功能紊乱中的作用[J]. 中国医学科学院学报, 2017, 39(5):699-704.
	Wang F, Zhang ZH, Xiao KZ, et al. Roles of hypothalamic-pituitary-adrenal axis and hypothalamus-pituitary-ovary axis in the abnormal endocrine functions in patients with polycystic ovary syndrome[J]. Acta Acad Med Sin, 2017, 39(5):699-704.
[29]	郑存风, 王峥, 刘海静, 等. 结直肠癌术后化疗患者核心症状的纵向研究及护理对策[J]. 中华护理杂志, 2025, 60(11):1309-1315.
	Zheng CF, Wang Z, Liu HJ, et al. Longitudinal study on core symptoms and nursing strategies for patients with colorectal cancer undergoing postoperative chemotherapy[J]. Chin J Nurs, 2025, 60(11):1309-1315.
[30]	Ethirajulu A, Alkasabera A, Onyali CB, et al. Insulin resis-tance,hyperandrogenism,and its associated symptoms are the precipitating factors for depression in women with polycystic ovarian syndrome[J]. Cureus, 2021, 13(9):e18013.
[31]	孙梦圆, 唐彬密, 曾琪雅, 等. 多囊卵巢综合征患者体像烦恼的研究现状[J]. 中国护理管理, 2022, 22(5):778-782.
	Sun MY, Tang BM, Zeng QY, et al. Research status of body image distress in patients with polycystic ovary syndrome[J]. Chin Nurs Manag, 2022, 22(5):778-782.