| Objective:To investigate the age,menstrual status and sex hormone levels of female patients with systemic lupus erythematosus(SLE)at reproductive age,analyze and conclude,and compare with the normal population to find the differences;To investigate the situation of SLE related ovarian function impairment,its relationship with disease activity and clinical features.To analyze the distribution of TCM syndrome types and influencing factors of lupus-related ovarian function injury,so as to provide theoretical basis for further exploring the etiology and pathogenesis of this disease and improving the quality of life of affected women.Method:The subjects included 280 female patients(study group)diagnosed with systemic lupus erythematosus from Affiliated Hospital of Shandong University of Chinese Medicine from June 2020 to October 2022,and 280 healthy people(control group)during the same period without immune diseases.A unified questionnaire was developed.General information such as name,sex,age,menstruation,fertility,etc.;A total of 190 patients in the patient group and 403 patients in the control group were selected to measure the sex hormone levels(follicle stimulating hormone(FSH),prolactin(PRL),luteinizing hormone(LH),estradiol(E2),testosterone(T),progesterone(P)),ovarian function levels(follicle stimulating hormone(FSH),estradiol(E2),antillerian hormone(AMH),sinus follicle number(AFC)).General data,changes in ovarian function with age in the lupus group,laboratory indicators(FSH,LH,E2,P,PRL,T,AMH)and imaging status(AFC)of the two groups were compared,and statistical analysis was performed using SPSS26.0.SLEDAI and SLICC scores and TCM dialectical typing were performed in the study group according to the NDL standard,and disease activity levels(ESR,C-reactive protein,Ig G,C3,anti-double-stranded DNA antibody)were measured.To study the relationship between ovarian function and disease activity in lupus patients,the relationship between syndrome type distribution and age and course of disease in lupus-related patients with abnormal ovarian function,as well as the differences in ovarian function indexes among different syndrome types,and statistical analysis was performed using SPSS26.0.Results:1.AMH in both lupus women and normal women decreased with age,and the decrease in the patient group was larger than that in normal women;The FSH value of the patient group was significantly higher than that of the healthy control group at all ages.The mean value of E2 in the patient group decreased with the increase of age,but not in the healthy group.2.Serum FSH and LH in SLE group were significantly higher than those in healthy control group,and the difference was statistically significant(P < 0.05),PRL in SLE group was significantly higher than that in healthy control group,and the difference was significant(P < 0.001);E2,T and P in SLE group were significantly lower than those in healthy control group,and the differences of E2 and T were significant(P < 0.001);P The difference was statistically significant(P < 0.05).3.AMH in patient group was lower than that in control group(P > 0.05);The AFC of the patient group was lower than that of the control group,P < 0.01,and the difference was significant.4.There was no significant difference in serum hormone levels between patients in active stage and inactive stage of lupus.Spearman correlation analysis was performed,and all P levels were greater than 0.05,showing no statistical significance.P of the items were all greater than 0.05,indicating no significant correlation between ovarian function and lupus activity index and cumulative organ damage index.5.The comparison of lupus activity indexes and serum sex hormone levels of patients showed that Ig G was positively correlated with E2(P < 0.05),while the rest showed no significant correlation(P > 0.05),showing no statistical significance.The results indicated that Ig G was positively correlated with E2 level,while the rest were not.6.The number of hemolytic anemia and nephritis in the patients with abnormal ovarian function was significantly higher than that in the patients with normal ovarian function(P < 0.05),and the number of thrombocytopenia in the patients with abnormal ovarian function was significantly lower than that in the patients with normal ovarian function(P < 0.05),the difference was significant,and the rest were not significantly correlated.7.Comparing the difference of TCM syndrome type distribution between lupus patients with abnormal ovarian function and patients with normal ovarian function,it can be seen that the two groups have different syndrome type distribution,abnormal group liver and kidney deficiency > qi and blood deficiency > spleen and kidney Yang deficiency > heat poison and blood stasis > rheumatic heat bi;In normal group,deficiency of liver and kidney > deficiency of spleen and kidney Yang > deficiency of qi and blood >heat poison and blood stasis > rheumatic heat bi.8.The data showed that the older the age,the higher the frequency of abnormal ovarian function;In patients under 20 years old,spleen and kidney Yang deficiency > Qi and blood deficiency = heat poison and blood stasis > liver and kidney Yin deficiency =rheumatic heat bi,the distribution of syndrome types in patients under 20 years old,21 to30 years old,heat poison and blood stasis > liver and kidney Yin deficiency = qi and blood deficiency > spleen and kidney Yang deficiency > rheumatic heat bi.In patients aged 31 to40 years,liver and kidney Yin deficiency > Qi and blood deficiency > spleen and kidney Yang deficiency > heat poison and blood stasis > rheumatic heat bi.In patients over 40 years old,liver and kidney Yin deficiency > Qi and blood deficiency > spleen and kidney Yang deficiency > rheumatic heat bi > heat poison and blood stasis.In general,all syndrome types showed age-related characteristics,and the difference was statistically significant(P<0.05).9.The distribution characteristics of syndrome types in lupus patients with abnormal ovarian function below: spleen-kidney Yang deficiency > heat toxic blood stasis and rheumatic heat Bi showed a decreasing trend with the increase of disease time;The type of Yin deficiency of liver and kidney increased with the course of disease.The type of spleen-kidney Yang deficiency decreased first and then increased.The deficiency type of Qi and blood increased first and then decreased.In patients with less than 5 years of disease course,the proportion of heat poison and blood stasis type was the highest,and the proportion of liver and kidney Yin deficiency type was the lowest.The proportion of heat poison and blood stasis type was the highest,and the proportion of spleen-kidney Yang deficiency type was the lowest.The proportion of qi and blood deficiency and liver-kidney Yin deficiency was significantly higher than other syndrome types,while spleen-kidney Yang deficiency was significantly lower than other syndrome types.In patients with more than 15 years of disease course,liver-kidney Yin deficiency type was significantly higher than other syndrome types,heat poison and blood stasis,rheumatic heat Bi type was significantly lower than other syndrome types.10.Comparison of ovarian function indexes among different syndrome types:(1)Difference in FSH distribution: FSH of spleen-kidney Yang deficiency and liver-kidney Yin deficiency was significantly higher than that of other syndrome types(P =0.00),among which FSH of liver-kidney Yin deficiency was significantly higher than that of spleen-kidney Yang deficiency(P<0.001),and there was no significant difference among the other three syndrome types.(2)Differences in E2 distribution: the level of E2 in liver-kidney Yin deficiency type was significantly lower than that in other syndrome types(P<0.001);the level of E2 in spleen-kidney deficiency type and qi and blood deficiency type was higher than that in other syndrome types(P<0.001);there was no significant difference between the two types(P>0.05);there was no significant difference between heat poison and blood stasis and rheumatic heat bi syndrome type(P>0.05).(3)Differences in the distribution of AMH: the AMH of liver-kidney Yin deficiency type and gas blood deficiency type was lower than that of heat toxic blood stasis type(P<0.001).There was no significant difference in AMH level between the two syndromic types,and no significant difference between the other syndromic types.(4)Differences in AFC distribution: The AFC level of heat toxin-blood stasis type was significantly higher than that of liver-kidney Yin deficiency type(P<0.001),and the AFC level of qi and blood deficiency type was higher than that of liver-kidney deficiency type(P>0.05).Conclusion:1.There are differences in serum sex hormone levels between SLE patients and healthy people.Estrogen,progesterone and prolactin have pro-inflammatory effects,while testosterone has anti-inflammatory effects.2.The ovarian function of female patients with systemic lupus erythematosus is lower than that of normal women,which may be mainly due to disease injury and drug influence.3.There is little correlation between ovarian function and disease activity in lupus patients.4.Patients with abnormal ovarian function have more hemolytic anemia,thrombocytopenia,and nephritis symptoms.5.In terms of the distribution of TCM syndrome types,patients with liver and kidney Yin deficiency accounted for the highest proportion,while those with heat toxicity and blood stasis accounted for the lowest proportion.There were significant differences in the distribution of age and course of disease among different syndrome types.6.FSH and AMH can better reflect the ovarian conditions of patients with lupus,while E2 can be interfered by the disease.AFC can be used as a whole reflection of the ovarian conditions of individuals,but it lacks sensitivity as an evaluation method for lupus,a highly heterogeneous and recurrent disease. 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