Studies On The Standard Of Common TCM Syndromes Of DUB

Background Dysfunctional uterine bleeding (DUB) is a common gynopathic stubborn disease, and its morbidity constitutes 10% of the gynopathic OPD. The mechanism of bleeding is very complicated and its clinic manifestation varies, badly influencing the health of women's body and heart. The theory of traditional Chinese medicine and herbs has an obvious therapeutic effect on "regulating menstruation" and "hemostasis". However, not only the lower corresponding degree of DUB in traditional Chinese medicine and Western medicine, but the syndrome differentiation and treatment is complex, without unified standard as well. It is necessary to carry out scientifically regular research into the traditional Chinese medical syndrome of DUB in order to take advantages of the treatment under the theory of traditional Chinese medicine and herbs.Objective By referring to the ancient and present literatures, we have a multi-analysis in DUB associated with the traditional Chinese medicine, and discuss the syndrome regulations of DUB in ancient and present traditional Chinese medicine. We try to use suitable statistical method to build the regulations of familiar DUB types of syndrome and its main syndrome, so as to build a series of scientific, rational and practical systems in the end, providing guilds and technology to refer to. Methods The research uses methods of studying literatures by consulting associated literatures of ancient and present times. We have obtained fullscale information of traditional Chinese medical syndrome associated with DUB and built a database of it. This paper adopts methods of Delphi experts consultation to value the supposed types of syndromes in traditional Chinese medicine and a system of main symptoms index associated with cycle of menstruation and quantity of menstruation. We analyze the reliability of our study by some index such as three rounds experts'consultative papers'reliability and validity as well as experts' Cronbach's coefficient, kendall coefficient and authoritative coefficient, using synthetic index method and critical value method to bolt index, using RSR method and distribution according to proportion method to confirm the weight of every index.Results The study totally selects 59 ancient books and 2082 modern journal literatures. After statistical analyzing 324 pieces of ancient information and 42 modern journal literatures which are qualified for the internalized standards, we establish experts'consultative paper to consult experts. The result shows:1. There were 85 kinds of traditional medicine syndrome associated with DUB in ancient books, and about 18 types of syndromes (syndrome of blood stasis, syndrome of qi asthenia of spleed, syndrome of yin asthenia of kidney, syndrome of qi asthenia of kidney, syndrome of liver depression and spleen asthenia, syndrome of liver depression transforming into fire, syndrome of simultaneous asthenia of heart and spleen, syndrome of downward of spleen qi, syndrome of qi stagnation of liver, syndrome of yang asthenia of kidney, syndrome of accumulation of damp-heat, syndrome of qi stagnation and blood stasis, syndrome of yang asthenia of spleen, syndrome of phlegm-dampness, syndrome of qi asthenia and blood stasis, syndrome of blood asthenia, syndrome of blood heat and stasis, syndrome of yin asthenia and blood stasis) and 11 key points of the types of syndromes of place of disease (spleen, liver, thoroughfare and conception, kidney, stomach, liver meridian, spleen meridian, uterus, heart, sea of blood, room of blood) and 19 key points of the types of syndromes of nature of disease(qi asthenia, qi stagnation, yin asthenia, blood asthenia, blood heat, blood coat, fire, downward of qi, depression-heat, damp-heat, asthenia, yang asthenia, phlegm-dampness, heat, angry, disorder of qi, blood-coat) in gathering; in present journal literatures, there are 53 kinds of traditional medicine syndromes associated with DUB, and 16 types of syndromes of nature of disease(syndrome of qi asthenia of spleed, syndrome of yin asthenia of kidney, syndrome of yang asthenia of kidney, syndrome of qi stagnation of liver, syndrome of qi asthenia and blood stasis, syndrome of blood heat, syndrome of simultaneous asthenia of heart and spleen, syndrome of qi asthenia and blood stasis, syndrome of qi asthenia of kidney, yndrome of liver depression and blood heat, syndrome of liver depression and spleen asthenia, syndrome of blood heat and stasis, syndrome of liver depression transforming into fire, syndrome of cold coagulation in uterus, syndrome of accumulation of damp-heat, syndrome of asthenia of qi and yin) and 6 key points of the types of syndromes of place of disease(spleen, kidney, liver, thoroughfare and conception, uterus, heart) and 10 key points of nature of disease(qi asthenia, blood stasis, blood heat, yin asthenia, qi stagnation, yang asthenia, blood asthenia, heat, damp-heat, fire) in gatherting.2. Each Cronbach's alpha coefficients of three rounds experts' consultation are respectively 0.9134,0.9062,0.9379; the consultative paper has a good face validity and content validity; cronbach's coefficients of three-round experts'consultation are 92%,95%and 93%; the authoritative coefficient of the first round and the second round are 0.76,0.80; the authoritative coefficient of the third round respectively are 0.81 in Syndrome of qi asthenia of spleed,0.75 in Syndrome of qi asthenia of kidney,0.81 in Syndrome of yin asthenia of kidney,0.90 in Syndrome of predominant yang and blood heat,0.63 in Syndrome of qi blood heat and blood stasis,0.78 in Syndrome of qi asthenia and blood stasis; the expert weight coefficient of this study are 0.881 and 0.887.3. After the first and the second round of experts'consultation, we totally delete 10 index of type of syndrome and get the common TCM syndromes of DUB are Syndrome of qi asthenia of spleed, Syndrome of qi asthenia and blood stasis, Syndrome of blood heat and blood stasis, Syndrome of yin asthenia of kidney, Syndrome of predominate yang and blood heat, Syndrome of qi asthenia of kidney.4. After the third experts'consultation, the collating sequence of weight coefficient of main syndrome associated with cycle and quantity of menstruation in the Syndrome of qi asthenia of spleed respectively are early menstruation 0.2049, profuse menorrhea 0.2049, metrorrhagis or metrostaxis 0.2049> irregularity of menstrual quantity 0.1966> menostax is 0.1888; the collating sequence of weight coefficient of main syndrome associated with cycle and quantity of menstruation in the Syndrome of qi asthenia of kidney respectively are early menstruation 0.1446, profuse menorrhea 0.1446, metrorrhagia or metrostaxis 0.1446> irregularity of menstrual quantity 0.1401> occasional bleeding 0.1297; the collating sequence of weight coefficient of main syndrome associated with cycle and quantity of menstruation in the Syndrome of yin asthenia of kidney respectively are are menostax is 0.2594, scanty menses 0.2594> intermenstrual bleeding 0.2376> metrorrhagia or metrostaxis 0.2437; the collating sequence of weight coefficient of main syndrome a ssociated with cycle and quantity of menstruation in the Syndrome of predominant yang and blood heat respectively are early menstrualtion 0.2193, profuse menorrhea 0.2193> metrorrhagia or metrostaxis 0.2133 > intermenstrual bleeding 0.1910> irregularity of menstrual quantity 0.1572; the collating sequence of weight coefficient of main syndrome a ssociated with cycle and quantity of menstruation in the Syndrome of blood heat and blood stasis respectively are early menstrualtion 0.2210> profuse menorrhea 0.2137> intermenstrual bleeding 0.1851> irregularity of menstrual quantity 0.1475> menostaxis 0.1292> irregularity of menstrual cycle 0.1033; the collating sequence of weight coefficient of main syndrome associated with cycle and quantity of menstruation in the Syndrome of qi asthenia and blood stasis respectively are irregularity of menstrual quantity 0.2222> metrorrhagia or metrostaxis0.2047> occasional bleeding 0.2005> irregularity of menstrual cycle 0.2000> menostaxis 0.1726.Conclusions By referring to literatures, evaluation Clustering analysia and Delphi evaluation, we establish the regulations of common DUB types of syndrome and main syndrome associated with cycle of menstruation and quantity of menstruation, which suit for clinical regulations of syndrome differentiation and treatment and have a certain science. It provides scientific guides and serve a base of technology for next clinical epidemiologic survey and even for building a series of DUB systems in the end.