Clinical Research On The Affecting Factors And Chinese Medicine Syndromes Of Perimenopausal Syndrome

ObjectiveThis study takes T-sect epidemiological methods, observes the common symptoms, tongue demonstration, pulse demonstration and demographical information of 160 women of perimenopausal syndrome and makes in-depth research of Chinese Medicine syndrome rules. The differentiated types avoid blindness of theoretical inference. It discusses the syndrome classification and affecting factors of perimenopausal syndrome, provides theoretical and practical reference for clinical treatment as well as basis for making Chinese Medicine or Integrated Chinese and Western Medicine treatment plans.MethodsThis study takes T-sect epidemiological methods, observes the common clinical symptoms, tongue demonstration, pulse demonstration and demographical information of Taiwan community populations. The author refers to the diagnostic standard of perimenopausal syndrome of Guidelines for Clinical Research of Chinese Medicine New Drug based on the answers of the interviewees the physical examination results. Input the qualified questionnaires into computer with software EPIDATA 3.1 and make descriptive analysis, x2 test and Wilcoxon rank sum test with software SPSS 15.0. Make statistical analysis of the general information including age, occupation, income and menstruation and the Chinese Medicine syndrome distribution, etc.Result1. Demographic Features of Perimenopausal Syndrome Patients143 qualified questionnaires are collected. Subjects are between 35 and 55 with 18.9% of 35-39,25.9% of 40-44,30.8% of 45-49,24.5% of 50-55 years old and the average age is 49.49 years old.63.6% are occupational homemakers and 36.4% have jobs. Education degree:23.1% received junior college education or above,26.6% received senior high school education,33.6% received occupational school education, and 16.8% received junior high school education or below.95.8% have married and have spouses and 4.2% haven't.79.0% have medium,8.4% superior and 12.6 low economical status.58.0% have good,28.0% have mediocre and 14.0% have bad husband and wife relationships.50.3% have relatives' support,33.6% have mediocre support and 16.1% don't have the support.62.2% have the menarche at 14-17,19.6% below 13 and 18.2% above 18 years old.73.4% have menopause and the average menopause age is 49.56 years old.8.4% have regular menstruation and 18.2% have irregular menstruation. 18.3% have mild difficult menstruation,41.9% don't have difficult menstruation and 9.8% have serious difficult menstruation.7.7% of the subjects have a menstruation cycle of≤22 days,66.4% between 23-28 days and 25.9%≥29 days. Personalities:95 subjects (66.4%) are introvert and 48 (33.6%) are extrovert with the majority of introvert personality.2. Affecting Factors of Perimenopausal SyndromeAmong the investigated perimenopausal syndrome women,38 (26.6%) have mild symptoms,87 (60.8%) have medium symptoms and 18 (12.6%) have serious symptoms.The investigation results show that factors like education level, working status, economical situation, spouse relationship, relatives'support and personalities are related to the severity degree of this disease (P<0.05 or P<0.01). Patients who have higher education degree haven't jobs, have good economical conditions and introvert personalities without relative's and spouse's support usually have more serious perimenopausal syndrome symptoms.Compare other factors including marriage status, menstruation, menopause and difficult menstruation and the severity of the perimenopausal syndrome and the author finds the difference has no statistical significance (P> 0.05). Since the sample size is small, this conclusion needs further confirmation with large-sample epidemiological investigation.3. Major Clinical Symptoms of Perimenopausal SyndromeThe most frequently occurred symptoms of perimenopausal syndrome are fidgety (72.72%), osteoarthritis (70.62%), languor and debility (68.53%), insomnia(67.13%), hectic fever and perspiration (65.73%), vertigo(64.34%), headache (62.24%) and depression (61.54%). It can be found that its pathogenesis is mainly liver depression, kidney yin deficiency and yang excess. 4. Type Distribution of Perimenopausal SyndromeAmong the 143 perimenopausal syndrome women patients, the major syndrome type is heart and liver fire (72.7%). The next is kidney yin deficiency (70.6%), liver and kidney yin deficiency (36.4%), liver depression and qi stagnation (26.6%), kidney yang deficiency (17.5%), both of kidney yin and yan deficiency together with spleen and kidney yang deficiency (11.2%). Perimenopausal syndrome patients mainly have liver and kidney pathological changes.5. Tongue Demonstration of Perimenopausal SyndromeThe tongue demonstration of the 143 subjects shows that subjects in the liver depression and qi stagnation group have pale red texture, fat tongue body, indentation at tongue border, thin lingual fur, white color and greasy feature; the heart and liver fire group subjects have mainly red tongue, yellow fur on the whole tongue, and sometimes red tongue tip only with pricks; the liver and kidney yin deficiency group or the kidney yin deficiency group subjects mainly have red tongue and white yellow fur; the kidney yang deficiency group and the kidney yin and yang deficiency group subjects have pale red tongue, thin fur and sometimes white and slippery fur; spleen and kidney yang deficiency group subjects have white, slippery, thick and greasy fur with fat tongue body and indentation marks as the most frequent demonstrations.6. Pulse demonstration of Perimenopausal SyndromeThe clinical observation of the 143 perimenopausal syndrome women is listed as follows:the heart and liver fire group subjects mainly have the string-like pulse; the liver and kidney yin deficiency and the kidney yin deficiency group mainly have the fine and quick pulses; the liver depression and qi stagnation group mainly have string-like pulses; the kidney yang deficiency group mainly have heavy and feeble pulses; the liver yin and yang deficiency group mainly have fine pulses; the spleen and kidney yang deficiency group mainly have heavy and fine pulses.ConclusionThe possible pathogenesis of perimenopausal syndrome is mainly fire derived from liver depression, kidney yin deficiency, yin deficiency and yang excess. It's related to the sentiment, social and family support and living habits. Therefore conducting the early-stage interference like adjusting sentiment, taking physical exercises, adjusting living habits and applying medical prevention, etc will effectively decrease the incidence ratio. Regulating liver and kidney plays an important role in the prevention and treatment of perimenopausal syndrome.