A Clinical Control Study On Two Subtypes Of Premenstrual Dysphoric Disorder (PMDD) With Liver-Qi Inversion And Liver-Qi Stagnation,Anger And Depression

Purpose: To observe the comparison of the two subtypes of "anger and depression" in the latest international classification in patients with Premenstrual Dysphoric Disorder(PMDD),and to explore the diagnosis and relationship between liver-qi inversion and liver-qi stagnation.therapeutic value.Through the treatment of traditional Chinese medicine Xiangshao granules and western medicine fluoxetine dispersible tablets for patients with the improvement of clinical symptoms and serum hormones(estradiol E2,progesterone P,etrahydroprogesterone ALLO)were comparedto verify the therapeutic value of the two drugs.In order to prove that the two syndromes of liver-qi inversion and depression in traditional Chinese medicine of PMDD have better diagnostic and therapeutic value than the two subtypes of anger and depression in modern medicine.Methods:1.According to the DSM-V PMDD diagnostic criteria,compare the PDSP scale to distinguish the two subtypes of "anger and depression",and diagnose the two syndromes of liver-qi reverse depression.Statistical analysis is to see the consistency of the two subtypes and the two syndromes in the diagnosis of PMDD.2.According to the combination of Western medicine diagnostic criteria and TCM syndrome differentiation,the included cases were integrated and analyzed,and they were divided into the liver-qi inversion group and the liver-qi stagnation group.The patients in the liver-qi inversion group and the liver-qi stagnation group were divided into three groups by administration of Xiangshao granules,fluoxetine dispersible tablets,and placebo.Three menstrual cycles were continuously intervened,and the patients were scored according to the "Severity of Syndrome Evaluation Form" and "Daily Report of Symptom Severity"(DRSP),and the changes in symptoms before and after medication were observed.Serum sex hormone levels were detected by immunosorbent assay.To compare the curative effect of drugs in treating PMDD with two syndromes of inverse stagnation of liver-qi.Results: 1.From the analysis of the scale results: the patients with liver-qi stagnation were obviously in line with depression according to DRSP.Patients with liver-qi inversion are obviously in line with anxiety disorders according to DRSP.2.The clinical symptoms of patients with liver-qi inversion and liver-qi stagnation were significantly improved after treatment with the drugs Xiangshao granules and fluoxetine dispersible tablets,and the effect was better than that of placebo.3.Serum hormone indexes in the patients in the liver qi inversion group were significantly recovered after treatment with Xiangshao granules(P<0.05),and the effect was better than that in the liver qi stagnation group(P>0.05);on the contrary,the patients in the liver qi inversion group took fluoxetine The effect of dispersible tablets was not good(P>0.05),in contrast,the effect of fluoxetine dispersible tablets in patients with liver qi stagnation was significant(P<0.05).Conclusions: Patients with liver-qi inversion and liver-qi stagnation are classified into two subtypes of anger and depression,respectively.Compared with the existing clinical subtypes in modern medicine,they have the characteristics of meeting the diagnostic criteria of PMDD disease,and have significant characteristics of mutual identification.Through the study of drug treatment effect,the efficacy of Xiangshao granules and fluoxetine dispersible tablets in the treatment of PMDD patients was significantly different,and Xiangshao granules showed better therapeutic effect on patients with liver-qi inversion,while fluoxetine dispersible tablets had Patients with liver qi stagnation have better treatment effect.