| Backgorund Primary dysmenorrhea is one of the common reasons for quality of work life down in women.In traditional Chinese medicine(TCM), it is called "hypogastralgia in menstrual period ".Syndrome differentiation and treatment is the kernel of TCM,but it is hard to master because of it's abstraction,so objectifing and standardizing of TCM is necessary and important in improving the diagnosis of primary dysmenorrhea.Objective To explore the diagnostic value of color Doppler ultrasonography in primary dysmenorrhea,analyse it's hemodynamic characteristics of uterine artery around menstruation,and to investigate it's relationship with syndrome differentiation in TCM.Methods 80 female university students with primary dysmenorrhea were selected as case group,all cases were classified into five types according to the "obstetrics and gynecology of TCM",including qi stagnation and blood stasis,cold dampness and move sluggishly,moist heat and blood stasis, deficient qi and blood and liver-kidney yin deficiency.27 cases of the first three types were classified as sthenia syndrome group,and 23 case of the last two types were classified as asthenia syndrome group.According to The Guide Principle of Clinic Study in New Chinese Traditional Medicine and severity of symptoms in primary dysmenorrhea,the group of primary dysmenorrhea were divided to mild dysmenorrhea group(36 cases),middle dysmenorrhea group(31 cases) and severe dysmenorrhea group(13 cases). Another 40 cases of health studens was selected as control group.The maximum velocity in systolic(Vmax) of uterine artery and branch (including arcuate artery,radial artery and spiral artery) was measured and resistent index(RI) was calculated by using Alokaα10 color Doppler ultrasonography in premenstrual period,early menstrual period and postmenstrual period respectively.The linear correlation analysis was performed between score of symptoms and RI and Vmax in primary dysmenorrhea.Result1.The color Doppler flow of uterine artery and arcuate artery could be showed clearly in all groups and value of RI could be measured easy;flow of radial artery and spiral artery were showed unsatisfied,but RI could be measure by blind method,and the detection rate of radial artery and spiral arteriy were 90.8%and 85%respectively.Intercompared RI of all branchs, the slenderer braches were,the lower value of RI were.2.In health control group,RI were higher than other period on the first day of the cycle(P＜0.05).Rvmax of these arteries were decreased in menstruation,but only Rvmax of spiral artery showed a significant difference between premenarche and menstruation(P＜0.05).3.Compared with the control group,before and after the menstrual, arcuate artery,radial artery,spiral arteries RI was increased in the sthenia syndrome group(P＜0.05),but no significant difference was seen before and after the menstruation in the sthenia syndrome group.4.RI was higher in menstruation than premenarche in the asthenia syndrome group(P＜0.05).Compared with control group,Rvmax of arcuate artery,radial artery,spiral arteries was lower and RI was higher in asthenia syndrome group after menstruation(P<0.05).5.RI of arcuate artery,radial artery,spiral arteries in severe dysmenorrhea groups were higher than mild dysmenorrhea and control group (P<0.05),and middle dysmenorrhea groups were higher than mild dysmenorrhea and control group in RI.6.Score of symptoms was increased followed RI of spiral arteries and positive correlation with it in sthenia syndrome group before menstruation. Score of symptoms was decreased followed Rvmax of spiral arteries and negative correlation with it in asthenia syndrome group after menstruationConclusion Transabdominal color Doppler ultrasound can be used to evaluate primary dysmenorrhea uterine artery blood flow dynamics changes, furthermore it is expected to help the classification of primary dysmenorrhea by traditional Chinese medicine dialectical... |
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