Clinical Study On The Distribution Rule Of Traditional Chinese Medicine Syndromes And Treatment Of Climacteric Syndrome Among Patients In Different Menopausal Status

Objective To explore the distribution rule of traditional Chinese medicine(TCM) syndromes of patients with Climacteric Syndrome(CS) in different menopausal status and the association between CS and sex hormone as well as glucolipid metabolism, and to supply credible evidence for the clinical therapy of CS.Methods Randomly selected patients with CS 50 cases in premenopausal, perimenopausal, postmenopausal status separately.After differentiation,the patients were treated with the appropriate Chinese medicine for 6 weeks. Questionnaire survey and serum testing including follicle stimulating hormone(FSH), luteinizing hormone(LH),estradiol(E2),total testosterone(T),fasting blood-glucose(FBG), postprandial blood glucose(PBG),insulin(INS),total cholesterol(TC),triglyceride (TG),high density lipoprotein(HDL),low density lipoprotein (LDL) and Leptin levels were conducted before and after treatment.Results 1,The Kupperman score of premenopausal,perimenopausal and postmenopausal patients with CS showed a gradual increasing trend, in which the lowest was premenopausal women and the highest was postmenopausal women.2,Sex hormone levels including FSH, LH, E2, T were different among premenopausal,perimenopausal and postmenopausal patients with CS;the FBG and PBG levels of postmenopausal patients were higher than those of premenopausal,perimenopausal patients with CS;the HOMA-IR of postmenopausal patients with CS was higher than postmenopausal ones';and the TC levels of perimenopausal patients with CS were higher than those of premenopausal ones;but there were not significant different among the levels of FINS,TG,HDL,LDL,Leptin.3,The most common symptoms among premenopausal patients were fatigue (80.0%), irritability (76.4%), insomnia (63.5%);which among perimenopausal patients were hectic fever and sweating (87.2%), fatigue (82.9%), insomnia (80.0%);and irritability (92.4%), fatigue (86.5%), hectic fever and sweating (81.8%) were the dominate symptoms among postmenopausal women. 4,The constituent ratio of TCM syndromes was different among CS patients in different menopausal status. Spleen deficiency,liver deficiency and kidney deficiency was common repectively in premenopausal, perimenopausal, postmenopausal patients.5,Among each symptoms of spleen deficiency,the most common are the hypodynamia, abdominal distension after meal, and borborygmus;The most frequent liver deficiency symptoms were irritability, pain in limbs, chest full stalking;and the most common kidney deficiency symptoms were forgetful, lumbar debility, dizziness and ringing in the ears.6,The climacteric syndrome was significantly improved in patients of all 3 groups after treatment,kupperman score was markedly reduced,but the level of endocrine hormone(E2,FSH,LH,T) didn't show any change.In the spleen deficiency group, FBG, FINS, HOMA-IR and Leptin were decreased significantly; HDL was increased in the liver deficiency group while FBG and TC were declined obviously in the kidney deficiency group after treatment.Conclusion 1,Not only sex hormones but also some parts of the glucose and lipid metabolism changed in CS patients with different menopausal status.The severity of symptoms in postmenopausal patients with CS were higher than the premenopause ones. The main symptoms troubled CS patients were hectic fever and sweating, irritability, fatigue, insomnia.2,There are some certern rules in the distribution of TCM syndromes among CS patients in various menopausal status.3,The incidence of CS maybe associated with cardiovascular disease risk factors, and we should pay attention to the regulation of glucose and lipid metabolism during the treatment.