| ObjectiveWith reference to various literature review, explore adenomyosis through its etiology, pathogenesis, diagnosis and treatment progress, to evaluate the correlation between adenomyosis and its syndromes related factors with TCM Constitution. Collect the clinical data of two groups:patients of adenomyosis and the healthy people. By the way of clinical epidemiology, analysis risk factors of uterine adenomyosis, and to explore further the associlation strength between the syndromes associated factors and TCM constitution. Simplify the complexity of the Chinese medicine dialectical system, provided the new ideas and methods for clinical TCM indivi dual izat ion to prevent adenomyosis. Like the old Chinese medication wisemen said:"cure the disease by its root"、"prevent is better than cure"Methods:1. Adopted personal interviews questionnaire method to collect the age of20-50yeares old, from April2012to March2014, during the gynecological clinic and impatient diagnostic in First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine for Patients with adenomyosis. Another alternative group would be from our hospital patients’family members, relatives, friends or colleagues aged between20-50years old, excepted adenomyosis, myoma of uterus and visceral lesions as healthy control group. There were125cases in each group respectively, collected the main physical characteristics of the patient, syndrome associated factors exercise habits and other informations.2. From the interviewed individual, collecting data, summarized their age, education, occupation, pregnancy history, dietary habits, analysis and pathogenesis;3. Through the investigation patients and control groups sports habits, analysis and pathogenesis;4. Collect physical characteristics of patients and control group through physical determination table contains nine physical subscale structures, including Balanced Constitution, Yang deficiency Constitution, Qi deficiency Constitution, Damp-heat Constitution, Phlegm-dampness Constitution, Yin deficiency Constitution, Blood Stasis Constitution, Qi-stagnation Constitution and Special endowment Constitution. Each subscale7-8entries, each entry has five answers, patients need to choose one appropriate answer, conduct to their respective physical type;5. By collecting four diagnostic data, summarized syndromes, analysis, look for any correlation of Chinese traditional constitution.Results:1. This study included125patients with adenomyosis. The high age of41-50years old accounted for55.2%.2. Conduct education and occupational survey showed that60%below primary and secondary education, college degree accounted for19.20%, accounting for17.60%of undergraduate, master’s or above3.2%; unemployed or engaged workers accounted for50.4%, followed by merchants, accounted for11.20%, the proportion of the remaining occupation were less than8.00%.3. Surveyed125patients, up to10times the number of pregnancies, number of births up to six times, the number of abortions up to6times. Accounting for83.20%of pregnancy history, no history of pregnancy accounted for16.80%; reproductive history accounted for76.80%, accounting for23.20%without reproductive history; history of abortion68.00%, no history of abortion accounted for32.00%;68.00%of patients had a history of abortion or of which other intrauterine operating history.4.125cases of uterine adenomyosis patients with other gynecological diseases, including pelvic inflammatory disease, cervicitis, vaginitis, endometritis, endometrial polyps, teratomas, uterine fibroids, ovarian cysts, which merged with one kind to5species of80cases, accounting for64%. Which merged with gynecological inflammation (including pelvic inflammatory disease, cervicitis, vaginitis, endometritis, endometrial polyps) accounted for54.4%.5. The findings showed that dysmenorrhea is the most common symptom, approximately72%of adenomyosis patients lodged the complaint of abdominal symptoms after coming. However, this study found that14.4%of adenomyosis patients without any clinical symptoms, the disease was revealed only under physical examination.6.125cases of adenomyosis diet survey, findings showed meat preference accounted for20%, spicy preference accounting for18.4%,14.4%vegetarian preference, fried or grilled foods accounted for11.2%, accounting for11.2%hard boiled soup,8.8%sweets, salty takers accounted for8%. The majority prefer meat and spicy food.7. In this study each125cases of uterine adenomyosis patients and control group, from their physical exercises habits, more than80%of patients group did not have exercise habits. Statistical analysis with patients group and the control group, the difference was statistically significant, Z is-7.3925,(P<0.05).8. Acounting for125cases of adenomyosis patients with TCM syndrome type, the first syndrome is Qi stagnation and blood stasis type(47.5%), the second syndrome is Kidney deficiency and blood stasis type(27.2%), the third is Qi deficiency and blood stasis type(11.2%), hot burning blood stasis type(8%), phlegm and blood stasis type(8%).9. Investigate adenomyosis syndromes related factors:vision, odour, questions and pulse rhythm, Four Diagnostic Methods of TCM, including signs and symptoms, chi-square tests for categorical variables and OR calculation and analysis, from the case-control study looking for exposure to disease-causing factors, there are significant differences, blood stasis syndrome is the most outstanding.10. This study of125cases of adenomyosis (case group) and125patients without adenomyosis group (control group) to investigate the constitution type. The results showed that patient group more inclined in blood stasis constitution,72%higher than other biased constitution; followed by Yang deficiency constitution, there is existence of composite constitution phenomenon. The highest score of the control group accounted for65.6%of Balance constitution, followed by Yang deficiency constitution. The study found that two groups of nine physical differences were statistically significant. Wherein for Balance constitution, the level of control is described as3(1-3), the group level is described as1(1-1), rank sum test Z=-8.0462(P<0.0001), the tendency described group in Balance constitution, the case group tended to non-balance constitution, Balance constitution is the protect factor of adenomyosis; For Blood stasis constitution, the level of description of the control group1(1-1), patient group described as2(1-3), rank sum test Z=9.4393(P<0.0001), described the case group tend to blood stasis constitution, bood stasis constitution is a risk factors for adenomyosis.11. Use Wilcoxon rank-sum test to analyse the correlation between blood stasis constitution and syndrome related factors with adenomyosis, the results demonstrate:enegetic, bright skin, sharp eyes, pink lips, good sleep are protective factors. Fatigue, dark skin petechiae lag, black circled eyes, deep purpled lips, bad sleep and back pain are risk factors.12. Taking adenomyosis case and control groups to establish logistc binary variable regression to a number of syndromes in patients as independent variables, the model results suggest that Blood stasis constitution and stasis syndrome closely associated with adenomyosis.Conelusions:1. This study suggests that age, number of past pregnancy, uterine operating history, gynecological inflammation, preference of carnivorous and spicy are the risk factors which may have negative effects on adenomyosis; Education sufficient and physical exercises are the protect factors which may have positive effects on adenomyosis.2. This research shows that dysmenorrhea is one of the most common symptoms of adenomyosis, but we found that a minority of patients with adenomyosis without any symptoms were diagnosed only by health examination, which indicate that the early stage of adenomyosis is hidden and it has great significance for early prevention, early treatment by the constitutioin of dialectical.3. From the constitution point of establishment of blood stasis constitu tion as the risk and followed by Yang deficiency constitution, primary p redisposition constitution by statistical analysis; Adenomyosis TCM syn drome type distribution up to qi stagnation and blood stasis, followed by kidney Deficiency and blood stasis syndrome, and the correlation betw een the blood stasis constitution and kidney deficiency and blood stasis is near; Chi square test of syndrome related factors showed that it ha s the most closed correlation between risk factors and blood stasis synd rome. All of this indicate the correlation between adenomyosis and blood stasis in the point of constitution, syndrome distribution, clinical man ifestation, once again arrowed that blood stasis is the pathological bas is of adenomyosis which is consistent with previous literature research. The research of constituton-disease-syndrome-syndrome related factors p rovide clinical evidence for the constitution differentiation-disease di fferentiation-syndrome differentiation, to simplify the complexity of th e Chinese medicine dialectical system, provide theory evidence and new i deas for early clinical TCM individualization prevention of adenomyosis. |
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