The Study Of Traditional Chinese Medicine Syndrome Distribution Pattern Of Delayed Menstruation And The Correlation With Depression And Anxiety

Objective:To study the relationship of delayed menstruation and emotion through literature and clinical research.Clinical research literatures of delayed menstruation with emotional symptoms were summarized and analysed.A database of the medication used in the literatures was built.Using the literature research method and relevant statistic method,to reveal the importance of emotion in the etiopathogenisis,etiology and syndrome pattern of delayed menstruation.Clinical study was carried out in order to understand the TCM syndrome pattern distribution of delayed menstruation.The correlation between this disease and depression and anxiety was investigated as well.Methods:Literature research:Clinical research literatures of recent 10 years(2008-2017)were searched from CNKI and Wanfong Data,with keywords of delayed menstruation and relevant words,selecting the literature that have reported the patients with emotional symptoms.Using EXCEL2010 to set up symptom database,differentiation syndrome database and medication database.Base on the data processing result,the importance of emotion in the etiopathogenisis,etiology and syndrome pattern of delayed menstruation is revealed.Clinical research:Delayed menstruation patients from the Chinese Medicine Specialty clinic of The Chinese University of Hong Kong and No.1 affiliated hospital of Guangzhou University of Chinese Medicine from April,2017 to December,2017 were recruited.Questionnaire survey was carried out.The questionnaire consist of three parts.The first part is about the Chinese medicine syndrome differentiation.The second part is the Self-rating depression scale(SDS).The third part is Self-Rating Anxiety Scale(SAS).Data processing and analysis was done by the use of SPSS in order to reveal the relationship of the differentiation syndromes and the depression and anxiety status of the patients.Results:Literature research:Kidney deficiency syndrome is the main syndrome of the delayed menstruation patients with emotional symptoms.The next important one is liver qi stagnation syndrome.It is found that heat syndrome was one of the highest frequency syndromes,which is different from the traditional belief.The top ten medications are yang supplement medicine,blood supplement medicine,blood circulation promoting medicine,qi supplement medicine,qin supplement medicine,heat removing medicine,expelling medicine,qi promoting medicine,astringents medicine,dampness removing medicine.The most commonly used prescription is Xiaoyao San.The top five symptoms are irritable and touchy,soreness and weakness of waist and knees,dizziness,tidal fever,tender breast.These are the symptoms of kidney deficiency and liver qi stagnation syndrome.Clinical research:The highest frequency syndrome is liver qi stagnation and spleen qi deficiency with dampness syndrome(30.2%).The second one is spleen yand deficiency with dampness syndrome(14.2%).The third one is liver qi stagnation,spleen and kidney deficiency with dampness syndrome(10.4%).Among the 106 patients,there are 63 patients with no depression nor anxiety status(59.4%),15 patients with depression status(14.2%),9 patients with anxiety status(8.5%),19 patients with both depression and anxiety status(17.9%).Among those patients with depression and anxiety status,liver qi stagnation syndrome is the most commonly occurred syndrome,66.7%in depression and 73.7%in anxiety respectively.Result of statistic analysis shows that patients of liver qi stagnation syndrome or spleen and kidney deficiency are more likely to have depression.On the other hand,patients of liver qi stagnation syndrome are more likely to have anxiety.The top five symptoms are tiredness(83%),irritable(74.5%),thirsty(66%),depressed(64.2%),tender breast(63.2%).Result of statistic analysis shows that watery stool and frequent urination at night are positively related to depression and anxiety.Insomnia is positively related to depression while dysmenorrhea and irritable are positively related to anxiety.Conclusion:1.From the result of literature research,Kidney deficiency syndrome is the main syndrome of the delayed menstruation patients with emotional symptoms.The next important one is liver qi stagnation syndrome.2.From the result of clinical research,the highest frequency syndrome is liver qi stagnation,spleen qi deficiency with dampness syndrome.This founding is different from the result of literature research which Kidney deficiency syndrome is the most important syndrome.Liver qi stagnation syndrome is related to the emotion factor and spleen qi deficiency with dampness syndrome is related to the climate of Guangdong region.This result indicates that emotion factor and the regional climate factor should be taken into account when treating patients.3.Delayed menstruation is closely related to depression and anxiety.The patients often have emotional symptoms.The commonly occurred somatic symptoms are also associated with emotion condition of the patients.4.Because of the relationship of delayed menstruation and emotion,besides medication treatment,psychotherapy is advised to be used in order to improve the curative effect.