The Clinical Research Of Diagnosis And Treatment With Yin Type Perimenopausal Syndrome Complicating Dyslipidemia

Background:Perimenopause period is an important physiological stage in female’s life. It cause by the decay of ovary’s function, which bring on estrogen absence or deficiency. And many syndromes, such as tidal fever and sweating, the vagina is dry and unsmooth and the emotion changes appear. The dysfunction of their endocrine is disorder, and the plasma lipoproteins are also changed in this period. Therefore it is known as menopausal syndrome complicating dyslipidemia. During this period E₂ descend, FSH and LH rise, TC、TG and LDL-C elevate, HDL-C decline. Keeping the plasma lipoproteins in the normal random, that can obviously decline the cardiovascular disease after menopause.Leading to the fact therefore cardiovascular disease, osteoporosis and senile dementia take place obviously increase, make this kind of woman’s existence quality drop. More and more women enter menopause, the life after menopause extend too. So the treatment and preventing of climacteric syndrome is an important component of global medical hygiene industry.The method of HRT which is proved good in practical treatment is used frequently in treating the syndrome of Perimenopause period accompanied by dyslipidemia. However, the side affect and latent risk of carcinogen restrict the compliance and area. Using the drug alone can not reduce the syndrome of perimenopause and aggravate it contrarily. Depended on the background of HRT and drugs, the pursu of safety and effective method is imperative under the situation, which provides a good chance for TCM treatment. TCM have piled up abundant experiences in the syndrome of perimenopause and exert its unique characters by the guidance of the Wholism and Yin-Yang theory. The reports in treatment practices which begin from the Bianzhenglunzhi and special treatment and drug is ample. The TCM drug which has a good future is natural, less side affect, and cheaper.Objective:Through the syndrome measuring scale in perimenopause, Kupperman Index measuring scale, endocrine level（E2、FSH） and the plasma lipoproteins level （TC、TG、 LDL-C、HDL-C）, evaluate the difference of curative effect of climacteric syndrome between traditional Chinese medicine under the dialectical theory and hormone therapy. Through security measuring, the adverse reaction observe forms to compare with the side reaction difference between the two.Method:This test adopts the perspective design plan, collects 60 climacteric patients consistent with internalize standard from climacter special course of study in TCM, from 2004.10-2007.1, divided into traditional Chinese medicine group and western medicine group at random. Traditional Chinese medicine group are given prescription of gengnianjiangzhi. Western medicine group are given Livial. Compare two groups of curative effect and adverse reaction with the side effect after treating for 2 months. Statistical analysis adopts SPSS13.0 counts software package and sets up the database and carries on the statistical analysis of the data, the main clinical index to the research object is carried on the describing analysis, measurement data adopt t test, analysis of variance or rank sum test, enumeration data group comparison adopt chi spuare test, P=0.05.Result:The mean age of the case is 50.72±3.63 years old, the menopausal age is 48.00±2.35 years old on average. Among the total, 24.14% is the following culture junior middle school, 43.10% is the culture of high and middle school, 32.76% is the culture of above junior college, the course of disease is 19.34±19.35 months on average. Two groups of base-line materials before treating have comparability. Traditional Chinese medicine group and Western medicine group total effective rate of the syndrome measuring scale after one month of treating is 33.3% and 32.8% respectively, there is no significance meaning in the difference between two groups; It is 73.3% and 78.6% respectively in the second month after treating, Western medicine group is superior to Traditional Chinese medicine. Traditional Chinese medicine group and Western medicine group total effective rate of Kupperman index measuring scale after one month of treating is 30.0% and 39.3% respectively. It is 76.7% and 82.1% respectively in the second month after treating, there is no significance meaning in the difference between two groups.Compare the means of difference between first-visit and 4 weeks, 8 weeks with syndrome measuring scale, Kupperman measuring scale, P＜0.05. It’s proved that the two groups’ treatment effect after 4 weeks, 8 weeks, the syndrome is improved progressively. But P＞0.05 between two groups, the difference has no significance. Traditional Chinese medicine group and Western medicine group total effective rate of the plasma lipoproteins level after treating is 83.3% and 75.0% respectively, there is no significance meaning in the difference between two groups. Comparing the level of E₂ after treatment, P＞0.05 between two groups, the difference has no significance. And Comparing other physics and chemistry index sign after treatment, P＜0.05, the syndrome is improved progressively. But between two groups P＞0.05, there is no significance. It’s proved that the two groups do not have significance meaning to the difference between the curative effect in different observation. Two groups of differences in security measuring do not have a significance meaning, but in the record of the adverse reaction, Traditional Chinese Medicine group has none, western medicine group have 3 examples of vagina irregular bleeding, one example exit the test because of adverse reaction.Conclusion:This syndrome is caused by deficiency of kidney yin, blood stasis and phlegm-dampness obstruction. Kidney asthenia, blood stasis and phlegm-dampness obstruction can interact each other. That is kidney asthenia can cause blood stasis and phlegm-dampness obstruction, and blood stasis and phlegm-dampness obstruction also can aggravate kidney asthenia, therefore aggravate symptoms before and after menopause.The prescription of gengnianjiangzhi compares favourably with Livial in improving enclosing in climacteric the syndrome symptom and regulating lipidemia; And it is superior to Livial in overdose adverse reaction; We want to give play to the Traditional Chinese medicine advantage, optimize the healing solution in menopause, in order to promote the development of academic level of Traditional Chinese Medicine and improve the health hygiene level of women of our country.