Chinese Medical Syndrome's Analysis Of Perimenopausal Dye Eyes And Related Clinical Indicators Study

Objective By investigating the TCM syndrome indexes of perimenopausal dry eye disease(PDED)patients,the author preliminarily discusses the rules of TCM syndrome differentiation of PDED patients,investigates and analyzes relevant factors,and probes into its general rules,in order to provide objective reference basis for clinical syndrome differentiation and medication of PDED dry eyes in perimenopausal patients.Methods From March 2018 to February 2019,ophthalmic dry eye outpatients and gynecological perimenopian outpatients were selected as the initial screening objects,PDED patients were screened,and the perimenopian dry eye syndrome questionnaire was filled in.Ward's method was used for cluster analysis to deter-mine the syndrome type.The collected clinical indicators were statistically analyzed by paired sample t test,independent sample t test,rank sum test(kruskal-wallis H),Spearman correlation analysis,one-way ANOVA,binary logistic regression and other methods.Results1.There were no statistically significant differences in the height of the tear stream,the first tear film rupture time,the average tear film rupture time,and the central corneal thickness between the left and right eyes(P>0.05).It indicates that the eyes have symmetry2.The perimenopausal group had higher dry eye consultation rate(47.51%),followed by normal menstruation(21.84%),menopause 1-5 years(20.31%),and menopause>5 years(10.34%).However,there was no difference in the diagnosis rate of dry eyes in the four groups(P>0.05).There was no difference in the classification and distribution of dry eyes in the four groups(P>0.05).3.No statistical difference was found in the frequency distribution of perimenopausal dry eyes in the classification of dry eyes(P>0.05)4.The syndrome differentiation of dry eyes in perimenopmenopausal period is divided into five syndromes:liver stagnation and kidney deficiency syndrome(13 cases),liver stagnation and spleen deficiency syndrome(27 cases),liver and kidney Yin deficiency syndrome(32 cases),spleen and kidney Yang deficiency syndrome(11 cases),and kidney Yin and Yang deficiency syndrome(10 cases).Yin deficiency of liver and kidney is more common.There was a significant difference in comeal thickness between the five syndromes(P<0.05),and the central corneal thickness was thicker in the syndrome of spleen-kidney Yang deficiency5.Corneal thickness was significantly weakly positively correlated with age(r=0.240,P<0.05).OSDI and Kupperman scores were significantly weakly positive correlated(r=0.383,P<0.05).The first tear film rupture time and average tear film rupture time were different between the eyeliner group and the non-eyeliner group(P<0.05).6.Influencing factors of perimenopausal dry eyes after multivariate binary logistic regression analysis,it was found that the influence of meibomian gland opening and meibomian gland morphology on dry eyes was statistically significant(P<0.05).7.There were no statistically significant differences in the number of pregnancies,number of miscarriages and age of menarche in the perimenopausal dry eye classification(P>0.05).Conclusion1.The onset time of dry eyes is about 35 years old,the symptoms of dry eyes are obvious at 42 years old,and the symptoms of dry eyes are more obvious at 49 years old.Dry eyes onset time earlier than perimenopause,earlier than the change of menstrual cycle,or as the first symptoms of perimenopause.2.The syndrome differentiation of dry eyes in perimenopian period is divided into five syndromes:liver stagnation and kidney deficiency syndrome,liver stagnation and spleen deficiency syndrome,liver and kidney Yin deficiency syndrome,spleen and kidney Yang deficiency syndrome,kidney Yin and Yang deficiency syndrome.Yin deficiency of liver and kidney is more common.There were significant differences in comeal thickness among the five syndromes.Comeal thickness can be used as the microscopic index of TCM syndrome differentiation.3.Eyeliner,blocked meibomian gland openings,abnormal meibomian gland morphology,and mental mood are risk factors for dry eyes.