1.中国福利会国际和平妇幼保健院(上海 200030)
2.上海市金山区亭林医院(上海 201505)
王晓轶,女,硕士,主治医师,主要从事中医妇科临床与研究工作
金富锐,副主任医师;E-mail:jr1973@163.com
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王晓轶,黄立师,杨东见,等.围绝经期综合征相关症状及中医证型分布规律研究[J].上海中医药杂志,2023,57(1):35-38.
WANG Xiaoyi,HUANG Lishi,YANG Dongjian,et al.Study on distribution of related symptoms and TCM syndromes in women with perimenopausal syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(1):35-38.
王晓轶,黄立师,杨东见,等.围绝经期综合征相关症状及中医证型分布规律研究[J].上海中医药杂志,2023,57(1):35-38. DOI: 10.16305/j.1007-1334.2023.2112017.
WANG Xiaoyi,HUANG Lishi,YANG Dongjian,et al.Study on distribution of related symptoms and TCM syndromes in women with perimenopausal syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2023,57(1):35-38. DOI: 10.16305/j.1007-1334.2023.2112017.
目的,2,研究围绝经期综合征患者相关症状及中医证型分布规律。,方法,2,借助自主研发的更年期应用程序收集围绝经期综合征患者的资料,进行改良Kupperman评分、绝经状态分级和中医证型判定,分析主要症状、绝经状态和中医证型的分布情况;比较不同中医证型患者的改良Kupperman评分差异,以及不同绝经状态、中医证型患者的年龄差异。,结果,2,①共收集有效病例846例,其中半数以上出现疲乏(95.74%)、情绪波动(89.13%)、失眠(86.05%)、性交痛(70.33%)、心悸(68.91%)、头痛(68.91%)、骨关节痛(65.37%)、抑郁疑心(64.07%)、潮热出汗(63.36%)、眩晕(62.53%)等症状。②本研究收集的病例以轻度、中度绝经状态居多,分别为296例(34.99%)、399例(47.16%);中医辨证分型以肾阴阳两虚证(42.67%)、肾虚肝郁证(32.51%)多见,其余依次为肝肾阴虚证(13.59%)、心肾不交证(11.23%)。③不同中医证型患者的改良Kupperman评分存在差异,其中肾虚肝郁型患者评分最高、肝肾阴虚型患者评分最低,差异有统计学意义(,P,<,0.05)。改良Kupperman评分各分项中,肾虚肝郁型患者潮热出汗评分最高(,P,<,0.05),心肾不交型患者失眠评分最高(,P,<,0.05),肾阴阳两虚型患者的抑郁疑心评分最高(,P,<,0.05)。④重度绝经状态患者的年龄最大,绝经状态分级随着年龄的增大而加重(,F,=28.31,,P,<,0.001)。⑤肾阴阳两虚证患者的年龄最小,其余分别为肾虚肝郁证、肝肾阴虚证、心肾不交证(,F,=13.606,,P,<,0.001)。,结论,2,围绝经期综合征患者常见疲乏、情绪波动、失眠等症状,中医证型以肾阴阳两虚和肾虚肝郁为主,且肾虚肝郁型患者的绝经状态较重,绝经状态随着年龄的增大而加重。
Objective,2,To investigate the distribution of related symptoms and traditional Chinese medicine (TCM) patterns in women with perimenopausal syndrome.,Methods,2,The data of patients with perimenopausal syndrome were collected with the self-developed menopausal application, and modified Kupperman Index (KI), menopausal status classifications and TCM syndromes were determined to analyze the distribution of main symptoms, menopausal status and TCM syndromes. The differences in modified KI scores of patients with different TCM syndromes, as well as the differences in age of patients with different menopausal status and TCM syndromes were compared.,Results,2,①A total of 846 valid cases were collected, of which more than half presented with fatigue (95.74%), mood fluctuation (89.13%), insomnia (86.05%), painful intercourse (70.33%), palpitations (68.91%), headache (68.91%), bone and joint pain (65.37%), depression and suspicion (64.07%), hot flashes and sweating (63.36%), and dizziness (62.53%), and other symptoms. ②The majority of cases collected in our study were mild and moderate, with 296 (34.99%) mild ones and 399 (47.16%) moderate ones. According to the TCM syndrome differentiation, the predominant ones were kidney yin-yang deficiency syndrome (42.67%) and kidney deficiency and liver depression syndrome (32.51%), and the rest were liver-kidney yin deficiency syndrome (13.59%) and disharmony between heart and kidney syndrome (11.23%). ③The modified KI scores of patients with different TCM syndromes differed, with the highest scores in patients with kidney deficiency and liver depression syndrome and the lowest scores in patients with liver-kidney yin deficiency syndrome, and the differences were statistically significant (,P<,0.05). Among the subscales of the modified KI, patients with kidney deficiency and liver depression syndrome had the highest score in the subscale of hot flashes and sweating (,P,<,0.05); patients with disharmony between heart and kidney syndrome had the highest score in the subscale of insomnia (,P,<,0.05); and patients with kidney yin-yang deficiency syndrome had the highest score in the subscale of depression and suspicion (,P,<,0.05). ④Patients with severe menopausal status were the oldest, and the menopausal status grading increased with age (,F,=28.31, ,P,<,0.001). ⑤Patients with kidney yin-yang deficiency syndrome were the youngest, followed by those with kidney deficiency and liver depression syndrome, liver-kidney yin deficiency syndrome, and disharmony between heart and kidney syndrome (,F,=13.606, ,P,<,0.001).,Conclusions,2,Fatigue, mood fluctuation, and insomnia are common symptoms in patients with perimenopausal syndrome, and the dominant TCM syndromes are kidney yin-yang deficiency syndrome and kidney deficiency and liver depression syndrome. Patients with kidney deficiency and liver depression syndrome have a relatively more severe menopausal status, and the menopausal status worsens with age.
围绝经期综合征更年期临床症状中医证候辨证论治
perimenopausal syndromemenopauseclinical symptomstraditional Chinese medicine syndrometreatment based on syndrome differentiation
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