[经前期烦躁不安证气不稳主要证候的变化]。

中国中西医结合杂志 Pub Date : 2017-01-01
Xiang-Hong Zhan, Pan-Pan Wu, Li-Ping Yang, Hui-Yun Zhang, Guo-Li Yan, Chuan Zhao
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引用次数: 0

摘要

目的观察经前烦躁不安(PMDD)患者中医症状、中医证候分布特征及相关神经内分泌水平的变化。方法采用临床流行病学问卷对3 541例18 ~ 45岁门诊女性患者进行访谈。根据DSM-IV中的PMDD诊断标准,确定PMDD患者的CM综合征。比较两组患者主要症状和常见CM综合征的CM症状评分。检测血清中8项神经内分泌指标[5-羟色胺(5- ht)、促肾上腺皮质激素(ACTH)、血管紧张素- ii (Ang-II)、糖皮质激素(GC)、同型半胱氨酸(Hcy)、褪黑素(MLT)、一氧化氮(NO)、神经肽Y (NPY)]的含量。结果3 541例18 ~ 45岁女性门诊患者共检出经前不悦症258例。经前不悦症(PMDD)患者的主要证候和常见证候为肝气逆侵证[40.3%(104/258)]和肝气郁结证[34]。其次为甘滞脾虚证[7.8%(20/258)]、甘滞血瘀证[7.4%(19/258)]、甘滞火上亢证[6.2%(16258)]、甘滞脾虚证[3.1%(8/258)]、脾虚阳虚证[0.4%(1258)]。与肝气逆袭证相比,肝气郁结证的主要表现为情绪压抑、情绪低落。两种症状的评分均升高(P < 0.05)。05)。结论经前不悦症与肝不能维持正常气运密切相关。肝气证逆侵与肝气证郁结具有不同的科学内涵和生物学依据。因此,应将调肝作为首选。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Changes of Main Syndromes of Gan Failing to Maintain Normal Flow of Qi in Premenstrual Dysphoric Disorder].

Objective To observe the changes of Chinese medicine (CM) symptoms, the distri- bution characteristics of CM syndromes, and related neuroendocrine levels in premenstrual dysphoric disorder (PMDD) patients. Methods Totally 3 541 female outpatients (18 -45 years old) were inter- viewed by clinical epidemiological questionnaire. According to PMDD diagnostic criteria in DSM-IV , PMDD patients' CM syndromes were identified. Their scores of main symptoms and CM symptoms of common CM syndromes were compared. Contents of 8 neuroendocrine indicators in serum were detected [5- hydroxytryptamine (5-HT) , adrenocorticotropic hormore (ACTH) , angiotensin-II (Ang-II ) , glucocorti- coid (GC), homocysteine (Hcy), melatonin (MLT), nitrogen monoxide (NO), neuropeptide Y (NPY)]. Results Totally 258 PMDD were detected in 3 541 female outpatients (18 -45 years old). The main syn- drome and common syndromes of PMDD patients were reversed invasion of Gan qi syndrome [40.3% (104/258)] and stagnation of Gan qi syndrome [34. 9% (90/258) ], followed by Gan stagnation Pi deficiency syndrome [7.8%(20/258)], Gan stagnation blood stasis syndrome [7.4% (19/258)], Gan stagnation induced fire hyperactivity syndrome [ 6.2% ( 16258 )], Gan stagnation Shen deficiency syndrome [3.1%(8/258)], and Pi-Shen yang deficiency syndrome [0.4%(1258)]. Compared with reversed invasion of Gan qi syndrome, emotional depression and low spirits were main symptoms of stagnation of Gan qi syndrome. Scores for the two symptoms increased (P <0.05). Compared with stagnation of Gan qi syn- drome, irritability, upset, abdominal distension, anxiety, headache, dizziness, insomnia, head distension, bitter mouth, unclear vision were main symptoms of reversed invasion of Gan qi syndrome. Scores for the 10 symptoms increased (P <0.05). Compared with stagnation of Gan qi syndrome, the Hcy level in serum obviously decreased in reversed invasion of Gan qi syndrome (P <0.05). There was no statistical difference in the rest indices (P >0. 05). Conclusions PMDD is closely related to Gan failing to maintain normal flow of qi. Reversed invasion of Gan qi syndrome and stagnation of Gan qi syndrome have different scientif- ic connotations and biological bases. So regulating Gan should be considered as the first choice.

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