| ObjectiveTo discuss the symptoms of Menopause Syndrome and influence factors of the disease, in order to take corresponding prevention measures.MethodsThe research objects are natural postmenopausal women. Cases source:on the basis of the research objective, in the study, the clinical epidemiology cross-sectional survey method is adopted. Cases are collected from January2011to November2011in Taiwan Wu Guoxian's TCM clinic and related hospital and clinics who are natural post-menopausal women diagnosed as Menopause Syndrome. Survey the500women with an age range of35-55years and a history of childbirth as research objects. Use dictation and consultation questionnaire. The questionnaire is designed by the author, covering menopausal symptoms, delivery, and menstruation onset time after the birth, TCM syndromes, etc.The Western Medicine diagnosis standard of Menopause Syndrome refers to the Chinese Herbal Medicine New Drug Clinical Research Guiding Principles issued by the Ministry of Health in1997:women at the age of35to55years old or artificial postmenopausal women; sweating due to heat, associated with irritability, heart palpitations, insomnia, chest distress and headache, sentimental disorders, memory loss, waist sour and ache, etc. Endocrine determination:reduced serum estradiol, rise of follicle-stimulating hormone, and luteum hormone.The severity of the Menopause Syndrome is.evaluated by Kupperman evaluation method. With improved Kupperman symptom scores, six points or above indicates the Menopause Syndrome diagnosis is established. Equal to or less than15points indicates mild degree;16-30:medium; Equal to or above31:severe.The severity of the Menopause Syndrome, according to Kupperman evaluation meti(?) to evaluate, there were12, concrete including hot flashes sweating, feeling is unusual, insomnia, depression, dizziness, lack of power, and so on, each symptoms are basic points and divided into four level of degree points (0,1,2,3). Rating method is to use the basic cent times degree score, such as a symptom of the basic divided into4points, the measures are two points, so the symptoms score for eight points. The symptom scores for the sum total score. The doctor often total Menopause Syndrome according to judge the severity of this choice and drugs and treatment method. Specific see form Kupperman rating criteria.(?)M syndrome differentiation standard according to the traditional Chinese medicine industry standard of the People's Republic of China "and" the Chinese herbal medicine new medicine clinical research guiding principle", ZhangYuZhen editor of "Chinese woman science" make the following syndrome differentiation standard:Kidney Yin deficiency:before and after menopause, menstrual disorders, menstrual DiQianLiang less or capacity is much, or collapse or leak, the bright red color, leader dizzy, tinnitus, head of paroxysmal face hot flashes, sweat out, five upset hot, waist knees acid aches, sufficient with pain, or dry skin rash, itching, dry mouth and they, less urine color yellow, red tongue less moss, pulse count.Kidney Yang:before and after menopause, the line capacity is much, the dark lubricious weak, or collapse under the leak, sluggishness, complexion is dull, low back pain cold, urinate qing long, a night of urinary frequency number, or floating face limb is swollen, tongue weak, or fat tender side have teeth marks, moss thin white, pulse heavy thin.Kidney Yin and Yang all virtual:before and after menopause, menstrual disorders, quantity is little or much, at first glance at cold heat, baking hot sweat out, dizziness tinnitus, forgetfulness, low back pain cold, tongue light, moss thin, weak pulse sink.Kidney Yin deficiency:before and after menopause, menstrual disorders, multiple color red or dripping wet is not unique, dizzy, inspect content fuzzy, baking hot sweat out, five upset hot, lumbar debility, insomnia, red tongue less moss, pulse count.Kidney empty stomach:before and after menopause, menstrual disorders, capacity is much color red, dizzy, breast, breast pain threat, baking hot sweat out, be agitated irritability, depression or good TaiXi, seem suspicious, dry mouth tastes bitter, NaCha, red tongue moss thin, pulse string or count.Heart renal don't pay:before and after menopause, menstrual disorders, lumbar debility, dizziness tinnitus, baking hot sweat out, palpitation, upset the restless, insomnia, the tip of the tongue red moss thin, pulse count.Spleen and kidney Yang:before and after menopause, menstruation yan or closed after and do not, do the capacity is much, color light qualitative thin, sluggishness, fear of the cold, cold extremities, waist knees abdomen cold pain, long xie long dysentery, or the valley of the qing dynasty, the qing long urine, floating face is swollen limbs, taken down to the rare, tongue light moss thin white, pulse heavy thin and weak.In case the standard:(1) the age40to60one full year of life.(2) with the above Menopause Syndrome diagnostic criteria.(3) improved Kupperman score10points total score>.(4) nearly3months pregnant female, without the hormone therapy.Exclusion criteria do not conform to the diagnosis of traditional Chinese medicine and western medicine diagnosis standard.(1) primary hypertension, primary low blood pressure and chronic anemia patients;(2) the two side spayed, ovarian tumor and ovarian function premature aging patients;(3) less than45years old age or greater than55years old;(4) the hyperthyroidism, n/med tuberculosis, and combined cardiovascular, lung, liver, kidney and other serious primary disease, mental patients.Study design:the clinical epidemiology investigation questionnaire were cross-sectional survey. Using dictations asked several record methods, ask the table with the author of the homemade brief menopausal symptoms occur, delivery, and after the birth of the time head, syndromes, etc.Strictly carry out the design of clinical epidemiology investigation questionnaire, reduce selective bias and measuring sexual bias. Fixed investigators:investigation unit designate special persons to take charge of investigation, investigators for Chinese medicine gynecologists. Unified examination standard:strictly carry out the clinical diagnosis of unity and its standards, clinical symptoms standards. Set the personnel manual, are recorded by diagnostic criteria, into the standard and exclusion standard, the traditional Chinese medicine and other terms of the definition of the term unity to explain; Survey to participate in before investigators undertake unity training. Unified survey form:the deals in the project shall be by the questionnaire ", the formal investigation before the small scope project feasibility the investigation.(4) unified survey of time.Investigation contents including patients generally (such as gender, date of birth, menstrual history, history, etc in pregnancy), menstrual history, history, various kinds of Chinese medical symptoms down (including spirit, sleep, diet, ErBian, local symptoms, systemic symptom, etc), tongue pulse and traditional Chinese and western medicine diagnosis, named TCM syndrome type diagnosis, etc.Scene investigation:the clinical epidemiology cross-sectional survey methods, for the first time after admission or outpatient diagnosis of menstruation to be not moved patients the syndrome questionnaire survey, the investigators according to the questionnaire content ask for details of the subjects, when the same symptoms in patients have change or symptoms have change, with and without type change with syndrome differentiation points, can repeat into. More than two doctors and dialectical diagnosis, data timely, complete and correct, and clearly manned into the questionnaires, in order to reduce the dialectical diagnosis bias. Fill in the questionnaire is correct and complete, modify the need to maintain the original record clearly visible and correct place must be approved by the researchers sign and date indicated.Statistics processing and data conclusion:will all data entry EpiData3.01software, establish the relevant project database. According to the symptoms of the project have, value0,1respectively, finishing each input corresponding numerical and database and questionnaires one by one to check, make sure the extraction and the entry process without omissions and errors. Application SPSS17.0statistical software for frequency, and statistical correlation analysis. Statistical graphics Graphd Prism4.03by drawing.ResultsThis research altogether collected to report cases of500qualified, all for the clinic patients. The survey of500natural post-menopausal women, there are400people in there before and after menopause symptoms of menopause, incidence in80.0%, menopause at an average age of50.0years. The general information of the specific conditions of the see the following each table. Age distribution in (35-55) between age, with an average age of50.0+/-4.7years old.45to49years old group is in the majority,41.8%, second respectively for40～44years old group and50to55years old group;40years old the following, accounted for9.5%.Vocational distribution percentage than a sequence as follows:business staff, service personnel, agriculture, forestry, fishery, animal husbandry staff, professional or technical and relevant personnel and production and related workers, transportation equipment operators, administrative and directors, housework, supervision and ZuoLi personnel.Professional composition of comparison:business personnel (29.8%), service personnel (24.4%), agriculture, forestry, fishery, animal husbandry staff (12.4%) are in the majority.The composition of cultural degree:women cultural degree bachelor of about43.7%, quality is higher.Marriage composing in:married the total92.2%, no spouse31, accounting for7.8%of the total number. In the majority of a spouse.Age at menarche17years old to14-the majority, about61.4%; Less than1393people, about23.3%; More than61people in18years old, about15.3%.Menopause Syndrome illness degree constitution:the mild symptoms of125people, about31.3%; Moderate symptoms of199people, about49.7%; Severe symptoms of76people, about19.0%. Moderate symptoms are in the majority.Syndromes questionnaire investigation:women to a certain age, ovarian function gradually decreases, this stage says menopause, it appears during the signs and symptoms of menopause comprehensive said. The symptoms of Menopause Syndrome many, can be classified as the cardiovascular system symptoms, spirit nervous system symptoms and metabolism and barriers of3kinds. The extent of the symptoms, duration of symptoms length, how much, and ovarian function to drop the speed of the constitution, and menopause, neural type age related to such factors. The survey of500natural post-menopausal women, there are400people in the before and after menopause symptoms of Menopause Syndrome appear. All symptoms of specific conditions in the following each table shows.(1) the cardiovascular system symptomsThe cardiovascular system symptoms have hot flashes, heart palpitations, dizziness, high blood pressure, etc., and also is the typical symptom menopausal hot flashes. Hot flashes a rate of71.7%, palpitations is44.9%, and16.8%for high blood pressure, dizziness70.3%. (2) spirit nervous system symptomsSpirit nervous system symptoms of menopause spirit nervous system symptoms appear, is because the estrogen loss, and cause a series of material from the chabge of metabolism. The results show, moody's55.4%,42.4%of the insomnia.(3) metabolism disordersThe metabolism of female menopause is because women obstacles osteoporosis happen joint pain, this investigation has25.2%. Obesity is body fat, water and salt and the functional disorder, accounting for16.8%. Due to increased blood lipid menopause are obese, atherosclerosis, and is likely to develop (?)h blood pressure, coronary heart disease and other ailments. The genital tract atrophy, and often present is vaginitis, micturition impeded and infection, uterine and vaginal prolapse, incontinence, etc. This vaginitis of incidence of24.3%.Menopause Syndrome, the clinical symptoms and signs the main distributionMenopause Syndrome main symptoms and signs distribution and the percentage constitute sequence arrangement as follows:be agitated irritable, joint pain, fatigue, insomnia, tired damp sweating, dizziness, headache, depression, heart palpitations, itchy skin, feeling is unusual, urinary tract symptoms, sexual desire decline. The main symptoms appear most ten symptoms were fidgety irritable, joint pain, fatigue, insomnia, tired damp sweating, dizziness, headache, depression, heart palpitations, itchy skin.Among the symptoms of Menopause Syndrome patients, irritability is the most frequently occurred psychiatric and nerve disorder. About4/5of the patients have such psychological changes like irritability, anxiety and depression, etc. The author thinks on one hand it's because the objects'little knowledge about Menopause Syndrome brings about too much worry about this disease and heavy psychological burden will further worsen the disease which may cause patients to become agitated and irritable. On the other hand, considering the education and occupation of the objects, the author thinks the changes of roles and the conflicts between women and the society are very critical elements for the occurrence of Menopause Syndrome. Liver is in control of dispersion and adjusting sentiment. The disharmony of sentiment may lead to the disfunciton of dispersion of the liver and the stagnation of qi. The stagnation may develop into fire and disturb heart-spirit and that's why many sentimental disorders like fidgety and irritability are observed clinically. The percentage of the occurrence of arthralgia is76.6%, which is just next to fidgety and irritability (78.7%). Its occurrence is due to the decrease of menopause women's ovary function and less ESG secretion which cause the bone loss and bone rarefaction and finally arthralgia. TCM theories believe that kidney stores the renal yin and renal yang as well as essence. It affects the production of marrow in bone. After reaching middle age, people's kidney qi gradually declines and its function of storing essence and producing marrow also wanes. As bone loses the nutrition of marrow and essence, many symptoms of arthralgia occur. The percentage of the occurrence of fatigue is74.5%, ranking the third which is caused many by the deficiency of qi. That's because zang and fu organs (entrails) are too weak to produce qi and serious and long-time diseases also damage pneuma. Spleen is in charge of digestion and muscles of limbs. Stomach is regarded as the water and cereal sea and the essential origin of6fu organs. Spleen and stomach are the acquired foundation and the origin of qi and blood. Considering Menopause Syndrome, the author thinks fatigue is caused by the weak spleen and stomach and in sufficiency of generating and transforming of qi and blood. To summarize the most frequently met three clinical symptoms (fidgety and irritability, arthralgia, fatigue), their pathogenesis exists in liver, spleen and kidney in terms of zang organs.In the investigation of400Menopause Syndrome patients, it is observed that in terms of differentiation types, kidney-deficiency and liver-stagnation ranks29.9%and what follows are kidney yin deficiency (20.2%), liver and kidney yin deficiency (17.3%), failure of heart and kidney integration (12.3%), kidney yang deficiency (10.5%), kidney yin and yang deficiency (6.2%) and spleen and kidney yang deficiency (3.6%). Among the7types of Menopause Syndrome, the first three are kidney-deficiency and liver-stagnation ranks (29.9%), kidney yin deficiency (20.2%), liver and kidney yin deficiency (17.3%), totally67.4%. This explains fully that kidney deficiency is the root and liver stagnation (deficiency) is the sign. Kidney yang deficiency, kidney yin and yang deficiency and spleen and kidney yang deficiency account for20.3%of the total. The author believes this is related to the age period of objects. Generally, patients aged between35to55years old will not have such syndrome types like kidney yang deficiency, kidney yin and yang deficiency and spleen and kidney yang deficiency, though there's the tendency of kidney qi deficiency, exhaustion of menstruation, deficiency of yin fluid, insufficiency or failure of menstruation onset, etc.Conclusion:1. The occurrence of Menopause Syndrome is affected by many factors. Mental factors have huge impact on it. Other factors are different occupations, education levels, abnormal phenomenon at childbirth, the time of menstruation onset after birth, etc. These indicate that in the prevention and treatment of Menopause Syndrome, we should reduce the impact of mental factors. Being broad-minded and happy in spirit is the foundation for smoothly passing the climacterium.2. Fidgety and irritability, arthralgia and fatigue are the three most frequently occurred symptoms in clinic whose pathogenesis exists in liver, spleen and kidney in terms of zang organs.3. In the investigation of the syndrome differentiation types of400Menopause Syndrome patients, kidney-deficiency and liver-stagnation ranks first (29.9%) and what follows are kidney yin deficiency (20.2%), liver and kidney yin deficiency (17.3%), failure of heart and kidney integration (12.3%), kidney yang deficiency (10.5%), kidney yin and yang deficiency (6.2%) and spleen and kidney yang deficiency (3.6%). Three types of kidney-deficiency and liver-stagnation ranks, kidney yin deficiency and liver and kidney yin deficiency account for67.4%in total. This explains fully that kidney deficiency is the root and liver stagnation (deficiency) is the sign. Kidney yang deficiency, kidney yin and yang deficiency and spleen and kidney yang deficiency account for20.3%of the total. The author believes this is related to the age period of objects. And this is the focus of future research. |
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