Study On Distribution Of TCM Syndromes And The Characteristic Database Of The Tongue Of Primary Dysmenorrhea

Primary dysmenorrhea is a common disorder in women with a high incidence and difficult to be treated.It affects women's everyday life and even their work,so it is greatly concerned.Modern researches have found that blood stasis is the critical pathologic reason.Tongue,an important part of inspection in these researches, indicates physiological functions and pathological mechanisms.The tongue blood stasis(TBS) is very common in clinics and is of great clinical significance for the diagnosis of the body blood stasis syndrome.Because of the relevance between the blood stasis and primary dysmenorrhea,Primary dysmenorrhea is taken as the research object in the present study;the symptom and distribution of TCM syndromes of primary dysmenorrhea,the clinical characteristics and the mechanism of formation of TBS were be discussed;and the characteristic database of TBS was roughly established by the methods of literature research,clinical research,experimental study, image analysis of the tongue and so on,in order to realize the informationization, digitization,standardization of the diagnosis of TBS.The dissertation is divided into six parts.Part 1 Research BackgroundThe related literature,which were correlated with primary dysmenorrhea and TBS of all times and in all countries were reorganized and studied systematically.The ancient Chinese phisicians had done many researches about blood stasis tongue image, especially about the bluish tongue,the purplish tongue,the petechia tongue, ecchymosis on the tongue,and changes of sublingual meridians.Doctors in the modern age have studied TBS from many angles such as clinical observation, experimental study,automatic recognition and analysis by computer,etc.TCM reviews on primary dysmenorrhea indicated that cold syndrome mostly appear among the patients suffering from primary dysmenorrhea,and very few patients were without blood stasis,so distribution of TCM syndromes of primary dysmenorrhea were high frequency of cold and blood stasis syndrome.Its formation was a combination of many factors,with blood stasis as its main pathogenesis."Stagnancy of both blood and qi syndrome" and "blood stasis due to cold syndrome" mostly appear among the patients suffering from primary dysmenorrhea, but "deficiency syndrome" and "heat sydrome" seldom appear among those patient.Diagnosis of the tongues of patients with primary dysmenorrhea were mostly studied from clinical observation and experimental study,but there were few reports on tongue images of patients with primary dysmenorrhea.Part 2 Literature ResearchObjective:to explore primary dysmenorrhea patients' ages,courses of diseases, marriages,clinical characteristics of pain and syndromes of by literature retrieval.Objects:literatures of primary dysmenorrhea in TCM in VIP informationMethod:to put cases,syndrome types,ages,courses of disease,marriages,clinical characteristics,times and parts of pain into excel tables and establish database.Results and Conclusions:The patients with primary dysmenorrheal were mostly young unmarried women;their main symptoms were pains in the inferior belly and lower back, espically before and during their menstruation.It was clear that the proportions of "Stagnancy of both blood and qi syndrome" and "blood stasis due to cold syndrome" were the highest in excess syndrome,but "deficiency of both blood and qi syndrome" and "deficiency of liver and kidney symdrome" mostly appeared among patients with deficiency syndrome.The stagnation of blood stasis,occurring during the whole pathogenic process,was the main pathogenesis of primary dysmenorrhea.Part 3 Clinical ResearchObjective:to explore the symptoms,syndromes and clinical characteristics of tongues of patients with primary dysmenorrhea.Objects:100 cases with primary dysmenorrhea.Method:The retrospective study was made.Results and Conclusions:The patients with primary dysmenorrhea were mostly young unmarried women.Their diseases were relevant with heredity.Their pains often occurred in the inferior belly,espically before and during their menstruation,and there were relevance between the courses of disease and syndromes,there were four main syndrome types among the 100 patients with primary dysmenorrhea,i.e.,"Stagnancy of both blood and qi syndrome","blood stasis due to cold syndrome","deficiency of both blood and qi syndrome",and "deficiency of liver and kidney symdrome".Stagnation of blood stasis was an important factor to the occurrence of primary dysmenorrhea.Clinical observation showed that most tongue bodies of patients with primary dysmenorrhea manifested tongue blood stasis(TBS),especially pale darkish tongue.Serious abnormal sublingual meridians also existed in patients with primary dysmenorrhea.Part4 Clinical Experimental StudyObjective:to explore the pathologic mechanism of the tongue of blood stasis of primary dysmenorrhea(TBSD) on the molecular levelObjects:22 cases with TBSD and 19 cases with TNBSD were observed among patients who were selected in the clinical research,and 20 healthy cases were also used.Method:take hemospasia venous blood to examine the following indexes:(1)β2-GP1 Ab IgG(2) platelet activating factor(PAF)(3) platelet-activating factor acetylhydrolase(PAF-AH)Results and Conclusions:1.Results1.1 the contents ofβ₂-GP1 Ab IgG in patients of TBSD were higher than those in patients of TNBSC and healthy cases group,but there were no significant deviation between that in patients of TNBSC and healthy cases group,and there were no significant density deviation ofβ₂-GP1 Ab IgG among these groups(P＞0.05).1.2 the contents of PAF in patients of TBSD were higher than those in patients of TNBSC and healthy cases group,but there were no significant deviation between in patients of TNBSC and healthy cases group,and there were no significant density deviation of PAF among these groups(P＞0.05).1.3 the contents of PAF-AH in patients of TBSD were higher than those in patients of TNBSC and healthy cases group(P＜0.01),but there were no significant deviation between in patients of TNBSC and healthy cases group(P＞0.05),and there were no significant deviation of PAFA among these groups(P＞0.05).2.Conclusions2.1β2-GP1 Ab IgG is a risk factor for the formation of TBSDβ2-GP1 Ab IgG's content levels were related to the formation of primary dysmenorrhea, especially the pathologic mechanism of the tongue blood stasis of patients with primary dysmenorrhea(TBSD).β2-GP1 Ab IgG is a danger factor in the information of primary dysmenorrhea.2.2PAF is an important pathologic basis of the formation of TBSDContent level of PAF in patients is a important factor in the formation of high thickness in blood of patients with primary dysmenorrhea.These PAF help to form hypercoagulable states through many ways,but the exact ways are unknown now.undoubtedly,platelet activation can enhance platelet adhesion and platelet aggregation,which will slow down coronary flow and cause anoxia,and which will finally cause tongue blood stasis.2.3PAF-AH is an important part of the formation of TBSDIt is concluded that the deficiency of PAF-AH is likely to be an inflectional factor leading to the formation of tongue blood stasis of patients with primary dysmenorrhea.The content level of PAF-AH has great significance in ill states and prognosis of tongue blood stasis of patients with primary dysmenorrhea.Part 5 Image segmentation of TBSDObjective:to explore the digitization,standardization of the diagnosis of TBSDMethod:Study tongue blood stasis of patients with primary dysmenorrhea by "the shortest path based on the medical tongue image segmentation approach".Results and Conclusions:Image segmentation,a classical subject of computer image processing,is the most critical step and very first in tongue image processing.In this study,image segmentation based on "the shortest path based on the medical tongue image segmentation approach" obtained satisfactory results,and made the tongue coating and the sublingual collateral situation be understood.It has advanced the standardization of numbers in clinical diagnosis of tongue images of patients with Primary Dysmenorrhea,and as a result of early exploration and research,It will serve as the direction of further study.Part 6 SummaryThe innovations in this study:1.The present study start from the law of its clinical symptoms,distribution of TCM Syndromes and tongue research of patients with primary dysmenorrhea, particularly tongue blood stasis research.The clinical distribution and formation mechanism of tongue blood stasis of patients with primary dysmenorrheal were understood through analyzing effective data.2.This research has applied image segmentation based on "the shortest path based on the medical tongue image segmentation approach",which can not only be more intuitive,but also can retain all the original image information,and improve the accuracy of the analysis.3.It has not only broaden the approaches of primary dysmenorrhea diseases research,but also explored important research methods that can help to establish diagnostic standards of tongue of blood stasis of patients with primary dysmenorrhea and found a way of applying that smoothly.