Study On The Menopausal Syndrome Rating Scale Of Disease And Combinated Syndrome

Purposes of Research:With the menopausalsyndrome to be a carrier,we try to explorate the methodology of the TCM evaluation of therapeutic efficiency.According to the theory of chinese medicine,basic on the characteristic and advantage of TCM, using content analysis method,psychometrics,clinical epidemiology and evidence based medicine,construct a rating scale of menopausal syndrome with disease and combinated syndrome which is consonant with the diagnosing and curate characteristics of TCM.we consider to bring different syndromes module to the rating scale,expect to evaluate the curative effect of TCM objectively.Research methods and content:Base on the Chinese Menopause Rating Scale(CMRS) which was construct in the "fifteenth" critical project of the National Science and Technology Development,we study the the Chinese Menopause syndromes literature with the TCM differentiation of symptoms and signs for classification of syndrome, using content analysis methods.Study Menopause syndromes literature which come from monograph,teaching material and medicine magazine with the differentation of every type syndromes of menopausal syndrome,sum up and analysis the main syndromes,extract the chief and secondary symptom to compose the symptom-complex module,and add them to the menopausal syndrome rating scale of disease and syndrom.The item pool of the rating scale is initial formation.The initial theory module of evaluate the TCM curative effect with differentiation of syndromes is constructed.We chose some menopausal syndrome patients to carry out the investigation in advance in the chinic.Inspect the senstinve,importantance,representation and distinguish using the surveying distribution of items methods,discrete method,correlational analysis method,t test method,resolving power coefficient method method and make it to reflect the curative effect well.Main results:1.Preliminary study on TCM literature relative to menopausal syndromes,using the content anylysis method.(1)The main syndromes of the menopausal syndrome.Totally 111 pieces of TCM literature relative to menopause syndrome were evolved in the study.There are 74 kinds of syndromes initially extract from all literatures.There are many syndromes which has the same essence but with different terminology name.According to the essence of the syndromes and the standard of differention of syndromes,we carry on the analysis of the 74 kinds syndromes and obtain 36 kinds of syndromes.We statistic the frequency of the 36 kinds of syndromes.There 6 syndromes whose frequency are higher than 25%.The kidney deficiency of yang syndrome appears 82 times(73.87%);73pieces literatures includ the kidney Yin deficient(65.77%);52 pieces literatures includ the kidney Yin and Yang deficiency(46.85%);44 pieces literatures includ type of failure of the heart and kidney integrating syndromes(36.64%);40 pieces literatures includ hepatic and renal yin deficiency(36.04%);32 pieces literatures includ the spleen kidney deficiency of yang(28.83%).We statistic the syndrome elements of the above syndromes using the content analysis,including the quantitative analysis and qualitative analysis.The menopause syndrome usually has companying with syndromes because the malfunction of zangfu organs.The main companying with syndromes are stagnation of liver-QI(21.62%),type of stagnation of phlegm-damp(8.11%),qi-stagnancy and blood stasis(8.11%)。(2) the syndrom module of menopause syndromeThe general idea is the basic in TCM theory and the human body is a whole.Yin and Yang are the two basic attributes in the whole body.a balance of Yin and Yang is the basic request of the body health,we split the main 6 sundromes of menopause syndrome according to the Yin and Yang attributes. Deficiency of kidney-YIN,hepatic and renal yin deficiency and failure of the heart and kidney integrating make up of the Yin deficiency module;The kidney deficiency of yang,the spleen kidney deficiency of yang make up of the Yang deficiency module;the kidney Yin and Yang deficiency is in the Yin and Yang deficiency module.2.Study the syndrome elements of all kinds syndromes of MS using the content analysis method.(1) Kidney deficiency of yangThere are 65literatures describe the kidney deficiency of yang' s syndrome elements,altogether 40 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,such as fear cold and member cold(96.92%);pale tongue(86.15%);clear abundant urineand Frequent urination at night(86.15%);listlessness(78.46%);swollenface and limbs(73.85%); loose stool(70.77%);laepcumx complexion(69.23%);waist abdomen cold pain (61.54%);deep or thready weak pulse(58.46%).(2) Deficiency of kidney-YINThere are 62 literatures describe the kidney Yin deficient' s syndrome elements,altogether 35 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,14 syndrome elements in total, such as tongue coating few(96.77%);hectic fever and perspiration(96.77%); red tongue(95.16%);dizzy(93.55%);thready and rapid pulse(91.94%);burning sensation of five centres(91.94%);sibilismus aurium(90.32%);waist and knee acidum weak(83.87%);menses blood colour bright red(62.90%);constipation (61.29%);Dry mouth(58.06%);the skin itches dryly(56.45%).(3) The kidney Yin and Yang deficiencyThere are 38 literatures describe the kidney Yin and Yang deficiency' s syndrome elements,altogether 38 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,7 syndrome elements in total, such assibilismus aurium(100.00%);dizzy(100.00%);hectic fever and perspiration(71.05%);hot and cold by turns(65.79%);pale tongue(60.53 %);waist and knee acidum weak(60.53%);tongue coating thinness(52.63 %)。(4) Failure of the heart and kidney integratingThere are 34 literatures describe the failure of the heart and kidney integratings syndrome elements,altogether 34 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,10 syndrome elements in total,such as insomnia and multi-dreams(97.06%);red tongue (91.18%);palpitation(85.29%);thready and rapid pulse(79.41%);perturbed and irritability(79.41%);loss of memory(73.5%);perturbed(64.71%),tongue coating few(55.88%),waist and knee acidum weak(52.94%),dizzy and sibilismus aurium(50.00%)。 (5) Hepatic and renal yin deficiencyThere are 23literatures describe hepatic and renal yin deficiency' s syndrome elements,altogether 38 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,12 syndrome elements in total, such as dizzy(100.00%);red tongue(95.65%);tongue coating few(91.30 %);sibilismus aurium(82.61%);hectic fever and perspiration(78.26%); waist and knee acidum weak(73.91%);burning sensation of five centres(73.91 %);thready and rapid pulse(60.87%);Dry mouth(60.87%);insomnia and multi-dreams(56.52%);perturbed and irritability(56.52%);constipation (52.17%)。(6) The spleen and kidney deficiency of yangThere are 20 literatures describe the spleen kidney deficiency of yang' s syndrome elements,altogether 40 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,loose stool(95.00%),bad appetite (90.00%),swollen face and limbs(80.00%);fear cold and member cold(70.00 %);weary and hypodynamia(60.00%);deep or thready pulse(50.00%);tongue coating thin and white(50.00%);pale tongue and imprints of the teeth(50.00 %);clear abundant urineand Frequent urination at night(50.00%)。(7) Syndrome of stagnation of liver-QIThere are 17 literatures describe stagnation of liver-QI' s syndrome elements,altogether 33 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,deprementia or sensitivity sentimentality(100.00%);hypochondrium distending pain(94.12%);thin and yellow coating(64.71%);red tongue(64.71%);hectic fever and perspiration (64.71%).(8) Qi-stagnancy and blood stasisThere are 7 literatures describe qi-stagnancy and blood stasis' s syndrome elements,altogether 29 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,1 syndrome elements in total, such aspurple toung or ecchymosis(71.43%).(9) Type of stagnation of phlegm-dampThere are 5 literatures describe type of stagnation of phlegm-damp' s syndrome elements,altogether 20 syndrome elements.The syndrome elements whose frequency are bigger than 50%are as follows,2syndrome elements in total, such asthickly furred and Slippery Nipple(60.00%);swollen face and limbs (100.00%).Different syndroms' element are different,a syndrome element may appear in many syndromes,every syndrome element has different importance to different syndromes.This research statistics the syndrome element using the qualitative analysis,quantitative analysis and the content analysis methods,sorting to every syndrome elements by the frequency of occurrence,according to the clinical experience,as well as after the topic core group discussion.Most chief symptomes come from the top three syndrome elements.Secondary symptomes come from the syndrome elements in the top ten.3.The chief symptomes and secondary symptomes of the main syndromes and accompanied with syndromes of the menopause syndromes.(1) The kidney deficiency of yangChief symptomes:fear cold and member cold:clear abundant urine and frequent urination at night:listlessness,secondary symptomes:swollen face and limbs;loose stool;cold pain in back and abdomen,bad appetite,epigastric distension and depression,waist and knee acidum weak.(2) Deficiency of kidney-YINChief symptomes:hectic fever and perspiration;burning sensation of five centres;dizzy;secondary symptomes:sibilismus aurium;waist and knee acidum weak;constipation;the skin itches dryly;Dry mouth;insomnia and multi-dreams; perturbed and irritability。(3) The kidney Yin and Yang deficiencyChief symptomes:dizzy;sibilismus aurium;hectic fever and perspiration; secondary symptomes:fear cold and member cold;waist and knee acidum weak, loss of memory,waist and psychroalgia.(4) Failure of the heart and kidney integratingChief symptomes:insomnia and multi-dreams;palpitation;perturbed and irritability;secondary symptomes:loss of memory;waist and knee acidum weak; dizzy;sibilismus aurium;hectic fever and perspiration;(5) Hepatic and renal yin deficiencyChief symptomes:dizzy;sibilismus aurium;hectic fever and perspiration; secondary symptomes:waist and knee acidum weak;burning sensation of five centres.(6) Syndrome spleen and kidney deficiency of yangChief symptomes:bad appetite;loose stool;swollen face and limbs; secondary symptomes:fear cold and member cold;weary and hypodynamia; clear abundant urine and frequent urination at night;abdominal distension; dizzy;waist and knee acidum weak.(7) Stagnation of liver-QIChief symptomes:deprementia or sensitivity sentimentality;hypochondrium distending pain;secondary symptomes:hectic fever and perspiration;chest feels tight and sigh;insomnia and multi-dreams,breast distending pain.(8) Qi-stagnancy and blood stasisChief symptome:purple toung or ecchymosis;secondary symptomes:distention and pain of head;insomnia and dreamful sleep.(9)Type of stagnation of phlegm-dampChief symptomes:puffiness of face;secondary symptomes:hectic fever and perspiration;chest distress and restlessness;dizzy;thickly furred and Slippery Nipple.4.Initially construct a model of menopausal syndrome rating scale of disease and syndromeThe rating scale model can reflect the change of the pattern syndromes and the syndrome characteristic,it can reflect the change of the soft indicator such as sensation of oneself,physiologic function,role function and mental health and so on.Conclusion:The syndromes shoule have standardization and the objectification,the standardization and the objectification of the syndromes are the basic of establishing the Chinese medicine clinical curative effect system.We should study the clinical curative effect of TCM basic on the syndromes.This research summarizes the syndromes in many literatures,reference the formerly epidemic investigation result,and study syndromes classifieation and syndrome elements using qualitative and quantitate analysis.Study the item with syndrome connotation standardizedly and scientificly.Construct a menopausal syndrome rating scale of disease and syndrome model which is consonant with the characteristics of TCM.