| Objective:1 To explore the relation between the social and psychological factors with liver-qi stagnation syndrome and liver-qi invasion syndrome of PMDD."The social factor",mainly directs the premenstrual phase syndrome the non-psychological reason.Including social,environment,life event and so on bad spirit stimulating factor by life event scale(LES),social support scale(SSRS);"the psychological factor",mainly directs the premenstrual phase syndrome the psychological reason.Namely despondent,anxious and so on bad mood and disposition characteristic.Self-Rating Anxious Scale(SAS),Self-Rating Depression Scale(SDS)and Eysenck Personality Questionnaire(EPQ)were used to evaluate the relationship between them.2 Based on the paroxetine neuroendocrine challenge test to explore the premenstrual irritability liver qi and depression central 5-HT function.Using the neuroendocrine challenge test as an entry point,try to find the index of central 5-HT function from peripheral biological characteristics.To explore and reveal the changes of 5-HT function in the two subtypes of PMDD liver qi invasion and liver qi stagnation,and to provide a basis for elucidating the pathogenesis and clinical classification.method:1 In this study,20 patients in hospital were collected as liver-qi stagnation group and 20 patients were collected as liver-qi invation group,20 healthy people were treated as control group.The three groups were surveyed by life event scale(LES),social support rating scale to evaluate the social factors,and SAS,SDS,and EPQ were used to evaluate the psychological factors.2 The 5-HT function was detected in the late follicular phase and late luteal phase in the PMDD liver-qi invasion group,the liver-qi stagnation group and the normal controls with the paroxetine challenge test.PRL,COR and ACTH were used as the response indexes in the challenge test.result:1 life events scale showed that the negative stimulus intensity of the two groups had increased in the last year,compared with the controls,the difference was statistically significant.Social support assessment showed that the two PMDD groups were significantly lower in the total score,subjective support and social support availability than the control.There was no significant difference between the three groups in the objective support.There were significant differences between the three groups in the scores of neuroticism(N)and internal and external(E)scores.Anxiety score showed that liver qi invasion group was significantly higher than the liver qi stagnation group and the controls.Depression scores showed that the liver qi stagnation group was significantly higher than the liver qi and control group,a statistically significant.Compared with treatment,the score of anxiety in the late Luteal phase was significantly decreased,and the depression score of the liver qi stagnation group was significantly lower.There was no significant difference in SAS and SDS scores between the three groups after treatment.2 The results showed that the main effect of PRL group and menstrual stage was significantly(P<0.01),the liver qi invasion group was significantly higher than the control group(P<0.01),the liver qi stagnation group was significantly lower than the controls(P<0.05).The late luteul phase in liver qi stagnation group was significantly lower than that in follicular phase.The interaction between the group and the menstrual stage was also significant(P<0.01)..The main effect and interaction between group and menstrual stage were not significant(P>0.05).The COR response of the liver qi stagnation group was significantly lower than that of the control group(P<0.05),but there was no significant difference between the two groups(P>0.05).The liver qi invasion group was higher than that of the normal control group(P<0.01).The levels of the three groups of the late were significantly lower than those of the late Follicular Phase(P<0.01).The interaction between the group and the menstrual stage was also significant(P<0.01).(P<0.05),and the trend of ACTH response in the patients was significantly lower than that in the control group(P<0.01).Conclusions1.Social and psychological factors are closely related to the occurrence of PMDD.Risk factors associated with the pathogenesis of PMDD are:(1)Depression(2)Anxiety(3)High neurotic personality(4)Social isolation(5)Negative life events.PMDD according to TCM syndrome differentiation is divided into liver qi syndrome and liver qi stagnation two subtypes,in the luteal phase,liver qi syndrome patients in a serious state of anxiety,liver qi stagnation patients showed severe depressive state,the physical and mental and work life seriously influences.In the personality traits,PMDD liver qi inverse group belongs to high neuroticism-exogenous type,liver qi stagnation group is high neurotic-introversion type,while the control group belongs to low neuroticism-exogenous type.The personality traits of PMDD patients showed obvious instability,and the control group showed obvious stability character.The disease is closely related to chronic psychological stress,the patient experienced more negative life events,subjective social support decreased,the use of social support is not enough.2.the response was significantly higher than that of the control group(P<0.01),Compared with the control group and the liver qi group,there were significant differences between the control group and the liver-qi invasion group.There were no significant differences in the late Luteal phase and late follicle in the three groups(P<0.05).The release of COR in the late Luteal phase was significantly enhanced,and the release of COR in the liver qi stagnation group was weakened,and the release of COR in the liver qi invasion group was significantly higher than that in the control(P<0.05)Significantly lower than the control group.The trend of ACTH in the late stage of the follicle was significantly lower than that in the liver qi qi group.The ACTH of the third group was the lowest in the 1h and the highest peak at 3h,which was compared with the baseline(P<0.01),while the ACTH response of the liver qi stagnation group was significantly lower than that of the control group(P<0.01). |
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