| AimDiagnostic standard of liver-Qi stagnation syndrome of symptoms and signs was set up and its pathophysiological bases were prelimilarily explored in this article.MethodsLiterature research was applied to investigate the frequencies of symptoms and signs about the liver-Qi stagnation syndrome in the classical and modern literatures. Those symptoms and signs with high percentile (95% &75%) in the literatures were listed as diagnostic standard and items included in the symptomological scale. Case-control research method was applied to investigate the clinical cases of liver-Qi stagnation syndrome in order to learn the coincidence rate of made diagnostic standard with the clinical gold standard which is decided by two experts at the same time. 96 cases were included in this investigation: 49 cases of liver-Qi stagnationsyndrome, 28 cases of non-liver-Qi stagnation syndrome and 19 cases of healthy participants.In the meantime, those symptoms and signs with statistical significance compared with non-liver-Qi stagnation syndrome were chosen to simplify the items listed in the scale for profound research in the combination of diseases with syndrome. Physical load examination including reflex of eye-heart, signs of skin stroke, check-up of interval of pulse and blood pressure were done to make sure the function state of vegetation nerve system. Self-rating depression scale and self-rating anxiety scale were adopted to measure the emotional state of patients of liver-Qi stagnation syndrome compared with patients of non-liver-Qi stagnation syndrome and healthy participants. The amount of participants in this investigation was the same as above. Radioimmunoassay and coat-A-count TSH IRMA methods were applied to test the amount of serum thyroid hormone including T3,T4,RT3,TSH of patients to learn its change rule of liver-Qi stagnation syndrome compared with the control group.64 cases were included in this experiment: 28 cases of liver-Qi stagnation syndrome, 18 cases of non-liver-Qi stagnation syndrome and 18 cases of healthy partakers.ResultsThe preliminary diagnostic standard of liver-Qi stagnation syndrome was generalized as follows:①distension or pain in the chest or flanks；②depression;③dysphoria and irritation;④bitterness in the mouth;⑤compression feeling in the chest;⑥sigh;⑦wiry pulse. One case includingfour or more than four items of above-noted symptoms and signs can be diagnosed as liver-Qi stagnation syndrome. That the coincidence rate of made standard diagnosis with clinical experts diagnosis was 71% shows that the concordance of made standard with expert diagnosis is pretty well. There isn't statistical significance in the function state of vegetation nerve in the group of liver-Qi stagnation syndrome compared with the control group (P>0.05). Compared with the control group, total standard marks of SDS and SAS were higher than the common people in China and their increase was statistically significant (p<0.01). The difference of amount of serum thyroid hormone was statistically insignificant in the liver-Qi stagnation syndrome compared with the control group (p>0.05).ConclusionThe self-made diagnostic standard was clinically applicable and can be used for profound clinical investigation in the research of combination of diseases with syndrome. The clinicl investigation scale was simplified as following items: distension or pain in the chest or flanks, depression, dysphoria and irritation, bitterness in the mouth, compression feeling in the chest, sigh, belching, compression and distension in the stomach and belly, distending pain in the lower and side abdomen, symptoms can be induced by nervousness, feeling of foreign body in the throat, red tongue texture. Emotional abnormality which is shown as coexistence of anxiety with depression is one characteristic change in the patients of liver-Qi stagnationsyndrome. What's more, the main change of emotion of the patients diagnosed as liver-Qi stagnationsyndrome is depression. Comprehensive and compound syndrome and small sample may... |
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