Correlative Study On TCM Pathology, Syndrome And Tongue In Perimenopausal Period

In this paper the rule of syndromes and the pathology of deficiency of kidney and liver Qi depression in perimenopausal period were studied through theoretical and clinical researches, which were helpful to perfect the TCM theory of reproductive physiology and pathology, and also provided a basic research and a new idea for the syndrome differentiation and treatment of perimenopausal period.In the research background section, the TCM theory of reproductive physiology was cleared up and that of etiological factor and mechanism of perimenopausal period was studied. It is considered that though the female reproduction is conducted mostly by kidney, it is also closely related to liver. Liver stores blood and bears the dipersive effect, and it is closed linked to the function of female reproduction. Deficiency of kidney is the basic reason in pathological changes of perimenopausal period, and liver Qi depression is the basic pathological link and is one of the pathological bases of perimenopausal period. It is also discussed the pathological mechanism in perimenopausal period from the angle of modern medicine.In the clinical research section, 61 female cases with perimenopausal period were observed, and 19 healthy women as control. With the indexes such as the mark and grade of deficiency of kidney and of liver Qi depression, tongue picture, sublingual vessel, maturation index(MI) and maturation value(MV) of exfoliative cell of vaginal and tongue coating , the study was carried out. The result showed that:1.The research used "syndrome elements differentiation" and integrative method to ascertain the type of syndrome. The result indicated that syndrome of hyperactivityyang due to yin deficiency and syndrome of liver Qi depression were the most common syndrome in perimenopausal period. It was concluded that mutual action of multiple factors was the pathological basis. Depression of liver Qi and deficiency of kidney were the primary pathogensis.2. Deficiency of kidney in different extents existed in various syndromes of perimenopausal period, which indicated that deficiency of kidney was the common pathological changes of perimenopausal period, and it was one of the pathological bases of perimenopausal period, which corresponded to the theory of traditional Chinese medicine. The integra and grade of liver stagnation in different syndrome groups were higher than that in control group, and liver Qi depression in different extents existed in various syndromes of perimenopausal period, which indicated that liver Qi depression was the important link in pathological changes of perimenopausal period. Moreover, the integra of liver stagnation was the highest among these types, which corresponded with the results. It indicated that "syndrome elements differentiation" and integrative method could reflect pathologic change of clinical types of syndrome.3.The changes of tongue pictures reflected the feature of pathology in various syndromes objectively. And the changes of sublingual vessel in different syndrome groups were higher than those in the control group, which indicated that the pathologic change of blood stasis existed in each types. The factor of blood stasis should not be neglected.4. MI and MV in different syndrome groups were markedly different from those in the control group and the changes of MI and MV in dark purple tongue, thick coating and peeling coating were the most obvious ones. The maturation trend of epithelial cell of tongue coating can not only reflect the formation of tongue coating, but also be related to the formation of tongue proper. Moreover, the changes of MI and MV related to the abnormal degree of tongue pictures: the more seriously the tongue pictures changed, the more obviously MI and MV changed.5.The MI and MV exfoliative cell of vaginal and tongue coating in different syndrome groups tended toward the middle zone, and the differences in all the typesof syndromes were very significant, which indicated that the changes of exfoliative cytology were related to the types of syndrome. Moreover, with the degree of seriousness of pathological transformation, the MV of exfoliative cell of vaginal and tongue coating was lower and lower, which indicated that the level of estrogen was lower and lower indirectly. It was concluded that the test of exfoliative cytology could be used as one of the indexes to determine the degree of seriousness of symptoms and signs.Through the study, the pathological mechanism of perimenopausal period was discussed from the angle of reproductive endocrine and traditional Chinese medicine. Some deficiencies were also discussed in this paper.