Changes Of Type Ⅰ/Ⅱ T Lymphocytes, Reproductive Hormone In The Patients With Menopathy Due To Asthenia Cold And The Effect Of Jingui Decoction For Warming Meridian On Them

Objective: The morbidity rate of asthenia cold syndrome in crowd was 9.95%, and it was heigher in female(13.21%)than that in male(5.56%). Asthenia cold can induce many kinds of menopathy such as hypomenorrhea, delayed menorrhea, menostasia, algomenorrhea, and so on. It seriously influenced female physical and mental health. But the investigation of menopathy of asthenia cold syndrome was less, and the therapeutic measure in western medicine was still unsatisfactory. For this reason, we should furtherly study the etiopathogenesis of it, aiming to provid some helpful consult in diagnose and treatment for doctors in the department of gynecology. It was a question which need to solve urgently. By analyzing the changes of typeⅠ/ⅡT lymphocytes and reproductive hormone in the menopathy of asthenia cold syndrome, and compareing with menopathy of asthenia fever syndrome, in aspects of endocrine and immunology, this investigation partly explored etiopathogenesis and mechanism of treatment for the menopathy of asthenia cold syndrome with the Decoction of Warming Meridianfrom Jin Gui Yao Lu(eDWMJ),so expected to provide some evidence for studying syndrome differentiation objectively and treatment based on the syndrome differentiation.Methods: 30 patients were selected for each group according to the criterion of asthenia cold and asthenia fever syndrome in menopathy. Then divided them into the groups as menopathy of asthenia cold syndrome(to abbreviate as"asthenia cold group"), menopathy of asthenia fever syndrome(to abbreviate as"asthenia fever group"). 30 healthy female volunteers were selected as normal group(any disease of cardia-cerebrovascular disease; endocrine disease such as liver, kidney, adrenal gland, thyroid, appendix cerebri; nervous system disease and blood disease and so on were excluded). In asthenia cold group there was 10 patients with algomenorrhea, 12 with delayed menorrhea, 8 with hypomenorrhea; the largest age was 44, the smallest was 22, mean age was 29.77±5.75; there were 18 had married, 12 unmarried; the longest course of disease was 11 years, the shortest was 1 year, average was 3.88±2.58. There were no statistical differences in the course of disease and score of pathogenetic condition between asthenia cold group and asthenia fever group. In the three groups there were no statistical differences in ages. So the three groups had comparability. Treated the patients in asthenia cold group with DWM, take orally one dosis(two times) a day for three menstrual cycles. Other drugs related to this disease are forbidden during the observation. Blood were collected from the patients with empty stomach in the three groups (before and after treatment for the asthenia cold group and before treatment for the asthenia fever group as well as in the normal group) in the morning of second day in the menstrual cycle, taking the sitting position, 6ml blood was draw from cubital vein of the patients, 1ml in the asepsis test tube mixed with EDTA anticoagulant, the rest 5ml was put in another asepsis test tube contained liquemine and mixed with them completely, and centrifuge them at the speed of 2000 roll per minute for 10 minutes, then get the upper serum and preserve them in refrigerator(below-20℃) for detection. The contents of serum P, E2, T, FSH, LH were detect by the methods of radio immunoassay, peripheral bloodⅠ/ⅡT lymphocytes were measured by means of immunofluorescence antibody labeling and flow cytometer, triad colour fluor parameter was obtained by the software of Cellquest.Result:1 The changes ofⅠ/ⅡT lymphocytes and reproductive hormones in the patients of pretherapy with menopathy of asthenia cold syndrome1.1 The changes ofⅠ/ⅡT lymphocytes in the patients of pretherapy with menopathy of asthenia cold syndrome Compared with normal group, the percentage of CD3~+T, CD3~+CD8~+T, Th2, Th2/Th1, Tc2, Tc1 cell in the prior treating patients of asthenia cold group was decreased(P<0.01), the percentage of Tc2/Tc1 was also decreased(P<0.05); CD3~+ CD4~+T was increased(P<0.05),CD3~+ CD4~+ T/ CD3~+ CD8~+ T, Th1 increased ( P < 0.01 ) .They all had statistical significance. Compared with normal group, the percentage of CD3~+T, CD3~+CD8~+T, Tc1 in the prior treating patients of asthenia fever group was decreased(P<0.01), CD3~+CD4~+T, Th1 was also decreased(P<0.05); Th2/Th1, Tc2 is increased(P<0.05), Tc2/Tc1 is also increased(P<0.01), they all had statistical significance. CD3~+ CD4~+T/ CD3~+CD8~+ T, Th2 had a tendency of increase, but had no statistical significance(P>0.05). Compared with asthenia fever group of pretherapy, the change of CD3~+ T in asthenia cold group of pretherapy had no statistical significance(P>0.05); the percentage of CD3~+ CD4~+ T, CD3~+ CD4~+ T/ CD3~+ CD8~+ T, Th1 wsa increased(P<0.01), Tc1 wsa increased(P<0.05); CD3~+ CD8~+ T, Th2, Th2/Th1, Tc2, Tc2/Tc1 was decreased(P<0.01). They all had statistical significance.1.2 The changes of the reproductive hormone in the patients of pretherapy with menopathy due to asthenia cold syndromeCompared with normal group, the content of E2, LH in the prior treating patients of asthenia cold group were decreased(P<0.05), the level of T, FSH were significantly decreased(P<0.01), they all had statistical significance. P had a tendency of decrease , but had no statistical significance(P>0.05). Compared with normal group, the content of T, LH in the prior treating patients of asthenia fever group were increased(P<0.05), P was significantly increased(P<0.01);FSH, E2 had a tendency of increase, but had no statistical significance(P>0.05). Compared with asthenia fever group of pretherapy, the content of E2 in prior treating patients of asthenia cold group was decreased(P<0.05), T, P, FSH, LH was significantly decreased(P<0.01). They all had statistical significance.1.3 The relations between typeⅠ/ⅡT lymphocytes and reproductive hormone in the prior treating patients with pmenopathy of asthenia cold syndromeThere were correlations between the cells of Th2, Tc2, Th1, Tc1 and reproductive hormone such as E2, T, FSH in patients with pmenopathy of asthenia cold syndrome, but there were no correlations with the level of P and LH. Our results indicated that there was positive linear correlation between Th2 cell, the ratio of Th2/Th1 and the level of E2(P<0.01), there was negative linear correlation between Th1 and the level of E2(P<0.05). There was positive linear correlation between Th2, Tc2(P<0.01), the ratio of Th2/ Th1(P<0.05)and the level of T. There was negetive linear correlation between Th1 and the level of FSH(P<0.05).2 The therapeutic result of menopathy due to asthenia cold syndromeAfter 3 course of treatment, the number of clinical recovery patients was 14 and the number of effective patients was 11, the effective rates was 83.3%. Further statistics according to the kinds of diseases, among the 10 patients with dysmenorrhea, there were 5 recovery cases, 3 effective cases, 2 inefficacy cases and the effective rates was 80%. Among the 12 patients with delayed menstrual period, the number of recovery was 5, effective patients was 6, inefficacy 1 and the effective rates was 91.7%. Among the 8 patients with hypomenorrhea, the number of recovery was 4, effective patients was 2 and the effective rates was 75% . Effective rates of the three diseases had no statistical significance .3 The effect of DWMJ onⅠ/ⅡT lymphocytes and reproductive hormones in the patients with menopathy due to asthenia cold syndromeAfter 3 course of treatment with DWMJ, compared with pre-treatment, the percentage of CD3~+ T, CD3~+ CD8~+ T, Tc2 and Tc1 were all increased(P<0.01), Th2, the ratioes of Th2/ Th1 and Tc2/ Tc1 were also increased(P<0.05);CD3~+ CD4~+ T, the ratioes of CD3~+ CD4~+ T/ CD3~+ CD8~+ T and Th1 were decreased(P<0.01);the contents of E2, T,LH and FSH were increased(P<0.05), they all had statistical significance. The content of P had a tendency of increase, but there was no statistical significance(P>0.05).After 3 course of treatment with DWMJ, compared with normol group, the percentage of CD3~+ T is increased, the changes of other indexes has no statistical significance.Conclusions:1 This investigation discovered that in patients with menopathy due to asthenia cold syndrome, the content of T, E2, FSH, LH were lower, the percentage of CD3~+T, CD3~+CD8~+ T, Th2, Th2/ Th1, Tc2, Tc1, Tc2/ Tc1 were lower , the percentage of CD3~+CD4~+ T, CD3~+CD4~+ T/ CD3~+CD8~+ T,Th1 were higher. These hinted that the state of polarizationⅠ/ⅡT lymphocytes changed, which leading to the obvious predominance ofⅠ-type cell, and there was correlations with the contents of hormone. The disorder of endocrine- immunological network function possibly led follicle to develop abnormally, finally caused the development of the menopathy due to asthenia cold syndrome such as hypomenorrhea, delayed menorrhea, even algomenorrhea.2 Ccompared with the menopathy due to asthenia fever syndrome, the contents of E2, LH, T, P, FSH in patients with menopathy due to asthenia cold syndrome were lower, CD3~+CD4~+T, CD3~+CD4~+T/ CD3~+CD8~+T, Th1, Tc1 were higher, CD3~+CD8~+T, Th2, Th2/ Th1, Tc2, Tc2/ Tc1 were lower. The changes of those index was possibly one of the etiological factor of asthenia cold syndrome.3 The changes of those index before or after DWMJ treating menopathy of asthenia cold syndrome proved that there was close relations between development of the menopathy due to asthenia cold and polarity drifting ofⅠ/ⅡT lymphocytes, reproductive endocrine disturbance. DWM treated menopathy due to asthenia cold syndrome by regulating disordered endocrine-immunological network.