Dynamic Evaluation Of The Therapeutic Effect Of Chaihu Shugan San On Perimenopausal Syndrome Of Liver Depression Type

Objective:Chaihu Shugan San was used to treat perimenopausal women with liver depression syndrome.The changes of syndrome elements and sex hormone levels before and after treatment were analyzed.The therapeutic effect was observed dynamically,and the significance of dynamic evaluation of therapeutic effect in clinical practice of traditional Chinese medicine was discussed.Methods:1.Based on the National Standard Terms of Diagnosis and Treatment of the People’s Republic of China-Symptoms Part,23 patients with liver-depression perimenopausal syndrome were selected to collect the information of their condition by using the standardized four-diagnosis information collection form（Appendix 1）.2.Oral Chaihu Shugan San（decoction-free Chinese herbal granules）,add or subtract according to the symptoms.Four weeks after treatment,four visits were collected once a week,including five initial visits.3.The levels of E₂,FSH and LH were measured before and after the treatment.4.The health status identification system is used to convert the four diagnostic information into syndrome element integral.To analyze the pathology,pathogenicity and complications of liver depression type perimenopausal syndrome,and to observe the therapeutic effect dynamically.Results:1.General data:A total of 32 patients with liver depression perimenopausal syndrome who met the inclusion criteria were collected in the clinic.9 cases were lost,accounting for28.125%of the total.2.The location,nature and complications of the patients with liver-depression syndrome in perimenopausal syndrome:the first five symptoms of liver-depression syndrome were liver,gallbladder,uterus,kidney,half surface and half interior,in which the frequency of liver was significantly higher than that of gallbladder,uterus,kidney and half surface and half interior;the first five symptoms of liver-depression syndrome were Qi stagnation,blood stasis,heat,blood deficiency and Yin deficiency,in which the frequency of qi stagnation was more obvious than that of gallbladder,uterus,kidney and half surface and half interior.It is obviously higher than blood stasis,heat,blood deficiency and Yin deficiency.3.Dynamic evaluation of curative effect of syndrome:After the treatment of Chaihu Shugan San,（1）There was significant difference in the disease location score between the five diagnoses of liver and half surface and half mile（P<0.05）.（2）There was a significant difference in the disease integral of qi stagnation among the 5 diagnoses（P<0.05）.（3）There were significant differences in the severity of liver,gallbladder,half surface,half interior and kidney among the 5 diagnoses（P<0.05）.（4）There were significant differences in the degree of disease among the five diagnoses of Qi stagnation,heat,essence deficiency,cold,blood deficiency,blood stasis,Yin deficiency,phlegm and yang hyperactivity（P<0.05）.（5）There were significant differences between the first diagnosis and the second,third,fourth and fifth diagnosis of liver syndrome（P<0.05）.（6）There were significant differences between the first diagnosis and the second,third,fourth and fifth diagnosis of qi stagnation（P<0.05）.（7）There were significant differences in the degree of stagnation of liver syndrome between 1 and 3,1and 4,1 and 5,2 and 5（P<0.05）.（8）There were significant differences in the degree of qi stagnation syndrome between 1 and 3,1 and 4,1 and 5,2 and 5（P<0.05）.4.There was no significant difference in E₂,FSH and LH levels before and after treatment（P>0.05）.Conclusions:1.In addition to the liver,the perimenopausal syndrome of stagnation of liver type also includes miscellaneous gallbladder,uterus,kidney,half surface and half mile;besides Qi stagnation,it also has miscellaneous blood stasis,heat,blood deficiency and Yin deficiency.2.Chaihu Shugan Powder has better curative effect in treating perimenopausal period of liver depression type.3.There are slight differences in the dynamic evaluation of curative effect between the points of syndrome elements and the degree of syndrome elements,which complement each other and make the evaluation of curative effect more comprehensive.4.Chaihu Shugan Powder has no obvious improvement on sex hormone level in patients with liver depression type perimenopausal syndrome.