Analysis Of The Pathogenesis In Emotional Syndrome Study Of Progesterone And Allopregnanolone Fluctuations In Menstrual Cycle Of Premenstrual Dysphoric Disorder With Liver-Qi Reverse And Stagnation Syndrome

Research Purpose:The fluctuations of serum Progesterone(P4)and Allopreganaolone(ALLO)were evaluated in the follicular phase,early luteal and late luteal phase of premenstrual dysphoric disorder(PMDD)woman with liver-qi reverse syndrome and liver-qi stagnation syndrome.Based on the pathogenesis of emotional disorders in traditional Chinese medicine(TCM),combined with modern medical indicators,the specific diagnostic indicators of PMDD and the observation indicators of the differences in TCM syndrome types of PMDD were evaluated,in an attempt to explore and supplement the clinical diagnostic means of PMDD.Research Methods:Participants with PMDD were screened firstly by questionnaire,and then assessed by the Daily Record of Severity of Problems(DRSP)for two menstrual cycles.Finally,according to the TCM classification scale,the patients with liver-qi reverse syndrome and stagnation syndrome were selected.The P4,ALLO and other related hormone values were measured by ELISA in follicular phase,early luteal and late luteal phases of each subject within one menstrual cycle.The symptoms when blood collected were recorded according to the DRSP.Finally,the data were analyzed by SPSS software.Results:① The level of ALLO in follicular phase of PMDD women in menstrual cycle was higher than that in luteal phase(P<0.001),and there was no significant difference in the fluctuation trend between the two subtypes of liver-qi syndrome.In the control group,the level of ALLO in the late luteal phase was significantly higher than that in the early luteal and follicular phase(P<0.001).② There was no significant difference in the levels of early luteal and late luteal phases among the subjects in the liver-qi reverse group(P>0.05);The level of late luteal phase in the liver-qi stagnation group was significantly lower than that of early luteal phase(P<0.001).There was no significant difference in the early luteal phase level between the two groups(P>0.05),but compared with the liver-qi stagnation group,the ALLO levels in the follicular and late luteal phase in the liver-qi reverse group were higher(P<0.05,P<0.001).③ P4 level of P.MDD women during menstrual cycle remained low and steady,and the fluctuation trend had no significant difference between the two groups of liver-qi syndrome.However,P4 level in late luteal phase of the liver-qi stagnation group was slightly higher than that in the liver-qi depression group(P<0.05);In the control group,P4 secretion peak appeared in the late luteal phase(P<0.001),and the levels were higher than those in the liver-qi reverse and stagnation group(P<0.001).④ Compared with the control group,the two subtypes of liver-qi syndrome lacked the peak of E2 secretion in follicular phase.The E2 level showed an increasing trend from the follicular phase to the late luteal phase,but there was no significant difference upon statistical examination(P>0.05).Considering the long time for blood collection,it was greatly affected by the extremum.⑤ALLO,P4 and E2 had significant effects on the symptom "easily angry" before menstruation(P<0.01).There was no significant effect on the premenstrual body symptoms(P>0.05).Conclusions:Through literature review and clinical trials,the following conclusions were draw:① The decreased level of ALLO in the late luteal phase and the steady-state low content of P4 in menstrual cycle are one of the pathological states of PMDD women.However,the difference in fluctuation trends of P4 and ALLO between of liver-qi reverse and stagnation syndrome is not significant.②It has meaning to list ALLO as the observation index of PMDD in emotional disorders.Meanwhile,the difference of ALLO content in the late luteal phase between the two groups was obvious,using the ALLO level as the syndrome type classification index has certain foreground.