| Objective:Based on the literature study of the development and evolution of Aub-o theory of diagnosis and treatment in ancient times and combined with modern clinical data,the clinical features,etiology and pathogenesis,syndrome types of TCM and their relationship with related pathogenic factors of AUB-O were reconsidered.It provides more AUB-O reference and new dialectical thinking for clinical diagnosis and treatment.Methods1.Based on the Chinese medical code and collecting ancient medical books,using the research methods of Chinese medical philology,the traditional Chinese medical literature on metrorrhagia,the advanced menstruation,menostaxis,intermenstrual bleeding and excessive menstruation was systematically collected and sorted out,the clear venation of the disease name,clinical features,etiology,pathogenesis,syndrome differentiation and treatment is put forward.2.The distribution of risk factors and bleeding pattern of AUB-O was studied by collecting standard AUB-O cases through clinical investigation.3.Through collecting clinical data of AUB-O cases,the distribution of common TCM syndromes of AUB-O was summarized by cluster analysis.4.To investigate the relationship between TCM syndrome types and clinical characteristics of AUB-O patients by investigating clinical and medical history data.Results1.Literature study: abnormal bleeding caused by organic diseases and other diseases can not be excluded,but the main trend is abnormal uterine bleeding due to ovulation disorder.1.1Ancient doctors believed that uterine bleeding can occur at any age,to menstruation will come and menstruation will dry when commom.The etiopathogenisis and pathogenesis of the disease have their own emphasis and are constantly developed and perfected.The ETIOPATHOGENISIS can be summarized as loss of daily living,internal injury due to emotional disorder,the six evils of the exogenous,and blood stasis and phlegm,it involves the damage of the liver,spleen and kidney,resulting in thoroughfare-conception meridian,heat forcing blood to act falsely,and stagnation of blood stasis,and so on,which can see that deficiency and excess should be identified first in syndrome differentiation,and that the more complete differentiation of symptoms and signs should be based on the non-hiding of blood in the liver,deficiency of the spleen,deficiency of vital energy,blood-heat and blood stasis,etc,and the treatment method is nothing but according to the age of "Arrest of bleeding,Clarification of cause and Recovery of health" method,and gradually form the treatment view of juvenile should tonifying soothing the kidney,middle-aged tonifying spleen.1.2In the Jin and Yuan Dynasties,doctors of all generations began to focus on the introduction of the advanced menstruation,menostaxis,intermenstrual bleeding and excessive menstruation,the advanced menstruation is the most discussed,excessive menstruation more than the advanced menstruation to be discussed,intermenstrual bleeding is not discussed.In the Song dynasty,there was a relatively clear view about the advanced menstruation.The name of the advanced menstruation began to be widely used in the Ming dynasty,"jing shui advanced","Jing Zao" scattered in various books,gradually began to separate the discussion,and excessive menstruation is mostly described as a symptom in menstrual disease,Liu Wansu began to discuss it as a separate disease,concluding that the causes of menses include pathogenic fire,anjer and worry about internal injury,heat-fire hyperactivity,fatigue,misuse of hot and pungent drugs,and excessive phlegm in the Constitution,the pathogenesis is blood-heat,deficiency of qi,deficiency of heat and phlegm-dampness,and the syndrome differentiation based on this is blood-heat caused by excess yang,deficiency of Yin or stagnation of liver-qi,deficiency of spleen-qi and deficiency of kidney-qi,deficiency-heat,blood-stasis and phlegm-dampness.The main pathogenesis of menostaxis is imbalance of qi and blood in viscera.The pulse and the Ren Pulse are unstable,losing control of the meridians and blood.2.The age of 256 AUB-O patients was concentrated in childbearing age and perimenopausal period;BMI ranged from 18.5 to 24.9;The top three occupational cases were unemployed,self-employed and technical personnel;Education background is concentrated in undergraduate;The bleeding pattern was concentrated in irregular vaginal bleeding.3.The clinical common evidence types of AUB-O patients are divided into four categories.The most common clinical syndromes of AUB-O patients were kidney yang deficiency with liver depression,accounting for 41.4%,followed by kidney yin deficiency with damp heat(20.7%),spleen kidney yang deficiency(19.5%),qi deficiency and blood stasis(18.4%)4.The relationship between TCM syndromes and clinical characteristics in AUB-O patients:4.1 Age: The type of deficiency of spleen-yang and kidney-yang was the largest,the type of deficiency of qi and blood stasis and the type of deficiency of kidney-yang and stagnation of liver-qi were the second.The type of damp-heat due to deficiency of kidney-yin is the youngest,and the difference was statistically significant.4.2 BMI: the number of pregnancies and births,the number of abortions: There was no statistical significance in BMI,the number of pregnancies and births,the number of abortions among different AUB-O patients.4.3 Physical strength: the whole physical condition of qi deficiency and blood stasis type was better than that of kidney yin deficiency with damp heat type,and the whole physical condition of kidney yang deficiency with liver depression type was better than that of qi deficiency and blood stasis type,with statistical purport.4.4 Occupational physical activity: the whole occupational physical exertion of kidney yang deficiency with liver depression type was lighter than that of qi deficiency and blood stasis type,with statistical purport.4.5 Physical exercise: The overall physical strength of kidney-qi deficiency and blood stasis type is better than that of kidney-yin deficiency and damp-heat type,and kidney yin deficiency with damp heat type and Qi deficiency with blood stasis type take the second place,with statistical purport.4.6 Staying up late: There was no statistically significant difference between different AUB-O patients in staying up late.4.7 History of abnormal uterine bleeding in mothers: There was no significant difference in maternal history of unusual uterine bleeding among different AUB-O sufferer.4.8 Course of disease: There was no statistical significance in course of disease among patients with different AUB-O.4.9 Previous menstrual period and period: there was no purport difference in former menstrual cycle and period among different AUB-O patients.5.Treatment of AUB-O patients:52.3% of the patients chose integrated traditional Chinese and western medicine.Conclusion1.The diagnosis and treatment theories of uterine bleeding,premenstrual period,prolonged menstruation,menorrhagia and bleeding between menstrual periods in ancient books and literatures have experienced the process of origin,development and innovation.The etiology does not exclude the pathological products of exogenous six evils,seven emotions and internal injuries,loss of daily life and phlegm and blood stasis.The pathogenesis is Qi and blood imbalance or phlegm dampness and blood stasis,which affects the viscera,Chong Ren is not solid,and menstrual blood acts recklessly Blood stasis,phlegm dampness and viscera syndrome differentiation.2.The main syndrome types of 256 AUB-O patients were as follows: Kidney-Yang deficiency combined with liver stagnation,Kidney-Yin deficiency combined with dampness-heat,Spleen and Kidney-Yang deficiency,Qi deficiency and blood stasis.3.Modern described AUB-O remained roughly the same in the etiology and pathogenesis,clinical characteristics and ancient books,except are virtual,heat,blood stasis,deficiency,heat and blood stasis were not excluded in the differentiation of symptoms and signs,etc.is a rare purely empirical,nowadays the AUB-O card is relatively complex,kidney sun be the spirit deficiency and liver depression syndrome is common.4.AUB-O patients with spleen kidney yang deficiency were older.AUB-O patients with kidney-yin deficiency mixed with dampness-heat were younger and had poor physical strength.AUB-O patients with kidney-yang deficiency combined with liver depression had less physical work and more physical exercise,it can guide the diagnosis and treatment in clinic,and is beneficial to the propaganda and education of patients.In clinical practice. |
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