Relationship Between PMS And Psychological Stress Based On ASLEC And TSST And Its Pathogenesis

ObjectiveWith the continuous development of social, the role of women in society, family and the role switching among them have turned into invisible preaaure, which has an increasingly serious effect on their physically and mentally. Premenstrual syndrome (PMS), belonging to the category of physical and mental diease, is a group of syndrome associated with menstruation period, showing as mental mood, body discomfort, and behavioral change.Recent worldwide epidemiological surveys show that incidence of PMS rises year by year, and has the tendency of moving from child-bearing perod to younger age groups.In combination with clinical practice, this disease is always neglectd by the majority of women owing to the periodic self-healing and unbvious characteristics, that is why the consultation rate is low, while the incidence is relatively high. Premenstrual anxiety disorder (PMDD) is a severe form of PMS, which can seriously influence a woman’s state of mind, the quality of life, and even lead to the tendency of violence and suicide, and becomes one of the high risk factors influencing social instability.This study intended to PMS as the breakthrough point, on the one hand, assessing the chronic psychological stress state, based on ASLEC; on the other hand, on the basis of TSST, which can cause the participants subjective and objective laboratory indexes change. On the codition of simulated acute psychological stress state, we probe into the etiological correlation between PMS pathogenesis and psychological stimulation, from the perspective of acute or chronic psychological stimulation, and explore further the inner pathogenesis of Chinese and Western medicine, providing certain theoretical basis for clinical prevention and treatment of the disease.At the same time, we grope for new targets in Chinese and Western medical science, though further studying related warning factors.Chaper 1 Clinical Research Analysis of 276 cases of PMS status of female college students in school Materials and methods1 Subject object:female college students in school of Beijing university of Chinese medicine, Beijing normal university.2 Methods:to fill in the "PMS status questionnaire" (including the general situation of subjects, menstruation, PMS diagnostic criteria of western medicine, Chinese medicine liver depression and qi stagnation syndrome diagnostic criteria), and the beck depression inventory (BDI), "beck anxiety inventory (BAI), Jane’s eysenck personality questionnaire (EPQ-RSC) and the college students’ life events scale (ASLEC).3 Criteria for the diagnosis3.1 Western medicine diagnostic criteria:set with reference to the American society of obstetrics and gynecology (ACOG) standard for the diagnosis of PMS.3.2 Traditional Chinese medicine liver depression and qi stagnation syndrome diagnostic criteria:refer to the TCM industry standard of the People’s Republic of China "standard of diagnosis of disease and curative effect of traditional Chinese medicine".4 Statistical analysisUsing SPSS17.0, the chi-square test, One-way ANOVA statistical analysis of testing and the participation.Results1 The incidence276 female college students in school, PMS,116, accounting for 42.03%.Among them, 94 liver depression,81.03%, of the person that liver depression is 22, accounting for 18.97%.Healthy volunteers,160, accounting for 57.97%.2 The premenstrual syndromeIncidence of PMS symptoms of liver depression is higher than the PMS of liver depression is higher than that of healthy women.Visible, the PMS liver depression and qi stagnation group of patients under more before the premenstrual symptoms.3 The scores of BDI and BAIPMS liver depression is higher than that of healthy women, with significant difference (P< 0.05), the PMS liver depression is higher than that of the PMS without liver depression, but no statistical difference (P> 0.05).4 EPQ-RSC personality dimensionsNeurotically, PMS patients with liver depression patients not high in patients with liver depression and healthy women (P< 0.05);Outgoing dimensions, healthy subjects was the PMS high liver depression and the PMS of liver depression group (P< 0.05);Mental quality, masked the two dimensions of three groups was no significant difference (P> 0.05).5 The score of ASLECPMS liver total score and each factor score were higher than the PMS without liver depression and healthy women, and the PMS liver depression and healthy women between differences statistically significant (P< 0.01), one of the biggest influence each participant factors are learning stress factors.Conclusion1 The incidence of PMS in the is higher in female college students in school groups, should cause enough attention.2 TCM syndrome types of PMS with liver depression and qi stagnation syndrome is given priority to, but not the liver depression and qi stagnation syndrome also occupies certain proportion, treatment in addition to the notice from the liver treatment, still cannot be ignored for other pathogenesis treatment.3 The PMS female college students with high neuroticism-introverted personality traits, clinical should pay attention to the recognition of the high-risk groups.4 Patients with PMS in certain depression, anxiety state of mind.5 Te PMS patients feel more negative life events, and more stress on the life events.Chapter 2 Based on college students’life events scale (ASLEC) mechanism of PMS and the correlation between chronic psychological stress and disease Materials and methods1 Subjects:female college students ofBeijing university of Chinese medicine, Beijing normal university.2 Early screening and grouped by filling in the PMS status questionnaire, Jane’s eysenck personality questionnaire (EPQ-RSC) screening of eligible subjects.3 Subjects into and grouped according to the PMS western medicine diagnostic criteria, diagnostic standard, TCM syndrome type and exclusion criteria, at the same time the introduction of EPQ-RSC neuroticism (N) score, according to the standard will be included in the patients were divided into the PMS liver depression group (N is higher than the norm), not to change the PMS group (N is lower than the norm) and healthy controls (N from low to high).4 Research methods4.1 Scale4.4.1 All fill in the object into the group of the PMS group of liver depression, the PMS of liver depression and healthy controls.4.1.2 Fill in time phase into the group after the first menstrual cycle of follicle and corpus luteum middle-late late.4.1.3 Scale selection fill in the from of the TCM symptom observation table "(include liver depression and qi stagnation and liver anaemia empty performance, a total of 35), the daily symptom severity watch list (DRSP) (for the currently accepted can reflect the severity of symptoms in patients with PMS international scale), BDI, BAI.4.2 Laboratory index determination4.4.1 Test object with scale.4.1.2 Testing phase in the group after the first menstrual cycle of follicle and corpus luteum middle-late late in TSST tests on the same day.4.1.3 The choice of test indicators into the group of participants in the detection phase 8 to 9 a.m. blood fasting blood, detection of serum estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), angiotensin-2 (ANG-2), glucocorticoids (GC), called S100B protein, blood thin element (LEP) and brain derived neurotrophic factor (BDNF) levels.5 Statistical methodsWith SPSS 17.0 software, using the chi-square test, one way ANOVA, and parameter test, rank and inspection, Pearson correlation analysis and multiple linear regression analysis method for statistical analysis.Results1 Score table of the TCM symptom observationPMS liver depression group and the PMS of liver depression scores were significantly higher than in corpus luteum middle-late late ovarian follicles (P< 0.05) and healthy controls during the two comparison there was no significant difference (P> 0.05).2 Score of DRSPPMS liver depression than not to change the PMS group is higher than the healthy subjects, and the PMS daily rating of liver depression group were significantly higher than that of healthy controls (P< 0.01).3 Score ofBDI and BAI PMS liver depression group of BDI and BAI in corpus luteum period is significantly higher than late ovarian follicles (P< 0.05).4 Sex hormoneE2, Prog level in the late follicular significantly below corpus luteum period, E2/Prog in corpus luteum middle-late late ovarian follicles significantly lower (P< 0.05);FSH and LH levels were significantly higher than that of corpus luteum middle-late in the late ovarian follicles (P< 0.05);PRL level PMS liver depression group is higher than the PMS of liver depression group, not to change the PMS group is higher than the healthy controls, and PRL levels significantly below corpus luteum middle-late late ovarian follicles (P< 0.05);T in each periods between the difference was not significant (P> 0.05).5The correlation between ASLEC and the TCM symptom observationBetween groups in luteal phase correlation between TCM symptoms and various factors of ASLEC points may establish the regression equation of the stability.6 The correlation between ASLEC and PRLPMS liver depression group and other factors and PRL has significant positive correlation (r=0.409) and healthy controls the other factor and the P exists significant negative correlation (r= 0.464), not to change the PMS group health adaptation factor and testosterone exist significant negative correlation (r=0.903).7 The correlation between ASLEC and S100B Healthy control group called S100B suit with total scores of ASLEC, learning pressure factor, health factor, there is a significant negative correlation between (r= 0.399, r= 0.399, r=0.398).8 The correlation between ASLEC and personality traits The score of ASLEC, interpersonal relationship factor, learning pressure factor there is significant positive correlation with neuroticism.(r=0.361, r=0.361, r=0.315).Conclusion1 PMS in corpus luteum middle-late patients show the obvious liver pathogenesis, liver blood deficiency symptoms, and compared with the late follicular symptoms volatile.2 The onset of PMS and closely related to the main pathogenesis is liver storing blood.3 Chronic psychological stress with the onset of the PMS has certain relevance, its possible mechanism forchronic psychological stress activated hypothalamic-pituitary-adrenal axis, affect the physiologicalfunction of the hypothalamus-pituitary-ovarian axis, through higher PRL expression to influence thepathogenesis of PMS.4 S100B protein is not for evaluating the PMS pathogenesis and prognosis of early warning factor.Chapter3 Based on social pressure test trier (TSST) acute psychological stress associated with PMS pathogenesis and mechanism of a preliminary study Materials and methods1 The object of study:from the Beijing university of Chinese medicine, Beijing normal university.2 Grouping:the same as chapter 2.3 Research methods3.1 All test objects into the group of the PMS group of liver depression, the PMS of liver depression and healthy controls3.2 Test subjects into groups after the first phase of the menstrual cycle follicle and corpus luteum middle-late late (28 days menstrual cycle, for example, respectively, for the period of 11-13 days,22 and 24 days, if the period of 28 days, subject to BBT).3.3 TSST of implementation3.3.1 Stress will be 0 minutes before try into the experiment room 1, the participants in the resting state, the determination of physiological index of resting state, heart rate, skin temperature, etc.To complete the extraction of saliva samples for the first time.3.3.2 Rainfall distribution on 10-12 stress 0 minutes after the participants were taken to the experiment room 2,5 minutes+complex proposition speech mental arithmetic task, after the completion of the task to complete the extraction of saliva samples for the second time.3.3.3 Stress were back to 10 minutes after the experiment room 1,10 minutes after the task, to complete the third extract saliva specimens.3.3.4 Stress after 20 minutes the participants within 20 minutes after the task, finish fourth saliva sample extraction.3.4 Determination of saliva index using the method of ELISA salivary estradiol (E2), testosterone (T), of progesterone (Prog), saliva cortisol (CAR), saliva amylase (sAA).4 statistical methodsWith SPSS 17.0 software, the use of repeated measurement double mixed design analysis of variance, Pearson correlation factors were analyzed.Results1 TSST stimulating salivary estradiol (E2) changes E2 in TSST spurred by grouping and menstrual phase difference (P> 0.05), but stress the edges of the phase differences, stress 0 min, stress after 20 min of E2 levels significantly below 0 min before the stress of the baseline values (P<0.05).2 TSST spurred by saliva changes of progesterone (Prog) Prog under the stimulus TSST grouping and stress phase difference (P> 0.05), there is only the menstrual phase difference:the level of the corpus luteum middle-late late follicle significantly higher (P< 0.05).3 TSST stimulating salivary testosterone (T) T under the stimulus TSST grouping, menstrual cycle phase and the main effects and interaction of stress stage (P> 0.05).But the falling trend exists in the process of acute psychological stress.4 TSST stimulating salivary cortisol (CAR) The CAR under the stimulus TSST grouping, menstrual cycle phase and the main effects and interaction of stress stage (P> 0.05).But the falling trend exists in the process of acute psychological stress.5 TSST spurred by saliva Amylase (alpha Amylase, sAA) changes SAA under TSST stress phase differences (P<0.05), but no and grouping, menstrual phase of the main effects and interaction (P>0.05).The sAA concentration appear 0 minutes after peak stress, and stress before 0 min,10 min after stress, stress after 20 min was statistically difference (P<0.05).Conclusion1 TSST can effectively induce acute psychological stress state.2 PMS closely associated with acute psychological stress, the possible mechanism for the stress HPAA and ANS activation, secrete more Saa, affect HPOA function, resulting in a decline in E2 level and lead to the female progesterone physiological ratio imbalance.