The Study Of The Relationships Between Epidemiology Study, The Physical Constitution Analysis And Endocrine Study On Menopausal Syndrome.

Melancholia is one of menopause symptoms, which cause mental depression disorder on women during menopause stage. WHO (World health organization) believes Hypochondria is one of three main diseases in twenty-first century. As women reached to their menopause stage, hypothalamus ( HPO-axis ) is changed and cause ovary function decline and weaken due to old age;plus hormone glandular excretion is reducing;all of these lead to a serial of symptoms and signs. At same time, due to family problem and social problem also impact to their psychological balance and combine with their body cycle changing, it further creates stress to their mental stress and result in mental disorder. In general, Hypochondria menopause symptoms is under human biology, psychology to sociality medical norm;it cause server problem to more and more women nowadays. Hence, more medical researches & clinical experiment are important to find out the common symptom of this disease. This study is consisted with three parts. There are historical medical research, epidemiology investigation and clinical research. First, historical medical research is looking at past 20 years medical records (1985-2004), by using Chinese medicine remedy and its action mechanism, reorganizing the menopause melancholia correlation theory and the findings. Epidemiological studies of the Taiwan region, investigating and exploring factors related to female menopause clinical epidemiological research and analysis. Last, clinical research is a random sampling 60 cases of female menopause depression case studies, by giving my personal special and careful planning of Chinese medicine prescription of " Banxia-houbu tang" , following up the research on the effect of remedy.First, Historical medical research part:Objective: To research, sort and analyze historical medical article between year 1985 to 2004 on the female menopause melancholia as references, so as to the understanding how effective Chinese medicine for the diagnosis and treatment to female menopause melancholia. From this baseline, which will lead to future more researches.Methodology: By taking information from The Chinese Periodical website, Taiwan Postgraduate website, Taiwan area correlation medicine magazine, Pub Med, Med line and Cochrane library and so on as the search information bank;searched for any medical reports or article which was ever published during 1985 to 2004 from above mentioned medicine magazine and website, concerning to the female menopause melancholia by using Chinese medicine treatment. Reorganized and analyzed these related articles its goal, the result of its research and the action mechanism be a baseline.Result: By entering keywords in both Chinese and English languages, " Perimenopausal depression disorder, climacteric depression and herb and/or Chinese medicine" as selection method, plus evidence-based medicine, EMB);both methods were resulted in collection of total 29 reverent articles, collate the results as shown in table 2.1. This database covers Chinese and English search of the medical literature related to important databases, but the female menopause to Chinese medicine treatment of depression related literature, but relatively few, most literature come from to the domestic scholar.Based on evidence-based medicine, EBM technique to screen medical research methodology, which is more accurate and fully cover wide range of medical articles. Including quantitative and qualitative nature of the research in animal experiments and human clinical research, including areas: epidemiology studies, psychological endocrine research, proprietary Chinese medicine herbal medicine alone study, acupuncture research, psychological therapy research;psychotherapy. In the collection of literature to Chinesemedicine treatment of female menopause depression study, it was discovered that there was no proper or effective treatment method from current medium scale of medical center. However, the majority of the study shown a lot of researches are going on which is a good sign. Secondly, epidemiology investigation:Objective: to surveys and analysis of female menopause depressionepidemiological at the Taiwan area, so as to discusses and analyzes its correlation factor as a baseline reference to the public health and disease preventing and controlling board.1. Methodology: Survey form of female menopause clinical and epidemiological behavior questionnaire and BDI-II clinical form was given. The questionnaire is divided into four parts, the first part is basic personal data, second part is menstruation and related disease historical medical record, third part is taking hormone medicine experience, forth part is menopause syndrome questionnaire. And patients were also given Beck depression forms (BDI-II clinical test) ratio and surveying on the degree of suffering from severe depression.2. Numbers of survey given: The numbers of surveys given was 2, 300 sets, it was based on the prediction on Taiwan year 2300 future total population and sampling 1 in 10,000 population on sunburn and urban area.Result: 2,300 questionnaires were sent out;796 questionnaires were effective recovery, the recovery rate 34.61%. BDI-II clinical test showed no trace of female menopause depression was rated for 82. 70%, with the ratio of female menopause depression 17. 30%. According to BDI-II clinical test score from mild, moderate and severely depressed the epidemiological investigations was analysis - the Taiwan region female menopause depression, according to the degree of suffering the results are : mildly 10.48%, moderated 4. 80% and the severely degree 2. 02%, the combined total percentage of 17.30%. In addition, based on their body physical evidence-based analysis, respectively 1. Normal qualitative 23.4%. 2. Late cold quality(quality of Yangxu) 19. 1% 3. Dry red quality (quality of yinxu) 23. 6%. 4. Tired indistinct quality (quality of cixu) 14.2% 5. Though sluggish quality (quality of shizuon) 8.4%. 6. (quality of Xueyu) 11.3%.The descriptive statistics questionnaire results are as follows : The average age is about 51.29 + 4.86 years;Marital status, accounted for 86.5% of married, unmarried 6.34%, divorce or widowed is 7.40%;education level, the following countries (including secondary, primary and non-literacy) accounted for32. 36%, accounting for 37.20% of high school level, graduated is accounted for more than30. 45%;employment status, civil service accounts for 17.93%, business accounted for 18.59%, , housewife accounting for28. 53%, medical staff accounted for 0.52%, blue collar is accounted for 34.42%;residential areas, accounting for 24.68% of Taipei District, North accounted forl2. 86%, accounting for 22. 73% of the Central district, accounting for 18. 96% Southern District, Kaohsiung-Pingtung area is accounted for17. 79%, representing the Eastern 2.98%;Constitutions, accounted for23. 4% of normal quality, late cold quality (quality may Yangxu) accounted for 19.1%, dry red quality (quality of Yinxu) accounted for 23. 6%, tired indistinct quality (quality of cixu) accounted forH. 2%, get sluggish quality (may shizuon) 8.4%, opaque quality (quality of Xueyu) accounted forll. 3%. After certification by the relevant statistics, found that female menopause depression degree is correlated with these factors, such as educational level, occupation, place of residence, health, the availability of chronic disease or menopause. Thirdly: clinical researchThe assessment of female menopause depression clinical efficacy by giving Chinese medicine prescription assessment: Objective:Taking 60 clinical cases, take Banxia-houpo Decoction as comparisongroup carries on the prescription "female menopause diagnosed side" clinical efficacy assessment to understand the "female menopause diagnosed side" of the efficacy of the female menopause depressionMethodology:1. Sampling 60 cases of female menopause depression, and random distributioncontrast, Group A is used " Banxia-houpo Decoction " and Group B "femalemenopause diagnosed side" approach to medicinal drugs per person twice per day, dosage is 180ml, duration is six-week treatment. By using Beck depression form (BDI-II Depression Scale) to measure before and after treatment and endocrine changes as efficacy assessment.2. Samples acceptance and Rejection conditions (1)Acceptance conditions:? Female, age 45- 65.? With Female menopause Kupperman index symptoms.? BDI-II Depression Scale scored more than 14.? Without any hormone treatment table 3 months before experimental studies(2)Rejection condition:? Premature senility of menopause? Suffering from major diseases, such as cancer? Incomplete case study.? Taken any hormone treatment 3 months before experimental studies started.Result:Beck depression form ((BDI-II Depression Scale)Before treatment, the former two forms of treatment Beck (BDI-II Depression Scale) score measurements are : "Banxia-houpo Decoction" Group (Group A) 26.03 (±7.52), "female menopause diagnosed side" (Group B) 22.90 (±5. 98). And, Beck depression treatment methods (BDI-II Depression Scale) score measurements for comparison between groups, P values are greater than 0.05 (ie. P>0. 05), which can be concluded that Group A and, B groups should come from same home groups, and no significant differences between the two groups. The relationship with the endocrine is:Before treatment, both groups of FSH endocrine therapy (mlU/ML), LH (mlU/ML), E2 (pg/ml) measurements are : " Banxia-houpo Decoction Group" (Group A) : FSH 52.27 (±33.58), LH 21.86 (±13.14), E2 30.96 (±16.93);"female menopause diagnosed side" (Group B): FSH 57. 90 (±41. 57), LH 25.13 (±15.77), E2 24.26 (±13.18);Comparison between two groups endocrine therapy FSH, LH, and E2 measurements, all P values are greater than 0. 05 (ie. P>0. 05), which can be concluded that Group A and B should be from the same home groups, and no significant differences between the two groups. Clinical research finding shown, "female menopause diagnosed side" and Banxia-houpo Decoction Group" under each type of treatment cards, the total efficiency respectively 63. 30% and 76.70%, and compared the results of treatment : " Banxia-houpo Decoction Group" Group BDI-II score declined 5. 70 (±6.24), and its treatment before and after has resulted in P values less than 0.05 (P<0. 05). There is a significant difference;"female menopause diagnosed side" group BDI-II score declined 5.47 (±2.54), its treatment before and after has resulted in P values less than 0. 05 (P<0. 05). There is a significant difference.This results indicate that both " Banxia-houpo Decoction Group" and "female menopause diagnosed side" are valid, but there is no significant differences between the two types of treatment efficacy.Before and after treatment the Endocrine record was changed. The " Banxia-houpo Decoction Group", FSH treatment before was 52.27 (±33.58), after treatment was 44. 58 (±30. 66), and the difference for before and after was 7.69 (±5.46), Group treatment has P<0.05, result in significant differences;LH treatment before was 21.86 (±13.14), after treatment was 18. 28 (±10. 41), and the difference for before and after was treatment 3. 58 (±3.40), group treatment has P<0. 05, result in significant differences;E2 treatment before 30.96 (±16.93), after treatment 38.62 (±19.21), the Group before and after treatment compared P<0. 05, reaching significant differences;"female menopause diagnosed side" FSH treatment before 57.90(±41. 57), after treatment 51. 33 (±39. 57), treatment and more 6. 57 (±5. 00), Group treatment and more P<0. 05, reaching significant differences;LH treatment before 25.13 (±15.77) treatment 21.78 (±13.25), and more treatment 3.34 (±4.45), Group treatment and more P<0. 05, reaching significant differences;FSH/LH treatment before 2.13 (±0.48), treatment 2.07 (±0.71) treatment and more 0.06 (±0.36);E2 treatment before 24.26 (±13.18), treatment 30.83 (±17.55), and more treatment 6.57 (±6.10), Group treatment and more P<0. 05, reaching significant differences. The results indicate that "female menopause diagnosed side" and " Banxia-houpo Decoction Group" under card-based treatment of female menopause depression, respectively, after their treatment endocrine changes FSH decline, LH decline and E2 rise;both results were effective and without any significant differences between these two types of treatment efficacy. Clinical research conclusions:1. Beck depression forms (BDI-II clinical test) :Both groups before treatment, Beck (BDI-II Depression Scale) score measurements are : * Banxia-houpo Decoction Group(Group A) 26.03 (7.52), "female menopause diagnosed side" (Group B) 22.90 (5.98). After treatment, Beck depression treatment methods (BDI-II Depression Scale) score measurements for comparison between groups, P values are greater than 0. 05 (ie. P>0. 05), which can be concluded that both groups should be from the same home groups, and there is no significant differences between these two groups.2.Clinical research targets: Research target based on above mention acceptance and rejection condition requirement, 60 female menopause depression patients were chosen for Taichung Taiwan, Changhua modern Chinese medicine clinic jointly. Based on randomly selection, patients were divided into two groups A and B. The statistical comparison between the two basic conditions (age, marital status, educational attainment, stopped by age, course of disease), the result is not significant statistical differencebefore treatment, and both Group A and B should come from the same home group.3. BDI-II scores and hormone FSH, LH, and E2 comparison T-test before treatment between two groups , both groups did not reach significant standards. And both group A and B female menopause depression level on hormone FSH, LH, and E2 levels were not changing statistical differences.4. By using Pair T-test to estimate and compared before and after treatment on Banxia-houpo Decoction Group(Group A) and BDI- II scores and the results of hormone measurements;the differences on Banxia-houpo Decoction (Group A) and the treatment, BDI- II scores and more hormone measurements, the results of the p value less than 0.05%, it' s shown remarkable differences after treatment. And clinical efficacy and efficiency level is 63.30%.5. Female menopause diagnosed side (Group B) treatment BDI- II scores and the measurement of results, such as hormone as below : Pair t-test methods is used to estimate comparison group differences in treatment and female menopause diagnosed side (Group B) and, BDI- II scores and hormone measurements, the results of the p value less than 0. 05%, that is remarkable differences after the treatment. And clinical efficacy and efficiency level is 76.70%.6. Both group after treatment result, the BDI- II scores and measurements of hormone results are as follows : Using independent sample t tests comparing estimates of the differences between the groups, both before and after treatment, BDI- II scores and hormone measurements compare differences between groups, the results are greater than the value of its p 0. 05, it is shown not significant differences between these two treatments. From the above analysis : Banxia-houpo Decoction and female menopause treat are both effective on clinical treatment of female menopause depression, however it does not have any significant differences between the two efficacy. Both effective level are the same.ConclusionWith five years on the Chinese medicine treatment study on female menopause depression, this research was mainly to integrated regulatory mechanismsthat analysis could serve as clinical treatment and research topics of female menopause depression reference.Expecting the results of this study will provide more clear picture on the impact on female menopause depression and its epidemiological factors related topics;and help medical staff to understand the importance on early intervention to deal with high-risk groups suffering from depression, for menopause women's psychological and physical health.