| ObjectiveThis research is in order to analyse the distribution and clinic syntrome of the Physicy of the Perimenopausal woman among Fujian,investigate the relationship between the common constitution type from the sociology, biology, psychology and clinical angles and estrogen receptor-α,βgene Polymorphism,observe the efficiency of the Chaihushugan Powder and liuweidihuang pill on the different gene,select the responsive gene of constitution type and provide individually intervention to prevent the perimenopause syndrome in basic research.Methods1. Classification and determination of constitution in TCM questionnaires that was promulgated by the China Association of Traditional Chinese Medicine were used in 630 perimenopausal woman to assess the constitution type and collect clinical datas,correlation coefficient, risk assessment and analysis of multivariate statistical analysis of the corresponding.2. Designing primers with Primer 3 Input network software, looking for Enzyme cut sites with Restriction Enzyme Site Mapper version 3 network software and Inspecting the estrogen receptor-αgene Polymorphism [rs2234693T/C,rs9340799 A/G], estrogen receptor-βgene Polymorphism [rs1256030C/T,rs3020444T/C] with the PCR-RFLP. Estimating haploid type frequency with SHEsis tool comparing the differnence of the comom constitution and multivariate Logistic regression analysis, etc.3. According to ERa, ERβpolymorphisms and constitution type of study,yin-deficiency constitution of perimenopausal woman is related with ERα-rs2234693-CC/TC,qi-depression constitution is related with Erβ-rs3020444-TT.Using simple random method,dividing the perimenopausal woman of yin-deficiency constitution Based on ERα-rs2234693 into two groups:23 TT gene type and 25 CC/TC gene type which are interved by liuweidihuang pill for 3months; dividing the perimenopausal woman of qi-depression constitution Based on ERβ-rs3020444 into two groups:24 TT gene type and 21 CC/TC gene type which are interved by Chaihushugan Powder for 3months and observing the curative effect.Results =5.671,P=0.017),other gene type in both two group didn't showed significant difference(p> 0.05);the the frequence of TT gene type in qi-depression constitution(85.7%) is more than in in-qi-depression constitution (74.2%) among Erβ-rs3020444-TT(x2=11.488,P=0.001),other gene type in both two group didn't showed significant difference(p>0.05);(3)Logistic regression analysis showed that the main risk fators of the yin-deficiency constitution contained pre-diabetes,45<～<50aged,ERa-rs2234693-CC/TC(P<0.05), after adjusting,the OR value of ERa-rs2234693-CC/TC is 1.465 (95% CI:1.055-2.035); the main risk factors of the qi-depression constitution contained negative stimulating,family relationship,marriage and ERβ-rs3020444-TT gene type (P<0.05), after adjusting, the OR value of ER(3-rs3020444-TT gene type is 2.252 (95% CI:1.425-3.559);(4)Among the constructing haploid type, the frequence of C-A gene type (rs2234693-rs9340799) in the yin-deficiency constitution (24.8%) is higher than in the in-yin-deficiency constitution (19.0%) (χ2=6.014, P=0.014), OR value of 1.406 (95% CI:1.070-1.845). the frequence of CC gene type (rs3020444-rs1256030) in qi-depression constitution (5.3%) in lower than in the in-qi-depression constitution(11.1%) (χ2=11.946, P=0.001), OR value of 0.449 (95% CI:0.283-0.714).3. (1) After intervention by Chaihushugan Powder for 12 weeks, the transformation mark of qi-depression constitution in ER(3-rs3020444-TT 61.80±17.46 before treatment than after treatment 46.16±15.26 decreased obviously and showed statistically significant(P<0.001);(2)After intervention by liuweidihuang pill for 12 weeks, the transformation mark of yin-deficiency constitution in ERα-rs2234693-CC/TC 63.75±18.55 before treatment than after treatment 51.71±15.22 decreased obviously and showed statistically significant(P< 0.001).Conclusions1. Distribution features of the TCM constitution in perimenopausal woman:type of constitution has diversified, among them with yin-deficiency constitution and qi-depression constitution as most common constitution; intersexuality constitution was found mostly,clinical characterization of Physical, psychological and social environment showed diferenence.It showed that it's necessary to focus on the mental anh physical healthy perimenopausal woman and the social environment issue and formulate the prevention scheme by individuality,in order to improve the health condition for perimenopausal women.2. C-A haploid type of ERa-rs2234693-rs9340799 was the most risk factor for the yin-depression constitution.ERa gene variance may be the hereditarily base of yin-depression constitution of the perimenopausal woman; C-C haploid type of ER(3-rs3020444-rs1256030 took a anti-part against depress. ER(3 gene variance may be the hereditarily base of qi-depression constitution of the perimenopausal woman. 1. (1)Distribution of the nine commom constitution in the perimenopausal woman ranged before six is yin-deficiency constitution(56.2%),qi-depression constitution(36.7%),blood stasisconstitution(35.6%),qi-deficiency constitution(20.2%),phlegm-dampness constitutio-n(14.4%),harmonical constitution(13%);(2)There are more intersexuality constitution in the perimenopausal woman, the rate of occurrence beyond 2% ranged by yin-deficiency and qi-depression constitution(14.4%),harmonical constitution(13.0%),yin-deficiency constitution(12.2%),blood stasisconstitu-tion(9.5%),qi-depression andyin-deficiency and blood stasisconstitution(8.7%),qi-deficiency and blood stasisconstitution(4.0%),qi-deficiency and phlegm- dampness constitution(3.8%),qi-deficiency and yin-deficiency constitution(3.0%),qi-depression and blood stasis constitu-tion(2.9%);(3) Compared with sex hormone level of the nine commom constitution in the perimenopausal woman, the blood stasis constitution E2 level is lower than the non-blood stasis constitution E2 level, has the significance difference, p=0.004; Gentle nature E2 is higher than the non-gentle nature E2 level, also has the significance difference, p=0.036; Has statistics significance;(4)T he rate of the occurrence of pre-diabetes in yin-deficiency(14.4%) is higher than in-yin-deficiency(8.3%),it showed significant difference;(5)T he rate of the occurrence of qi-depression is related with the negative stimulating, bad family relationship, introverted characted(p<0.05);(6)B lood stasis constitution showed significant difference in respect of emmeniopathy,Prehypertension(p<0.05);(7)P hlegm-dampness constitution showed higher incidence of overweight, hyperlipid-emia(58.2%,39.6%; p<0.05);(8) Hyperlipidemia in qi-deficiency constitution showed higher occurrence(25.2%,p< 0.05),qi-deficiency constitution is related with high education(p<0.05);(9)Aller gic constitution is qualitative mainly concentrated in 40<-< 45 age (60.0%,p< 0.05);(10)Harmonical constitution is related with other marrige and lower occurance of diabetes(1.2%,2.4%; p<0.05);(11)Age≥45 is related with yin-deficiency constitution,qi-depression constitution blood stasis constitution(p<0.05);(12)Brainwork whose income excess 2000 is closely related with qi-deficiency constitution and phlegm- dampness constitution (p<0.05).2. (1) Each group constitution type is suitful for the balance of Hardy-Weinberg.(2)χ2 segmentation showed the frequence of TT gene type in yin-deficiency constitution (44.1%)is lower than in in yin-deficiency constitution (53.6%) among Era-rs2234693(χ2 3. Accroding to the different gene type of ER-a and ER-β,we choose the clinical effective drug interention scheme for yin-depression constitution and qi-depression constitution of the perimenopausal woman.Then adjust the body and to observe the effect of the treatment.It show that personalized medicine in genomics approach is bebeficial to improve the effectiveness of drugs and also embodies the principle of applying proper therapeutic measures in lines with individuality.
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