| ObjectiveBy surveying and analyzing the syndrome type,constitutional type characteristics,symptoms severity and other factors of the menopausal syndrome in Hong Kong region,this study aimed to understand the distribution of the syndrome type,constitutional type and symptoms severity of the menopausal syndrome in Hong Kong region.Through identifying the common syndrome types and constitutional types of the disease,the correlation of them was investigated.The relationship between the influencing factors and the common syndrome types,symptoms severity of the menopausal syndrome were also investigated.Hopefully,this study would increase our knowledge about the disease,and improve the efficacy of chinese medicine in treating it.MethodsThe convenience sampling survey method was adopted in this study.The subjects of the study were the patients of Tung Wah Hospital Chinese Medicine General Outpatient Clinic which were diagnosed as menopausal syndrome within January to December 2016.Based on the diagnostic criteria,inclusion criteria and the exclusion criteria,283 female patients aged 40 to 60 were included in the study.With the informed consent of the patient,an on-site interview was carried out using the Hong Kong Region Menopausal Symptom Patient Demographic and Symptoms Questionnaire,Constitution in Chinese Medicine Questionnaire and modified Kupperman Index.After the questionnaire was completed,the interviewer would carefully examine the content.In case of scratchy answers,incomplete answers or inconsistency,the interviewee would be asked to clarify or provide more information.The Microsoft Office 2007 Excel was used to make the database.The questionnaires collected were coded and the data were analyzed by SPSS 17.0.Count data was described in percentage,and the measurement data was described in mean ± standard deviation.Pearson’s chi-squared test or Fisher exact test was applied for count data comparison.ANOVA or Kruskal-Wallis rank sum test was applied for measurement data comparison.Unconditional stepwise logistic regression was applied for multivariate correlation analysis.The distribution of the symptom type,constitutional type,symptoms severity of the menopausal syndrome patients were analyzed.The findings of these three items were compared with different influencing factors respectively and the results would be the reference for the prevention and the management of the menopausal syndrome.Results1.A total of 283 women with menopausal syndrome were included in the study.The mean age of the subjects was found to be 51.51 ±4.36 years and most of them were in the age group 50-54(40.28%).Most of the subjects were of education level of secondary/matriculation(50.88%),and 35.34%of them were of bachelor degree or above.Most of the subjects were of normal BMI(73.14%),and the mean was 22.58 ± 3.0.Most of the subjects occasionally did physical exercise(58.66%),while most of the them were of moderate stress level(59.72%).2.For the menstruation condition of the subjects,108 of them were still having menstruation(38.16%),156 of them had their menstruation naturally stopped(55.12%)and 19 artificially stopped(6.71%).The mean age at menopause was 49.56 ± 3.30 years and most of them were in the age group 50-54 and 45-49(159 subjects,90.86%).The mean duration of the menopausal syndrome was 2.72±2.41 years.While most of them were of 1-3 years(37.46%),less than 1 year was the least(25.44).3.For the severity of menopausal symptoms of the subjects,most of them were of moderate level(53.36%),37.81%of them were of mild level,while those of severe level were the least(8.83%).The mean score of the modified KI was 22.54±6.25,which was moderate.The prevalence of the symptoms of the Modified KI in descending order were:fatigue(94.70%),sweating hot flushes(92.58%),nervousness(92.23%),arthralgia or myalgia(91.17%),insomnia(90.46%),headache(72.79%),vertigo(67.13%),paresthesia(63.60%),sexual complaints(60.07%),heart palpitation(56.89%),melancholia(55.83%),Urinary tract infection(50.18%),Formication(39.93%).4.For the chinese medicine syndrome type,among the 283 subjects most of them were of the syndrome of depressed liver qi transforming into fire(26.50%),which was followed by those of the liver-kidney yin deficiency syndrome(22.97%),kidney yin deficiency syndrome(18.37%),kidney yin and yang deficiency syndrome(17.67%),heart-kidney non-interaction syndrome(6.01%),kidney yang deficiency syndrome(4.59%),and spleen-kidney yang deficiency syndrome(3.89%).There were 117 subjects were of the liver-kidney yin deficiency syndrome and the yin deficiency syndrome(41.34%),which showed that the yin deficiency syndrome was the dominant syndrome type of menopausal syndrome.While there were 140 subjects were of the syndrome of depressed liver qi transforming into fire and liver-kidney yin deficiency syndrome(49.47%),which showed that the menopausal syndrome was closely related to the liver.5.For the chinese medicine constitutional type,among the 283 subjects most of them were of the yin-deficiency type(24.03%),which was followed by those of the yang-deficiency type(21.91%),gentleness type(16.96%),qi-deficiency type(11.66%),phlegm-wetness type(8.13%),qi-depression type(7.42%),blood-stasis type(3.89%),wet-heat type(3.53%),and special diathesis type(2.47%).The constitutional types of the mild symptoms subjects were mainly the gentleness type,yang-deficiency type and yin-deficiency type;those of the moderate symptoms subjects were mainly the kidney yin-deficiency type,yang-deficiency type and gentleness type;and those of the severe symptoms subjects were mainly the the yang-deficiency type,yin-deficiency type and qi-deficiency type.6.There were statistically significant difference(P<0.05)in the following comparisons:(1)between the syndrome type and the menstruation status,symptom severity,stress level,BMI respectively;(2)between the constitutional type and the age,symptom severity;(3)between the symptom severity and the menstruation status,duration of the disease,stress level,BMI respectively.7.The results showed that among the menopausal syndrome patients,there were statistically significant difference(P<0.05)in the composition of syndrome type and constitutional type.There were associations between yin-deficiency type and liver-kidney yin deficiency syndrome,kidney yin deficiency syndrome.There were associations between yang-deficiency type and kidney yang deficiency syndrome,spleen-kidney yang deficiency syndrome,kidney yin and yang deficiency syndrome.8.As for the influencing factors,among the common syndrome types of the menopausal syndrome,there were positive correlations between:1)syndrome of depressed liver qi transforming into fire and stress level,number of pregnancy;2)liver-kidney yin deficiency syndrome and age,BMI;3)kidney yin and yang deficiency syndrome and duration of the disease.On the other hand,there were negative correlations between kidney yin deficiency syndrome and stress level,duration of the disease,KI scores.As for the symptom severity of the menopausal syndrome,it were positive correlated with stress level and number of pregnancy.ConclusionMost of the patients were of the age of 45-54 years,with the menstruation already stopped.Usually the duration of the disease was not long,62.90%of the patients had the disease for less than 3 years.It showed that people had fairly high awareness of their health.The disease was mainly mild or moderate,and its major symptoms were fatigue,sweating hot flushes,nervousness,arthralgia or myalgia,insomnia,etc.For the syndrome type,most of the patients were of the syndrome of depressed liver qi transforming into fire,which was followed by the liver-kidney yin deficiency syndrome,kidney yin deficiency syndrome and kidney yin and yang deficiency syndrome.The disease was closely related to the liver and the kidney(kidney deficiency as the root together with liver depression),mostly a deficiency-excess complex condition.For the constitutional type,most of the patients were of the yin-deficiency type,which was followed by the yang-deficiency type and gentleness type.The composition of syndrome type and constitutional type of the menopausal syndrome patients were different.There were associations between yin-deficiency type and liver-kidney yin deficiency syndrome,kidney yin deficiency syndrome.There were associations between yang-deficiency type and kidney yang deficiency syndrome,spleen-kidney yang deficiency syndrome,kidney yin and yang deficiency syndrome.As for the influencing factors,among the common syndrome types of the menopausal syndrome,there were positive correlations between:1)syndrome of depressed liver qi transforming into fire and stress level,number of pregnancy;2)liver-kidney yin deficiency syndrome and age,BMI;3)kidney yin and yang deficiency syndrome and duration of the disease.On the other hand,there were negative correlations between kidney yin deficiency syndrome and stress level,duration of the disease,KI scores.As for the symptom severity of the menopausal syndrome,it were positive correlated with stress level and number of pregnancy.In view of this,early adoption of preventive measures like dealing with the emotions correctly,reducing stress,doing exercise,controlling the weight,taking care of the liver and kidney would lower the incidence rate and the severity of the menopausal syndrome.It would also be helpful for the management of the disease to a certain extent. |
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