The Distribution Of TCM Syndrome Elements In Endometriosis And The Relationship Between Anxiety And Depression Status And Syndrome Types

ObjectiveTo discuss the characters of syndrome elements of Endometriosis(EM)from multi-center clinical epidemiological of cross-sectional survey,by means of questionnaire in patients with endometriosis.we used various mathematics methods to distill syndrome elements,in order to provide the reference for further syndrome differentiation and treatment of EM.To investigate the emotional state and the influential factors on anxiety and depression in EM patients,in order to explore the EM patients’ common emotional state and the relevance between TCM syndromes.MethodsThis research contains two parts.Part 1 summarized common symptoms accompanying symptoms,tongue manifestation and pulse condition of EM by referencing related documents.We formulated questionnaire on the basis of standardization of symptom,then made a multi-center clinical epidemiological investigation under the strict quality control,from December 2012 to March 2014,in different seven first-rate hospital of TCM over the country.Build an Epidata database according to the questionnaire,usd SPSS 17.0 statistical software for data frequency statistics,cluster analysis,factor analysis,evidence syndrome elements,explored the characteristics of TCM syndrome factors and distribution the rule of EM treatment.In part 2,EM patients who were treated in different seven first-rate hospital of TCM over the country from December 2012 to March 2014,were assessed by the HAMD and the HAMA,in combination with the result of experts’ opinions concerning the syndrome types,using SPSS 17.0 statistical software to analysis the emotional state of anxiety and depressionof EM patients,analysis its relationship with syndrome types,and also find out the influence factors of anxiety and depression in EM patients.Results1 Based on the frequency statistics,among 450 EM patients,83.1%of the patients were ovarian EM,most patients were in sexual maturity,87.8%of the patients age from 20 to 40.Patients’ career focused on Handle affairs personnel and concerned personnel,professionals,business services personnel,which was mainly mental work.57%of the patients had university degrees,most people were married and bad ever been pregnant.About comorbidity,18.2%of the patients with myoma of uterus,18%of the patients with adenomyosis,16.6%hyperplasia of mammary glands with hyperplasia of mammary glands.11.1%of the patients had family history of EM,including first-degree relatives,the largest proportion.Most patients complained dysmenorrhea,the rate was 50%.Frequency in more than 50%of the symptoms in turn were menses with clots,spiritlessness and weakness,cold limbs,soreness and weakness of waist and knees,distending pain of breasts during menstruation,irritability,pain relieved by heat,pain relieve after blood clots flow,dysmenorrhea or chronic pelvic pain,dim complexion,inhibited flow of menses.Frequency in more than 50%of the tongue manifestation in turn were white fur,red tongue,dark tongue color,thin fur.more than 50%of the pulse manifestation in turn were stringy pulse,slippery pulse.2 By means of index clustering analysis method,82 symptoms could been gathered for 34 classes or 28 classes.By using factor analysis,we got 24 common factors.The classification results of different methods were different,through the analysis and comparison of the results,we preliminary obtained the key syndrome elements of disease nature were:uterus,liver,kidney,spleen.The key syndrome elements of disease location were:qi stagnation,static blood,cold pathogen,heat pathogen,dampness pathogen,phlegm,qi deficiency,blood deficiency,yang deficiency,yin deficiency.3 By means of dynamic samples cluster analysis,450 EM patients could been divided into six classes,they were syndrome of coagulated cold and blood stasis,syndrome of stagnant dampness-heat,syndrome of qi stagnation and blood stasis,syndrome of deficiency of heart qi and blood stasis,syndrome of blood stasis due to kidney deficiency,syndrome of intermingled phlegm and blood stasis.Syndrome of qi stagnation and blood stasis was the most common symptoms,the proportion was 36.2%.4 About 29.8%of EM patients were in depression state,34.5%of EM patients had anxiety.Syndrome of qi stagnation and blood stasis patients had the highest total scores of HAMD and HAMA,and also their somatization and psychogenic scores were the highest,but the difference was no significant.5 History of abortion was a risk factor for EM patients with anxiety or depression.Lower score of r-AFS,normal menstrual cycle,bad born children,stable BMI were the protective factors against depression.Normal menstrual cycle,had born children were the protective factors against anxeity.Conclusions1 The key syndrome elements of EM nature were:uterus,liver,kidney,spleen.The key syndrome elements of EM location were:qi stagnation,static blood,cold pathogen,heat pathogen,dampness pathogen,phlegm,qi deficiency,blood deficiency,yang deficiency,yin deficiency.450 EM patients could been divided into six classes,they were syndrome of coagulated cold and blood stasis,syndrome of stagnant dampness-heat,syndrome of qi stagnation and blood stasis,syndrome of deficiency of heart qi and blood stasis,syndrome of blood stasis due to kidney deficiency,syndrome of intermingled phlegm and blood stasis.Syndrome of qi stagnation and blood stasis was the most common symptoms.2 EM patients had significant anxiety and depression.The occurment of EM may associate with patients’ emotional state.3 using multivariate statistical method can help us getting typical distribution of syndrome elements of EM,it can provide a basis for EM standardization study of syndrome of TCM.