Analysis Of TCM Syndrome Type Distribution And Related Factors In Patients With Repeated Pregnancy Loss

ObjectiveIn this study,a questionnaire survey was performed on patients with RPL and healthy women without a history of RPL to compare the general information,depression and anxiety scores,physical types,living environment and other epidemiological differences between the two groups.Summarize the distribution of etiology,the characteristics of TCM symptoms and syndromes in patients with rpl,and provide theoretical basis for RPL prevention,health care and clinical treatment of traditional Chinese medicine.MethodsA total of 128 RPL patients who were treated at the Reproductive Center of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from March 2019 to January 2020 were collected as a case group.At the same time,120 healthy women without a history of RPL during the same period were selected as healthy control groups for face-to-face interviews.Type one-to-one survey and enter the questionnaire.The information collected in the clinical questionnaire includes general information,depression and anxiety scores,physical type,living environment,etc.,combined with the four diagnosis information and case examination data to analyze the etiology of the case group and TCM syndrome classification Enter the collected data into the excel table,establish a database,use SPSS24.0software for data statistics,and choose the appropriate statistical method such as descriptive analysis,t-test,rank sum test,chi square test,logical analysis and factor analysis,etc.Results1.Comparison of general conditions between the two groups: There was no significant difference in the age,income,education,blood type,family history(father)between the RPL group and the control group(P>0.05),and there was a statistical difference in the history of BMI and mother’s spontaneous abortion.Significance(P<0.05),in which the mother’s spontaneous abortion history was a risk factor for RPL(OR=5.297,95%CI 1.242-22.581)2.Comparison of living environment factors between the two groups: The RPL group and the control group had statistically significant differences in passive smoking,annual number of hair dyes,sitting time,exposure to radiation,degree of work fatigue,and diet(including coffee,frozen desserts,fresh fruits and vegetables).P <0.05.Binary logistic regression analysis found that fresh fruits and vegetables were protective factors of RPL(OR= 0.351,95% CI 0.138-0.892),frozen desserts(OR=2.096,95%CI 1.050-4.182),and exposure to artificial electromagnetic radiation(OR=2.735,95%CI=1.562-4.788)and passive smoking(OR = 1.871,95% CI 1.077-3.249)were risk factors for RPL.3.Comparison of past and surgical history between the two groups: There is a statistically significant difference between the two groups in antiphospholipid syndrome,polycystic ovary syndrome,intrauterine adhesions and gynecological surgery(including uterine cervix,endometrial biopsy,and intrauterine adhesion separation surgery).Significance(P <0.05).4.Comparison of anxiety and depression between the two groups: the incidence of anxiety and depression in 128 patients with RPL was 31.25% and 25.78%,and the incidence of anxiety and depression in healthy controls was 15.00% and 14.17%,respectively.Academic significance(P<0.05).Anxiety was the risk factor of RPL(or = 2.662,95% CI1.361-5.206).5.Comparison of menstruation and leucorrhea between the two groups: The difference in menstrual flow and menstrual cycle distribution between the RPL group and the control group was statistically significant(p <0.05),of which 63 patients in the RPL group with daily menstrual volume ≤ 3 sanitary napkins(49.2 %)Were significantly higher than the control group of 40 cases(33%),and the menstrual cycle of the RPL group was ≥29 days in 82cases(64%),which was significantly higher than the control group in 59 cases(49%),there was no significant difference between the two groups in other menstrual conditions(age of menarche,color,quality etc)and under menstrual conditions(P > 0.05).6.Comparison of TCM constitution types in the two groups: The difference between the two groups in terms of peace and yang deficiency was statistically significant(P<0.05),and the differences in other constitutions were not statistically significant(P>0.05).7.Distribution of etiology in the RPL group: Among the causative factors with clear etiology at the current stage,46 were endocrine factors(35.94%),and the rest were ranked in descending order of anatomical factors in 43 cases(33.59%)and 36 cases(28.13%)of autoimmune factors.There were 16 cases(12.50%)of infectious factors,2 cases(1.56%)of genetic factors and 12 cases(9.38%)of prethrombotic state,of which 47 cases were single(36.72%),and 48 cases were mixed(37.50%).Other unexplained RPL patients total 33 cases accounted for 25.78%.8.Distribution of syndrome types in the RPL group: RPL patients are often accompanied by forgetfulness,chills,cold limbs,yellow stools,shortness of breath,dry lips,low drinking,pale or yellowish appearance,dry mouth,dry throat,and emotional depression.The analysis suggests that the pathogenesis of RPL mainly involves yang deficiency,yin deficiency,qi depression,qi deficiency,blood deficiency,blood stasis,blood heat,phlegm dampness,and damp heat;the disease position involves kidney,spleen and liver.The distribution is often mixed,with 103 cases of kidney deficiency syndrome(80.47%)accounting for the highest proportion in a single main card,of which 71 cases of kidney yang deficiency syndrome(55.47%)and 58 cases of kidney yin deficiency syndrome(45.31%).The other types of syndromes are listed in descending order of spleen(qi)deficiency syndrome,liver stagnation syndrome,blood stasis syndrome,phlegm-dampness syndrome and so on.Among the 56cases(43.75%),the highest number of deficiency syndromes of the spleen and kidney is 45cases(35.16%),and 41 cases(32.03%)of the kidney deficiency and dampness syndrome,and35 cases of kidney deficiency and liver depression syndrome(27.34%),29 cases of kidney deficiency and blood stasis syndrome(22.66%),25 cases of deficiency of qi and blood syndrome(19.53%),17 cases of dampness and stasis syndrome(13.28%).9.Distribution of syndrome types of different etiology in RPL group: Endocrine factors and The anatomic factors accounted for the highest proportion of kidney deficiency syndromes in 13 cases(76.47%)and 12 cases(85.71%),and the immune factors were the most common in the spleen(qi)deficiency syndrome in 6 cases(75.00%).(100.00%);According to Chi-square and Fisher test,57 cases of liver stagnation syndrome accounted for57.14% of anatomical factors higher than immune,endocrine and infection factors,and 6cases of wet syndrome accounted for 100% higher than anatomical factors.,Immune factors and endocrine factors,the differences were statistically significant(P <0.05).Distribution,was not statistically significant differences(P> 0.05).Conclusion1.Frozen desserts,exposure to artificial electromagnetic radiation,mother’s history of spontaneous abortion,and anxiety are risk factors for this disease,and fresh fruits and vegetables are protective factors for this disease.2.Among patients with RPL at the present stage,endocrine factors are the most common among the causative factors at present,and the other are anatomical factors,autoimmune factors,infectious factors,prethrombotic state and genetic factors.3.During the RPL patients,kidney deficiency syndrome is more common,and spleen and kidney deficiency syndrome is the main syndrome.Kidney deficiency and liver stagnation syndrome are common in anatomical factors.Infection factors are mostly kidney deficiency dampness syndrome.Menstruation is mainly manifested by low menstrual flow.There are symptoms of forgetfulness,chills,cold limbs,yellow urine,shortness of breath,dry lips,dry faces,dryness,dry throat,mood depression,and thin stools.4.RPL patients often have a biased constitution,and its incidence is closely related to yang deficiency.