| Objective and significance:To observe the expression of hemorheology and cytokines in normal people and in people with primary dysmenorrhea syndrome of cold coagulation and blood stasis and qi stagnation and blood stasis,and to explore the difference of hemorheology and cytokines expression in the two types of primary dysmenorrhea syndrome,hoping to provide objective support for the differentiation of primary dysmenorrhea syndrome and blood stasis with specific laboratory indicators in the future,and to unify the understanding of syndrome types.To further understand the pathogenesis of immune factors of primary dysmenorrhea,so as to achieve targeted treatment of primary dysmenorrhea.Research methods:50 normal women and 100 primary dysmenorrhea patients(50 cases of cold coagulation and blood stasis syndrome,50 cases of Qi stagnation and blood stasis syndrome)were selected for clinical study.Dysmenorrhea score and VAS score were evaluated from 7 days before menstruation to during menstruation.Whole blood viscosity(1s),whole blood viscosity(10s),whole blood viscosity(60s),whole blood viscosity(150s),whole blood viscosity(200s),plasma viscosity;Seven cytokines:tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-2(IL-2),interleukin-4(IL-4),Interleukin-6(IL-6),interleukin-10(IL-10),interleukin-17(IL-17).Descriptive statistics,linear correlation and logistic regression were used for evaluation.Research results:1 Baseline data comparisonThe distribution of age,height,weight,education,sexual life history,reproductive history,age of menarche,menstrual cycle and menstrual period in the normal group,the cold coagulation and blood stasis group and the qi stagnation and blood stasis group showed no statistical significance after statistical analysis(P>0.05),and the baseline data of the three groups were evenly distributed and comparable.Statistical analysis of the distribution of dysmenorrhea course,dysmenorrhea score,dysmenorrhea degree and VAS score between the cold coagulation and blood stasis and blood stasis groups showed no statistical significance(P>0.05),indicating that the distribution of baseline medical history data between the two groups was balanced and comparable.2 Related indexes of hemorheologyCompared with the normal group,the whole blood viscosity(1s),whole blood viscosity(10s),whole blood viscosity(60s),whole blood viscosity(150s),whole blood viscosity(200s)and plasma viscosity values of the cold coagulation blood stasis group and Qi stagnation blood stasis group were higher than those of the normal group,with statistical significance(P<0.05).However,compared with the qi stagnation blood stasis group,There was no statistical significance between them(P>0.05).3 Seven cytokines3.1 TNF-αThere was statistical difference in serum TNF-α concentration among the three groups(P<0.05).Serum TNF-α concentration in primary dysmenorrhea cold coagulation blood stasis group and Qi stagnation blood stasis group was significantly higher than that in normal group,the difference was statistically significant(P<0.01).However,there was no significant difference in serum TNF-α concentration between primary dysmenorrhea group and Qi stagnation and blood stasis group(P>0.05).3.2 IFN-γThere was statistical difference in serum IFN-γ concentration among the three groups(P<0.05).The serum concentrations of IFN-γ in the primary dysmenorrhea cold coagulation blood stasis group and Qi stagnation blood stasis group were significantly higher than those in the normal group,with statistical significance(P<0.01);At the same time,compared with the primary dysmenorrhea group and the Qi stagnation and blood stasis group,the serum concentration of IFN-γ in the cold coagulation and blood stasis group was significantly lower than that in the qi stagnation and blood stasis group,the difference was statistically significant(P<0.01),3.3 IL-2There were statistical differences in serum IL-2 concentration among the three groups(P<0.05).Serum IL-2 concentration in primary dysmenorrhea cold coagulation blood stasis group and Qi stagnation blood stasis group was higher than that in normal group,and the difference was statistically significant(P<0.05).However,there was no significant difference in serum IL-2 concentration between primary dysmenorrhea group and Qi stagnation and blood stasis group(P>0.05).3.4 IL-4There was statistical difference in serum IL-4 concentration among the three groups(P<0.05).The serum IL-4 concentration in the primary dysmenorrhea group was significantly higher than that in the normal group,the difference was statistically significant(P<0.01).There was no significant difference in serum IL-4 concentration between primary dysmenorrhea group and normal group(P>0.05).At the same time,compared with the primary dysmenorrhea group and the Qi stagnation and blood stasis group,the serum IL-4 concentration in the cold coagulation and blood stasis group was significantly higher than that in the qi stagnation and blood stasis group,the difference was statistically significant(P<0.05).3.5 IL-6There was statistical difference in serum IL-6 concentration among the three groups(P<0.05).Serum IL-6 concentration in primary dysmenorrhea cold coagulation blood stasis group and Qi stagnation blood stasis group was significantly higher than that in normal group,the difference was statistically significant(P<0.01).However,there was no significant difference in serum IL-6 concentration between primary dysmenorrhea group and Qi stagnation and blood stasis group(P>0.05).3.6 IL-10There were statistical differences in serum IL-10 concentration among the three groups(P<0.05).There was no significant difference in serum IL-10 concentration between the primary dysmenorrhea group and the normal group(P>0.05).Serum IL-10 concentration in primary dysmenorrhea Qi-stagnation and blood stasis group was significantly higher than that in normal group,the difference was statistically significant(P<0.01).At the same time,compared with the primary dysmenorrhea group and the Qi stagnation and blood stasis group,the serum IL-10 concentration in the cold coagulation and blood stasis group was significantly lower than that in the qi stagnation and blood stasis group,and the difference was statistically significant(P<0.01).3.7 IL-17There were statistical differences in serum IL-17 concentration among the three groups(P<0.05).Serum IL-17 concentration in primary dysmenorhea cold coagulation blood stasis group and Qi stagnation blood stasis group was higher than that in normal group,and the difference was statistically significant(P<0.05).At the same time,compared with the primary dysmenorrhea group and the Qi stagnation and blood stasis group,the serum IL-17 concentration in the cold coagulation and blood stasis group was lower than that in the qi stagnation and blood stasis group,the difference was statistically significant(P<0.05).4 Correlation analysis of seven cytokines and dysmenorrhea scoresPearson correlation coefficient test showed that serum concentrations of TNF-α,IFN-γ,IL-6 and IL-17 were significantly positively correlated with dysmenorrhea scores(r values were 0.768,0.636,0.845,0.791,P<0.001).Serum IL-2,IL-4 and IL-10 concentrations were not correlated with dysmenorrhea scores(r values were 0.013,-0.071,-0.167,respectively),and the difference was not statistically significant(P>0.05).5 Correlation analysis of seven cytokines and dysmenorrhea scoresPearson correlation coefficient test showed that serum TNF-α concentration was positively correlated with serum IFN-γ concentration(r=0.469,P<0.001).Serum TNF-α and IFN-γconcentrations were positively correlated with serum IL-6 concentrations(r values were 0.704,0.533,P<0.001).Serum TNF-α,IFN-γ and IL-6 were positively correlated with serum IL-17 concentration(r values were 0.603,0.61,0.656,P<0.001).There was no correlation among other cytokines,and the difference was not statistically significant(P>0.05).6 Logistic regression analysis of primary dysmenorrhea patients and influencing factorsBinary Logistic regression analysis showed that 16-35 years old was a risk factor for patients with primary dysmenorrhea(P=0.012<0.05),and the risk of primary dysmenorrhea in this age group was 1.18 times that of other age groups(OR=1.18,95%CI=1.037-1.342).Reproductive history was a protective factor for patients with primary dysmenorrhea(P<0.001),and the risk of primary dysmenorrhea was 0.083 times higher in those with a reproductive history than in those without a reproductive history(OR=0.083,95%CI=0.0210.324).Conclusion and significance:1 Patients in the primary dysmenorrhea cold coagulation blood stasis group and qi stagnation blood stasis group presented blood stasis state,which was objectively quantified by the following hemorheological indexes:whole blood viscosity(1 s),whole blood viscosity(10s),whole blood viscosity(60s),whole blood viscosity(150s),whole blood viscosity(200s)and plasma viscosity values.2 Serum concentrations of cytokines such as IFN-γ,IL-4,IL-10 and IL-17 can be used as objective indexes for syndrome differentiation of primary dysmenorrhea cold coagulation blood stasis and qi stagnation blood stasis.IL-4 may be abnormally increased in syndrome type of cold coagulation and blood stasis,and IFN-γ,IL-10 and IL-17 may be abnormally increased in syndrome type of Qi stagnation and blood stasis.The above laboratory indicators can be used as differentiating indicators for the two blood stasis syndrome types.3 Serum concentrations of TNF-α,IFN-γ,IL-6 and IL-17 were positively correlated with dysmenorrhea scores in patients with primary dysmenorrhea.Serum TNF-α concentration was positively correlated with serum IFN-γ concentration.Serum TNF-α and IFN-γ concentrations were positively correlated with serum IL-6 concentrations.Serum TNF-α,IFN-γ and IL-6 were positively correlated with serum IL-17 concentration.4 The logistic regression results of primary dysmenorrhea disease and influencing factors showed that 16-35 years old was a risk factor for patients with primary dysmenorrhea,and reproductive history was a protective factor for patients with primary dysmenorrhea.In conclusion,there is a close relationship between primary dysmenorrhea syndrome of cold coagulation and blood stasis,Qi stagnation and blood stasis,blood rheology and cytokines.Blood stasis syndrome may be quantized by various hemorheological indexes,and the two types of blood stasis syndrome can be distinguished according to the concentration of serum cytokines such as IFN-γ,IL-4,IL-10,and IL-17.Serum concentrations of cytokines such as TNF-α,IFN-γ,IL-6 and IL-17 may be used as indicators to evaluate the severity of primary dysmenorrhea.These studies have laid the foundation for the next large sample,multi-center clinical research,and more clinical and animal experimental studies are needed to further confirm. |
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