台湾地区女性月经不调的中医证候分析
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摘要
目的
月经不调是妇科临床的常见病、多发病,给广大妇女身心健康带来巨大伤害,已引起国内外学者的普遍关注。本研究应用临床流行病学方法,通过现场调查并应用探索性因子分析和证实性因子分析,了解月经不调的主要中医证候和兼证,为“同病异证”提供一种定量的分析方法。同时还可以分析证候间的相关关系,从而探讨月经不调诊断和中医证候规律,从而为月经不调病证评定标准规范化研究提供一种可借鉴的思路和方法,以指导中医妇科临床及科研工作。
方法
研究对象为月经不调患者。选择常见的月经不调病种(月经先期、月经后期、月经先后不定期、经期延长、月经过多、月经过少),纳入符合诊断标准而不在排除标准的患者540例,其中月经先期、月经后期、月经先后不定期、经期延长、月经过多、月经过少各90例。患者填写调查问卷。研究结束后,临床资料及时汇总,输入计算机,用EpiData3.01软件建立数据库,进行数据管理,用SPSS17.0软件进行统计分析。
结果
本研究共有合格研究对象540例。闭经倾向性月经不调(包括月经后期、月经过少)180例；崩漏倾向性月经不调(包括月经先期、月经过多、经期延长)270例；月经先后不定期90例。
本课题通过流行病学调查方法对月经不调疾病的中医证候展开了初步系统的研究,血热证、经因子分析发现：崩漏倾向性月经不调主要为肝郁气滞证、肾气虚肝郁
阴虚血热兼肝郁证、肾气虚肝郁兼血瘀证、肾气虚肝郁兼湿热证。闭经倾向性月经不调主要为肾阳虚证、肾阳虚肝郁气滞证、肾气虚肝郁气滞证、肾阴虚肝郁兼血瘀证。月经先后不定期主要为肾气虚肝郁气滞证、肾阴虚肝郁气滞证、肾阳虚肝郁气滞证、阴虚血热兼肝郁证。临床表现除有各自相同的崩漏或闭经倾向外,尚有自己的特有的临床表现。
产次、人流、清宫、药流及自然流产,长期接触噪声、辐射、化工印染、剧烈运动、汽油,是月经不调的危险因素,可能与本病的发生有一定的关系。不同年龄阶段月经不调患者分布情况不同。
结论
本课题通过流行病学调查方法对月经不调疾病的辨证分型展开了初步的研究,发现月经不调的证型多为复合证型,涉及脏腑以肝、肾为主,病性多虚实夹杂。
(1)崩漏倾向性月经不调的中医证候主要为肝郁气滞证、肾气虚肝郁证、阴虚血热兼肝郁证、肾气虚肝郁兼血瘀证、肾气虚肝郁兼湿热证。以虚实夹杂证多见,虚者见肾虚(肾阳虚、肾气虚)、阴虚。实者见肝郁气滞、肝郁血热、湿热、血瘀。
(2)闭经倾向性月经不调的中医证候主要为肾阳虚证、肾阳虚肝郁气滞证、肾气虚肝郁气滞证、肾阴虚肝郁兼血瘀证。主要涉及肝肾两脏,虚证见肾虚(肾阳虚、肾阴虚、肾气虚),实证见肝郁气滞、血瘀。
(3)月经先后不定期的中医证候主要为肾气虚肝郁气滞证、肾阴虚肝郁气滞证、肾阳虚肝郁气滞证、阴虚血热兼肝郁证。多为虚实夹杂,主要涉及肝肾两脏,虚证见肾虚(肾气虚、肾阴虚、肾阳虚)、阴虚血热,实证见肝郁气滞。
(4)小于30岁的患者以月经后期最常见,其次为月经先期、月经过多；30-39岁则以经期延长最常见,其次为月经先期、月经过少；40-45岁以月经先后不定期最常见,其次为月经先期、月经过少。
(5)长期受到噪声、辐射、化工印染、汽油等外界危险因素,以及产次、人流、清宫、药流、自然流产,剧烈运动等自身危险因素的影响,可能与月经不调的发生有一定的关系。
Objective
Application clinical epidemiological methods, through the investigation and application of exploratory factor analysis and confirmed the factor analysis, and observation of the main TCM Syndromes of irregular menstruation and syndromes, will be a disease to western medicine is divided into several of traditional Chinese medicine accordingly syndrome, for "with disease different card" provides a quantitative analysis method. At the same time also can be analyzed the relationship between syndrome. In the field investigation data of statistical analysis process, statistical workers are in the state of blind, only the index coding analysis, this ensures that the analysis result is objective.
Application prove sexual factor analysis can provide all measuring index in different male factor loading size, so the index evaluation for doctors in different syndromes progression of provide quantitative analysis method.
Confirmed sexual factor analysis can also factor analysis of the relationship between the characteristics of the index and some factors exist between the correlation between the traditional Chinese medicine doctors know clinical syndrome and in-depth study of the inner relation between syndrome the dynamic changes of the relationship between the indexes and provide useful information.
This clinical epidemiological study menstruation to be not moved disease characteristics of traditional Chinese medical syndrome; To menstruation to be not moved disease clinical epidemiology investigation and statistical analysis, this paper discusses menstruation to be not moved diagnosis and syndromes rules and do not move for menstruation disease and syndrome evaluation standards standardized research provides a can draw a line of thought and method, in order to guide clinical and research work of traditional Chinese medicine gynecology.
Methods
The subjects of menstruation to be not moved patients. Choose common menstruation to be not moved diseases (first menstruation, menstrual period has not late, regular menstrual extension, menstruation, too much, month after little), into the diagnostic criteria and not in accord with the exclusion standard in600cases, of which100cases of first menstruation, menstruation later in100cases, has not regular menstrual100cases,100cases of menstrual extension, menorrhagia in100cases, month after less100cases. Patients fill out a questionnaire. Another collection of100cases of menstruation normal women were collected as normal control group. At the end of the study, clinical material was timely summaried into the computer with EpiData3.01software based on the database, data management was used with SPSS17.0software for statistical analysis.
Results
This study,540patients with qualified research object. Patients who amenorrhoea tendentiousness menstruation to be not moved (including the late on after menstruation, less) were180cases. Uterine bleeding tendency menstruation to be not moved (including first menstrual period, and too much, menstrual extension)270cases). Menstruation regular90cases has not.
This topic through the epidemiological survey methods to menstruation to be not moved the disease of TCM syndrome has launched the preliminary system research, blood heat syndromes, the factor analysis found that:uterine bleeding tendency menstruation to be not moved mainly for the stomach and kidney deficiency syndrome, stomach
Yin deficiency blood hot and kidney empty stomach certificate, stomach and kidney deficiency syndrome, exhibitionism blood biaoben huanji and damp and hot card. Tendentiousness menstruation to be not moved mainly for kidney Yang Yang syndrome, kidney and kidney empty stomach card, stomach and kidney Yin deficiency syndrome, amenorrhoea biaoben huanji and blood exhausting the card. Menstruation regular mainly for kidney gas has not empty stomach and kidney Yin deficiency syndrome, stomach and kidney syndrome, Yang and Yin deficiency stomach card, heat and blood biaoben huanji card. Clinical manifestations in addition to have their own the same uterine bleeding or amenorrhoea tendency outside, still have their own unique clinical manifestation.
Production time, people and palace, medicine flow and natural abortion, long-term exposure to noise, radiation, chemical printing and dyeing, vigorous exercise, gasoline, is menstruation to be not moved risk factors may with the disease occurs with a certain relationship. Different age menstruation to be not moved patients with different distribution.
Cone I us i on
This topic through the epidemiological survey methods to menstruation to be not moved disease differentiation points on the preliminary research on the type, found that menstruation to be not moved the evidence for the composite type certificate type, involving viscera in liver and kidney is given priority to, disease more than the actual sex inclusion.
(1) Uterine bleeding tendency of irregular menstruation main TCM syndrome of liver qi stagnation and kidney deficiency, stagnation of liver-qi, deficiency of yin and blood-heat and the stagnation of liver-qi stagnation of liver-qi, deficiency of kidney qi and blood stasis, deficiency of kidney qi stagnation and damp-heat syndrome, deficiency and excess situation mixture was the mainly kind, deficiency including kidney (kidney deficiency of Yang, deficiency of kidney qi, yin deficiency). The excess was including qi stagnation, stagnation of blood heat, damp heat, blood stasis.
(2) Amenorrhea tendency of irregular menstruation syndrome mainly deficiency syndrome, liver qi stagnation, deficiency of kidney qi deficiency of liver qi stagnation, yin deficiency syndrome of stagnation of liver qi and blood stasis. Mainly involves the kidney and the liver. The deficiency was including the kidney deficiency (kidney yang deficiency, yin deficiency, kidney deficiency). The excess was including liver qi stagnation and blood stasis.
(3) Irregular menstrual was mainly for kidney deficiency of liver qi stagnation, yin deficiency of liver qi stagnation, deficiency of liver qi stagnation, yin deficiency and blood stagnation of liver. For the deficiency and excess situation mixture was mainly related to kidney deficiency of liver and kidney,(deficiency of kidney qi, deficiency of kidney yin, deficiency of kidney yang) and deficiency of yin and blood-heat, The excess was including stagnation of liver-qi.
(4) Patients less than30years of age in the late menstruation is the most common, followed by menstruation, menorrhagia, menostaxis;30-39years in the most common, followed by menstruation, menstruation;40-45years old has irregular menstrual is most common, followed by menstruation, menstruation.
(5) Long terra exposure to noise, radiation, chemical dyeing, gasoline and other external factors, and parity, abortion, palace, vagina, spontaneous abortion, the effect of strenuous exercise and its risk factors may not transfer, and there is a certain relationship between menstruation.
月经不调是妇科临床的常见病、多发病,给广大妇女身心健康带来巨大伤害,已引起国内外学者的普遍关注。本研究应用临床流行病学方法,通过现场调查并应用探索性因子分析和证实性因子分析,了解月经不调的主要中医证候和兼证,为“同病异证”提供一种定量的分析方法。同时还可以分析证候间的相关关系,从而探讨月经不调诊断和中医证候规律,从而为月经不调病证评定标准规范化研究提供一种可借鉴的思路和方法,以指导中医妇科临床及科研工作。
方法
研究对象为月经不调患者。选择常见的月经不调病种(月经先期、月经后期、月经先后不定期、经期延长、月经过多、月经过少),纳入符合诊断标准而不在排除标准的患者540例,其中月经先期、月经后期、月经先后不定期、经期延长、月经过多、月经过少各90例。患者填写调查问卷。研究结束后,临床资料及时汇总,输入计算机,用EpiData3.01软件建立数据库,进行数据管理,用SPSS17.0软件进行统计分析。
结果
本研究共有合格研究对象540例。闭经倾向性月经不调(包括月经后期、月经过少)180例；崩漏倾向性月经不调(包括月经先期、月经过多、经期延长)270例；月经先后不定期90例。
本课题通过流行病学调查方法对月经不调疾病的中医证候展开了初步系统的研究,血热证、经因子分析发现：崩漏倾向性月经不调主要为肝郁气滞证、肾气虚肝郁
阴虚血热兼肝郁证、肾气虚肝郁兼血瘀证、肾气虚肝郁兼湿热证。闭经倾向性月经不调主要为肾阳虚证、肾阳虚肝郁气滞证、肾气虚肝郁气滞证、肾阴虚肝郁兼血瘀证。月经先后不定期主要为肾气虚肝郁气滞证、肾阴虚肝郁气滞证、肾阳虚肝郁气滞证、阴虚血热兼肝郁证。临床表现除有各自相同的崩漏或闭经倾向外,尚有自己的特有的临床表现。
产次、人流、清宫、药流及自然流产,长期接触噪声、辐射、化工印染、剧烈运动、汽油,是月经不调的危险因素,可能与本病的发生有一定的关系。不同年龄阶段月经不调患者分布情况不同。
结论
本课题通过流行病学调查方法对月经不调疾病的辨证分型展开了初步的研究,发现月经不调的证型多为复合证型,涉及脏腑以肝、肾为主,病性多虚实夹杂。
(1)崩漏倾向性月经不调的中医证候主要为肝郁气滞证、肾气虚肝郁证、阴虚血热兼肝郁证、肾气虚肝郁兼血瘀证、肾气虚肝郁兼湿热证。以虚实夹杂证多见,虚者见肾虚(肾阳虚、肾气虚)、阴虚。实者见肝郁气滞、肝郁血热、湿热、血瘀。
(2)闭经倾向性月经不调的中医证候主要为肾阳虚证、肾阳虚肝郁气滞证、肾气虚肝郁气滞证、肾阴虚肝郁兼血瘀证。主要涉及肝肾两脏,虚证见肾虚(肾阳虚、肾阴虚、肾气虚),实证见肝郁气滞、血瘀。
(3)月经先后不定期的中医证候主要为肾气虚肝郁气滞证、肾阴虚肝郁气滞证、肾阳虚肝郁气滞证、阴虚血热兼肝郁证。多为虚实夹杂,主要涉及肝肾两脏,虚证见肾虚(肾气虚、肾阴虚、肾阳虚)、阴虚血热,实证见肝郁气滞。
(4)小于30岁的患者以月经后期最常见,其次为月经先期、月经过多；30-39岁则以经期延长最常见,其次为月经先期、月经过少；40-45岁以月经先后不定期最常见,其次为月经先期、月经过少。
(5)长期受到噪声、辐射、化工印染、汽油等外界危险因素,以及产次、人流、清宫、药流、自然流产,剧烈运动等自身危险因素的影响,可能与月经不调的发生有一定的关系。
Objective
Application clinical epidemiological methods, through the investigation and application of exploratory factor analysis and confirmed the factor analysis, and observation of the main TCM Syndromes of irregular menstruation and syndromes, will be a disease to western medicine is divided into several of traditional Chinese medicine accordingly syndrome, for "with disease different card" provides a quantitative analysis method. At the same time also can be analyzed the relationship between syndrome. In the field investigation data of statistical analysis process, statistical workers are in the state of blind, only the index coding analysis, this ensures that the analysis result is objective.
Application prove sexual factor analysis can provide all measuring index in different male factor loading size, so the index evaluation for doctors in different syndromes progression of provide quantitative analysis method.
Confirmed sexual factor analysis can also factor analysis of the relationship between the characteristics of the index and some factors exist between the correlation between the traditional Chinese medicine doctors know clinical syndrome and in-depth study of the inner relation between syndrome the dynamic changes of the relationship between the indexes and provide useful information.
This clinical epidemiological study menstruation to be not moved disease characteristics of traditional Chinese medical syndrome; To menstruation to be not moved disease clinical epidemiology investigation and statistical analysis, this paper discusses menstruation to be not moved diagnosis and syndromes rules and do not move for menstruation disease and syndrome evaluation standards standardized research provides a can draw a line of thought and method, in order to guide clinical and research work of traditional Chinese medicine gynecology.
Methods
The subjects of menstruation to be not moved patients. Choose common menstruation to be not moved diseases (first menstruation, menstrual period has not late, regular menstrual extension, menstruation, too much, month after little), into the diagnostic criteria and not in accord with the exclusion standard in600cases, of which100cases of first menstruation, menstruation later in100cases, has not regular menstrual100cases,100cases of menstrual extension, menorrhagia in100cases, month after less100cases. Patients fill out a questionnaire. Another collection of100cases of menstruation normal women were collected as normal control group. At the end of the study, clinical material was timely summaried into the computer with EpiData3.01software based on the database, data management was used with SPSS17.0software for statistical analysis.
Results
This study,540patients with qualified research object. Patients who amenorrhoea tendentiousness menstruation to be not moved (including the late on after menstruation, less) were180cases. Uterine bleeding tendency menstruation to be not moved (including first menstrual period, and too much, menstrual extension)270cases). Menstruation regular90cases has not.
This topic through the epidemiological survey methods to menstruation to be not moved the disease of TCM syndrome has launched the preliminary system research, blood heat syndromes, the factor analysis found that:uterine bleeding tendency menstruation to be not moved mainly for the stomach and kidney deficiency syndrome, stomach
Yin deficiency blood hot and kidney empty stomach certificate, stomach and kidney deficiency syndrome, exhibitionism blood biaoben huanji and damp and hot card. Tendentiousness menstruation to be not moved mainly for kidney Yang Yang syndrome, kidney and kidney empty stomach card, stomach and kidney Yin deficiency syndrome, amenorrhoea biaoben huanji and blood exhausting the card. Menstruation regular mainly for kidney gas has not empty stomach and kidney Yin deficiency syndrome, stomach and kidney syndrome, Yang and Yin deficiency stomach card, heat and blood biaoben huanji card. Clinical manifestations in addition to have their own the same uterine bleeding or amenorrhoea tendency outside, still have their own unique clinical manifestation.
Production time, people and palace, medicine flow and natural abortion, long-term exposure to noise, radiation, chemical printing and dyeing, vigorous exercise, gasoline, is menstruation to be not moved risk factors may with the disease occurs with a certain relationship. Different age menstruation to be not moved patients with different distribution.
Cone I us i on
This topic through the epidemiological survey methods to menstruation to be not moved disease differentiation points on the preliminary research on the type, found that menstruation to be not moved the evidence for the composite type certificate type, involving viscera in liver and kidney is given priority to, disease more than the actual sex inclusion.
(1) Uterine bleeding tendency of irregular menstruation main TCM syndrome of liver qi stagnation and kidney deficiency, stagnation of liver-qi, deficiency of yin and blood-heat and the stagnation of liver-qi stagnation of liver-qi, deficiency of kidney qi and blood stasis, deficiency of kidney qi stagnation and damp-heat syndrome, deficiency and excess situation mixture was the mainly kind, deficiency including kidney (kidney deficiency of Yang, deficiency of kidney qi, yin deficiency). The excess was including qi stagnation, stagnation of blood heat, damp heat, blood stasis.
(2) Amenorrhea tendency of irregular menstruation syndrome mainly deficiency syndrome, liver qi stagnation, deficiency of kidney qi deficiency of liver qi stagnation, yin deficiency syndrome of stagnation of liver qi and blood stasis. Mainly involves the kidney and the liver. The deficiency was including the kidney deficiency (kidney yang deficiency, yin deficiency, kidney deficiency). The excess was including liver qi stagnation and blood stasis.
(3) Irregular menstrual was mainly for kidney deficiency of liver qi stagnation, yin deficiency of liver qi stagnation, deficiency of liver qi stagnation, yin deficiency and blood stagnation of liver. For the deficiency and excess situation mixture was mainly related to kidney deficiency of liver and kidney,(deficiency of kidney qi, deficiency of kidney yin, deficiency of kidney yang) and deficiency of yin and blood-heat, The excess was including stagnation of liver-qi.
(4) Patients less than30years of age in the late menstruation is the most common, followed by menstruation, menorrhagia, menostaxis;30-39years in the most common, followed by menstruation, menstruation;40-45years old has irregular menstrual is most common, followed by menstruation, menstruation.
(5) Long terra exposure to noise, radiation, chemical dyeing, gasoline and other external factors, and parity, abortion, palace, vagina, spontaneous abortion, the effect of strenuous exercise and its risk factors may not transfer, and there is a certain relationship between menstruation.
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