[关键词]
[摘要]
【目的】基于生殖衰老分期 (STRAW) +10调查广州地区围绝经期代谢综合征患者的中医体质类型分布,为围绝经期代谢 综合征患者提供中医体质调养理论依据。 【方法】根据代谢综合征的诊断标准,纳入围绝经期代谢综合征患者共90 例,根据 STRAW +10分期标准分为绝经过渡早期 (-2期) 组49例、绝经过渡晚期 (-1期) 组24例、绝经后期早期 (+la期) 组17例。采用 《中医体质分类与判定标准》对所有调查对象进行中医体质调查,同时采用焦虑自评量表 (SAS) 及抑郁自评量表 (SDS) 进行焦 虑抑郁评分,分析不同STRAW +10分期患者的中医体质类型分布,比较不同STRAW +10分期患者的SAS、SDS评分情况。【结果】(1) 绝经过渡早期 (-2期) 组的最主要中医体质类型中,出现频次最高的中医体质为阳虚质14例 (29.79%) ,其次为平 和质10例 (21.28%) ,再次之为阴虚质和血瘀质各6例 (12.76%) ;绝经过渡晚期 (-1 期) 组的最主要中医体质类型中,出现频 次最高的中医体质为阳虚质6例 (25.00%) ,其次为平和质和血瘀质各4例 (16.66%) ,再次之为气虚质和痰湿质各3例 (12.50%) ;绝经后期早期 (+la 期) 组的最主要中医体质类型中,出现频次最高的中医体质为阳虚质7例 (46.67%) ,其次为平 和质、痰湿质、血瘀质各2例 (13.33%) ,再次之为气虚质、气郁质各1例 (6.67%) 。 (2) 绝经过渡早期 (-2期) 患者的SAS评分 和SDS评分分别为 (34.55 ± 7.46) 、 (35.55 ± 10.61) 分,均高于绝经过渡晚期 (-1期) 患者的 (33.83 ± 7.73) 、 (35.46 ± 11.35) 分 和绝经后期早期 (+la期) 患者的 (35.65 ± 8.67) 、 (36.59 ± 12.07) 分,且均高于总体平均水平。 【结论】围绝经期代谢综合征患 者的中医体质以阳虚质为主,平和质随着分期的进展逐渐减少,而偏颇体质从阴虚质、血瘀质逐渐转变为气虚质、痰湿质, 再到痰湿质、血瘀质;随着分期进展,围绝经期代谢综合征患者本虚更虚而标实之邪也在加重。
[Key word]
[Abstract]
Objective To investigate the distribution of traditional Chinese medicine(TCM) constitution types in patients with perimenopause metabolic syndrome in Guangzhou based on the Stages of Reproductive Aging Workshop+10 (STRAW+10) ,so as to provide a theoretical basis for TCM constitution regulation for patients with PMS. Methods According to the diagnostic criteria of metabolic syndrome,a total of 90 patients with PMS were included. Based on the STRAW+10 staging criteria,the PMS patients were divided into early perimenopause group (-2 phase of STRAW+10,49 cases) ,late perimenopause group (-1 phase of STRAW+10,24 cases) ,and early postmenopausal group( +la phase of STRAW+10, 17 cases) . Traditional Chinese Medicine Constitution Classification and Distinguishing Criteria were used to identify the TCM constitution types of all the subjects. At the same time,the Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS) were used for scoring anxiety and depression. The distribution of TCM constitution types in patients with different STRAW+10 stages was analyzed,and the SAS and SDS scores of patients with different STRAW+10 stages were compared. Results (1)The primary TCM constitution types in the early perimenopause group(-2 phase of STRAW+10) were yang deficiency constitution(14 cases, 29.79%), balanced constitution(10 cases, 21.28%), yin deficiency constitution(six cases,12.76%) and blood stasis constitution(six cases,12.76%) . In the late perimenopause group (-1 phase of STRAW+10) ,the primary TCM constitution types were yang deficiency constitution (six cases, 25.00%),balanced constitution(four cases,16.66%),blood stasis constitution(four cases,16.66%),qi deficiency constitution (three cases,12.50%) and phlegm-damp constitution (three cases,12.50%) . In the early postmenopausal group(+la phase of STRAW+10),the primary TCM constitution types were yang deficiency constitution (seven cases,46.67%) ,balanced constitution (two cases,13.33%) ,phlegm-damp constitution (two cases,13.33%),blood stasis constitution(two cases,13.33%),qi deficiency constitution(one case,6.67%) and qi stagnation constitution(one case,6.67%) .(2) The SAS score and SDS score in the early perimenopause group (-2 phase of STRAW+10) were (34.55 ± 7.46) points and (35.55 ± 10.61) points,respectively,which were higher than those in the late perimenopause group (-1 phase of STRAW+10) [ (33.83 ± 7.73) points and (35.46 ± 11.35) points,respectively] and in the early postmenopausal group(+la phase of STRAW+10) [ (35.65 ± 8.67) points and(36.59 ± 12.07) points,respectively]. All of the scores were higher than the overall average level. Conclusion The TCM constitution of patients with perimenopause metabolic syndrome is predominated by yang deficiency constitution. The percentage of the balanced constitution gradually decreases with the progression of STRAW+10 staging,and the biased constitutions gradually develop from yin deficiency constitution and blood stasis constitution into qi deficiency constitution and phlegm-damp constitution,and then into phlegm-damp constitution and blood stasis constitution again. With the progression of the stage, the deficiency in the fundamental of the PMS patients becomes more deficient and the pathogens of excess in the incidental also grow.
[中图分类号]
R271.29
[基金项目]
广东省中医药局科研项目 (编号:20212063)