258例经前焦虑性障碍的临床流行病学调查分析

The clinical epidemiological investigation into 258 cases of premenstrual dysphoric disorder

目的:探讨经前焦虑性障碍(PMDD)的患病情况、中医症状及证候分布特点。方法:应用临床流行病学现况调查法对3 541例18～45岁女性门诊患者进行面访调查,根据《精神疾病诊断和统计手册》第4版(DSM-IV)确定被调查对象为患者,填写临床流行病学现况调查表,对不同年龄、职业等PMDD患者的中医症状及证候进行描述性分析。结果:调查对象中PMDD 258例,患病率为7.3%,不同年龄、职业、婚姻状况、文化程度的PMDD患病率差异有统计学意义(P<0.01)。PMDD患者的常见症状有15个,程度均较重,肝气逆证和肝气郁证为PMDD的主证与常见证,但以复合证为主。结论:PMDD患病群体呈现年轻化趋势,该病病机与肝失疏泄密切相关,故临床调理当以肝失疏泄立论,从肝论治为宜。

Objective： To explore the prevalence, the traditional Chinese medicine symptoms and the distribution features of pre- menstrual dysphoric disorder （PMDD） in order to increase the understanding of PMDD and provide some measures to clinical diagnosis and treatment. Methods： Clinical epidemiological survey method was used to interview 3 541 female outpatients aged 18 -45. According to the PMDD diagnostic criteria in Diagnostic and Statistical Manual of Mental Disorders （4th Edition） , known as DSM -IV, the patients were se- lected from the respondents, and asked to fill in the questionnaire of Clinical Epidemiology Survey, and the PMDD patients of different ages, occupations, etc. were taken descriptive analysis in terms of the traditional Chinese medicine symptoms and signs. Results： The PMDDprevalence of the respondents was 7.3% , 258 cases out of 3 541. The difference of the PMDD prevalence among the respondents with different ages, occupations, marital status and educational background was of sta- tistical significance （P 〈 0. 01 ）. 15 common PMDD symptoms werefound, all of which were serious. The main and common syndromes of the PMDD patients were the invasion and stagnation of liver qi. But the clinical manifestations of this disease were complex, in which compound syndromes were regarded as the primary. Conclusion ： The sick- ness group of PMDD has the trend of getting younger, and the pathogenesis of PMDD is related to the failure of liver controlling conveyance and dispersion. So in the clinical regulation we should consider the failure of liver controlling conveyance and dispersion as the basis, and it is advisable to treat this disease from the liver.