动态观测血清T_3、T_4、TSH在PMS肝气逆、肝气郁两证患者月经周期各时相的变化

Dynamic Observation on Change of T_3, T_4 and TSH in PMS Patients with Liver-qi Invasion Syndrome and Liver-qi Depression Syndrome in Each Phase of Menstrual Cycle

目的:研究三碘甲状腺原氨酸(T3)、甲状腺素(T4)、血清促甲状腺素(TSH)在经前期综合征(PMS)肝气逆、肝气郁两证型中的变化规律。方法:采用流行病学横断面调查的方法,选取济南、青岛两市女性职工为目标人群,参照PMS国际诊断标准及证候诊断标准筛选患者。对PMS两证患者在经期的卵泡期(6-14天)、黄体期(15-23天)、经前期(24-28天)及月经期(1-5天)4个时期采集血样,放免法检测经期不同时段T3、T4、TSH水平。结果:与正常组比较,在经前期与经期,两证患者血清T3水平均显著降低(P<0.05);血清T4、TSH水平发病前较发病后改变不显著,但在发病前后的经期各个时相,均呈现显著性升高。结论:T3、T4、TSH的改变是肝气逆、肝气郁两证发病的机制之一。这一微观改变是机体"气血潜在不畅"的实质之—,是两证发病的机体条件。

This study was aimed to reveal the roles of biological factors T3, T4 and TSH in the pathogenesis of liverqi invasion syndrome and liver-q/depression syndrome of premenstrual syndrome （PMS） in the body. Thus, we may expound the connotation of concept ＂potential stagnation of qi and blood,＂ Female workers of Jinan and Qingdao were selected as target groups by epidemiological cross-sectional survey. And specially trained investigators were responsible for screening patients referred to criterion on the international diagnostic standards and syndrome diagnosis of PMS. Patients＇ blood was taken as samples during the follicular phase （6 to 14 days）, luteal phase （15 to 23 days）, premenstrual phase （24 to 28 days） and the menstrual phase （1 to 5 days）, respectively. Blood samples were disposed according to requirements of radioimmunoassay. Single factor analysis of variance was used in the comparison with the level of T3, T4 and TSH in menstrual blood for different time intervals of the ease group and the normal group by SPSS 10.0 statistical software. The results showed that T3 levels of patients with either syndrome were significantly reduced during the premenstrual phase and the menstrual phase （P 〈 0.05）. There were no significant changes on the level of serum T4 and TSH before and after the occurrence of the disease. Both of them were significantly increased during each phase of the menstrual cycle. It was concluded that changes of T3, T4 and TSH were one of the mechanisms in disease with liver-qi invasion syndrome and liver-qi depression syndrome. The micro change was the essence of ＂potential stagnation of qi and blood＂, which was the body condition of this disease.