经前烦躁障碍症证候和症状分布的临床流行病学调查分析

Clinical Epidemiological Investigation on Pattern and Symptom Distributions of Premenstrual Dysphoric Disorder

目的 :探讨经前烦躁障碍症(PMDD)中医证候及症状分布特点,初步筛选经前烦躁障碍症肝气逆证和肝气郁证两个亚型。方法:通过临床横断面流行病学调查选取106例经前烦躁障碍症患者,运用SPSS 16.0软件统计根据PMDD证型症状,采用频数分析、Spearman相关分析和因子分析对数据进行处理。结果:肝气逆证、肝气郁证是PMDD主要常见证。常见症状有23个,且以轻中度为主。公因子1为情志抑郁、焦虑、感觉无望、疲劳、胸闷、善太息、工作能力下降、学习能力下降,与肝气郁证症状相似。公因子2为急躁易怒、多梦、头胀、目涩、口干咽燥、胸胁胀满、胸胁胀痛,与肝气逆证症状相似。结论:PMDD肝气逆证与肝气郁证体现出两类相对独立的症候群,推断其为PMDD两个亚型。针对两个亚型,分别采用平肝降逆和疏肝解郁治疗。

Objective：To investigate the prevalence,pattern and symptom distributions of premenstrual dysphoric disorder（PMDD）,initial screen two subtypes of adverse liver-qi and liver-qi stagnation. Methods：Total106 patients of premenstrual dysphoric disorder were selected by clinical cross-sectional epidemiological survey. According to the symptoms and patterns of PMDD,frequency analysis,Spearman correlation analysis and factor analysis were used by SPSS 16.0. Results：The adverse liver-qi and liver-qi stagnation are the main common patterns of PMDD. There are 23 common symptoms,mild to moderate mainly. Common factor 1 included emotional depression,anxiety,hopelessness,fatigue,chest tightness,frequent sighing,decreasing ability in work and learning,which was similar to liver-qi stagnation. Common factor 2 included irritability,dreaminess,fullness in head,dry eyes,dry throat,fullness in chest and hypochondrium,chest pain,which was similar to adverse liver-qi. Conclusion：Adverse liver-qi and liver-qi stagnation reflected two relatively independent types of syndromes,can be inferred as two subtypes of PMDD. For the two subtypes,suppressing hyperactive liver Qi for descending adverse Qi and dispersing stagnated liver Qi for relieving Qi stagnation can improve the clinical diagnosis and treatment of PMDD.