CLINICAL ANALYSIS TO 74 CASES OF MENOPAUSAL SYNDROME TREATED WITH SIMPLE FIRE NEEDLE

In this paper,simple fire needle pricking the points of Du（Governor）and Ren（Conception）meridians was employed to treat 74 cases of menopausal syndrome.The result showedthat 41 cases were clinically cured,17 markedly improved,15 improved and 1 ineffective,with thetotal effective rate 87％.With the advantages of extensive materials used,simple manipulation andlarge variety of indications,this method is worthy to be popularized.

Acupuncture Treatment of Menopausal Syndrome

Case History Ms. Li, aged 51 years, a staff member from a certain university in Beijing, paid her first visit on Feb. 17,2003, with the chief complaint of irregular menstrual cycle for more than 2 years. The patient complained that in the recent two years, she had shortened menstrual cycle, sometimes only with a 10-day interval between each two cycles, and each menstrual period lasting 3-10 days. The menstrual blood was profuse and fresh-red in color, accompanied with such symptoms as feverish sensation in the face,uncontrollable irritability and peevishness, poor sleep,excitation, difficulty in falling asleep. She also sometimes had vexation, palpitation, dizziness,forgetfulness, lumbar soreness, dry throat and thirst,dry stool, and yellow urine. She had been diagnosed by western medicine to have menopausal syndrome,and treated with western medicine accordingly with little effect.

Effect of self prescription for nourishing liver and kidney combined with tibolone on hormone levels, lipid metabolism and immune response in women with menopausal syndrome

Objective:To study the effect of self prescription for nourishing liver and kidney combined with tibolone on hormone levels, lipid metabolism and immune response in women with menopausal syndrome.Methods: Patients with menopausal syndrome who were admitted in Hebei Weichang County Hospital between April 2014 and March 2017 were selected as the research subjects and randomly divided into to the combined group who accepted self prescription for nourishing liver and kidney combined with tibolone therapy and the control group who accepted tibolone monotherapy. The serum levels of sex hormones, lipid metabolism and immune cytokines were detected before treatment and3 months after treatment.Results: 3 months after treatment, serum E2, HDL-C, Omentin-1, VaspinC, IL-4 and IL-10 levels of both groups of patients were significantly higher than those before treatment while LH, FSH, TC, TG, LDL-C, Rsistin, IFN-γ and IL-2 levels were significantly lower than those before treatment, E2, LH and FSH levels were not significantly different between the two groups, serum TC, TG, LDL-C, Rsistin, IFN-γ and IL-2 levels of combined group were significantly lower than those of control group while HDL-C, Omentin-1, VaspinC, IL-4 and IL-10 levels were significantly higher than those of control group.Conclusion: Self prescription for nourishing liver and kidney combined with tibolone is equivalent to tibolone monotherapy in regulating the sex hormones, and more significant than tibolone monotherapy in improving the lipid metabolism and immune response in patients with menopausal syndrome.

Menopausal Status and Metabolic Syndrome in Women in Climacteric Period Treated at a Clinic in Southern Brazil

Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syn- drome according to sample characteristics. Methods: A cross-sectional study was conducted with 551 women treated at a clinic in southern Brazil. MetS and its components were defined according to NCEP-ATP III and menopausal status as pre, peri, and post-menopause. Prevalences of menopausal status and of MetS and its components were calculated. Estimates of prevalence ratios crude and adjusted with confidence intervals of 95% were calculated by Poisson Regression with robust variance. Demographic, socioeconomic, behavioral, and reproductive characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of MetS determination. Results: The prevalence of Metabolic Syndrome in the sample was 56.1% (CI95%: 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche 11 years old, with three or more pregnancies and in the post-menopausal period. In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause;however, the confidence intervals include the unit. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%;CI95%: 81.7 to 87.8), waist circumference (66.4%;CI95%: 62.5 to 70.4) and HDL cholesterol (51.7%;CI95%: 47.5 to 55.9). There was a linear increase on mean blood glucose through menopausal status. Conclusions: Our study indicates variation on the distribution of MetS and each component according to menopausal status and other women characteristics. Future studies on MetS should also have foresight to use this type of approach to improve understanding and targeting of actions and programs focusing on women in this period of life.

Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.

坤宝丸治疗更年期综合征临床疗效和安全性Meta分析

目的系统评价坤宝丸治疗更年期综合征的有效性和安全性。方法采用计算机检索PubMed,EMbase,The Cochrane Library,Web of Science及中国知网(CNKI)、万方(WanFang)、维普(VIP)数据库自建库起至2022年12月的相关文献。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.3软件对纳入研究进行Meta分析。结果共纳入13项研究,涉及1590例更年期综合征患者,其中观察组803例,对照组787例。按对照组的用药种类进行亚组分析,坤宝丸单用组的临床疗效显著高于氟桂利嗪+谷维素+维生素B1组[RR=1.75,95%CI(1.38,2.22),P<0.00001],坤宝丸联用组临床疗效显著高于戊酸雌二醇+甲羟孕酮组[RR=1.18,95%CI(1.03,1.34),P=0.01]和刺五加组[RR=1.20,95%CI(1.08,1.33),P=0.0007];坤宝丸单用组对更年期临床症状调查表(Kupperman)评分显著低于替勃龙组[MD=-6.00,95%CI(-7.72,-4.28),P<0.00001];坤宝丸联用组卵泡刺激素(FSH)显著低于刺五加组[MD=-25.70,95%CI(-33.22,-18.18),P<0.00001];坤宝丸联用组促黄体素(LH)显著低于刺五加组[MD=-11.20,95%CI(-12.05,-10.35),P<0.00001];坤宝丸单用组雌二醇(E2)显著高于替勃龙组[MD=-7.00,95%CI(-11.44,-2.56),P=0.002]。药品不良反应主要为腹胀、便秘、头晕、阴道出血、体质量增加等,患者均能耐受。结论坤宝丸对更年期综合征患者的临床疗效、Kupperman评分、激素指标等的改善效果与激素类药物相当,甚至更优。但由于纳入研究的质量不高,尚需更严格、高质量的临床研究进一步证实。

300 CASES OF MENOPAUSAL SYNDROME TREATED BY ACUPUNCTURE

Caused by hypo-ovarianism, menopausal syndrome usually occurs in women aged from 45-55 years. With high incidence and various symptoms, the disease often severely jeopardize the health of the women. The authors had treated 300 cases of menopausal syndrome by acupuncture and obtained a good result.

正念减压疗法对改善女性更年期综合征生活质量及负性情绪的效果

目的研究分析正念减压疗法对改善女性更年期综合征生活质量及负性情绪的效果。方法选择2020年1月—2022年6月在梅州市第三人民医院接受治疗的100例女性更年期综合征伴负性情绪患者为研究对象,并按照随机数字表法分为对照组(n=50)与观察组(n=50)。两组均接受抗抑郁药治疗,观察组在此基础上给予正念减压疗法。比较两组干预前后负性情绪、激素水平、女性绝经期自测量表评分及生活质量。结果干预后,观察组焦虑自评量表及汉密尔顿抑郁量表评分均低于对照组,组间差异有统计学意义(P<0.05);干预后,观察组5-羟色胺、雌二醇水平高于对照组,女性绝经期自测量表评分低于对照组,组间差异有统计学意义(P<0.05);观察组干预后生活质量评分高于对照组,组间差异有统计学意义(P<0.05)。结论正念减压疗法可改善女性更年期综合征负性情绪及激素水平,缓解患者临床症状,提高生活质量。

中医药治疗围绝经期综合征文献可视化分析

目的基于文献计量学方法对中医药治围绝经期综合征(MPS)相关文献进行分析,探索中医药治疗MPS的研究现状、前沿热点与发展趋势。方法以中国知网(CNKI)为文献数据来源,检索2000-2020年中医药治疗围绝经期综合征的相关文献,利用CiteSpace6.1.R3软件,对发文量、作者、机构、关键词等绘制相关知识图谱并分析。结果最终纳入文献1623篇,共有618位作者,以李瑛、傅萍、卢苏等为代表;研究机构共计550家,以南京中医药大学、北京中医药大学、山东中医药大学等为代表;关键词共计429个,高频关键词有中医疗法、二仙汤、辨证论治,聚类图谱显示研究主要包括围绝经期综合征中医药治疗与临床疗效研究,突现词分析可知研究焦点集中于临床疗效、研究进展。结论中医药在治疗MPS的领域上逐步地发展与完善,失眠症、抑郁症与性激素是其研究热点,辨证论治与针灸是其研究趋势,还需加强作者、团队之间合作联系,以形成广泛联系的合作网络。

郭志强教授基于“脾肾互赞”理论论治绝经综合征经验

中医妇科学者普遍认为绝经综合征核心病机在于肾阴虚,而郭志强教授总结临床经验后发现患者肾阴阳俱虚者多见,且脾胃不足者亦不少。故提出临证须注重脾肾同治,以“脾肾互赞”为理论依托,着重健补脾胃,发挥脾肾相赞功能,在补益精血、温补阳气、安神定志等重要治疗方向上发挥疗效。本文总结了郭志强教授基于“脾肾互赞”理论论治绝经综合征的经验。

单核细胞计数/高密度脂蛋白胆固醇及促甲状腺激素对绝经期女性急性冠脉综合征患者预测价值及与冠状动脉病变相关性研究

背景既往研究发现单核细胞计数、高密度脂蛋白胆固醇(HDL-C)、促甲状腺激素(TSH)与急性冠脉综合征(ACS)相关,然而单核细胞计数/高密度脂蛋白胆固醇(MHR)与ACS发病的相关性研究较少,绝经期女性MHR、TSH与ACS发病是否存在关联仍不明确。目的探讨MHR、TSH对绝经期女性ACS患者发病的预测价值,并研究上述指标与患者冠状动脉狭窄程度的相关性。方法选择2020—2021年在苏北人民医院心血管内科住院诊治并行冠状动脉造影的325例绝经期女性作为研究对象。通过电子病历系统收集患者一般资料,研究对象入院后采集静脉血检测单核细胞计数、总胆固醇(TC)、三酰甘油(TG)、HDL-C、低密度脂蛋白胆固醇(LDL-C)、TSH等。以双平面Simpson法测量左心室射血分数(LVEF),通过冠状动脉造影术观察冠状动脉病变情况。采用Gensini评分标准统一衡量冠状动脉病变情况。符合ACS诊断标准的患者为ACS组(n=184),非ACS者为对照组(n=141)。同时依据Gensini评分三分位数将ACS组进行分组:≤36.5分为低危亚组(n=59),36.6~66.5分为中危亚组(n=64),>66.5分为高危亚组(n=61)。采用单因素及多因素Logistic回归分析探究ACS的影响因素。绘制受试者工作特征(ROC)曲线评估TSH、MHR及联合检测对ACS的诊断价值并计算ROC曲线下面积(AUC)。采用Spearman秩相关分析探究TSH、MHR及联合检测指标与Gensini积分的相关性。结果ACS组与对照组患者基线资料结果示,ACS组BMI、吸烟比例、高血压、糖尿病、LDL-C、单核细胞计数、TSH、MHR高于对照组,LVEF、HDL-C低于对照组(P<0.05)。多因素Logistic回归分析结果示,吸烟、高血压、BMI≥24.0 kg/m^(2)、LDL-C≥3.30 mmol/L、TSH≥2.1m U/L、MHR≥0.25是绝经期女性发生ACS的危险因素,HDL-C≥1.2 mmol/L为保护因素(P<0.05)。ROC曲线结果显示,MHR、TSH及联合预测指标诊断绝经期女性ACS的AUC分别为0.777(95%CI=0.725~0.830,P<0.001)、0.747(95%CI=0.694~0.800,P<0.001)、0.810(95%CI=0.764~0.857,P<0.001)。中危亚组、高危亚组MHR、TSH均高于低危亚组,高危亚组MHR、TSH高于中危亚组(P<0.05)。Spearman秩相关分析结果示,ACS组患者MHR(r_(s)=0.497,P<0.01)、TSH(r_(s)=0.498,P<0.01)及联合预测指标与Gensini评分均呈正相关(r_(s)=0.600,P<0.001)。结论TSH及MHR升高是绝经期女性发生ACS的独立危险因素,两指标及联合对病情预测具有较高的灵敏度和特异度,并与患者冠状动脉病变程度相关,对绝经期女性ACS的早期识别及风险评估具有一定的临床应用价值。

维生素E对围绝经期和绝经后妇女健康的影响

随着年龄的增长,卵巢功能由旺盛期到逐渐减退,直至衰竭,女性也将从生殖期逐渐进入老年期。这不仅会对月经周期和生育能力有影响,还会伴随着一系列身体和心理上的变化,严重时会影响生活和工作。研究发现卵巢卵泡的发育以及绝经前后出现的泌尿生殖功能异常、骨质疏松、神经认知功能障碍及心血管病变等疾病的发生发展可能与氧化应激反应有着密不可分的关系。维生素E具有抗氧化特性和稳定细胞的能力,已经被证实可在代谢综合征、骨质疏松、心脑血管、神经系统等疾病的预防和治疗方面发挥着重要作用,并且发现维生素E在一定程度上还具有模拟雌激素的作用。因此,补充维生素E对围绝经期和绝经后妇女的健康具有潜在的益处。综述维生素E对围绝经期卵巢卵泡发育、雌激素的影响和绝经综合征的预防和治疗作用,为维生素E作为改善围绝经期和绝经后妇女身心健康的辅助或替代治疗方案提供参考依据。

全国名中医尤昭玲基于“以胞宫为中心的五脏一体观”诊治绝经前后诸证

绝经前后诸证对应西医学围绝经期综合征,或多种因素致卵巢功能衰竭而出现围绝经期综合征临床表现的患者。全国名中医尤昭玲基于《黄帝内经》“五脏一体观”,提出“以胞宫为中心的五脏一体观”,认为“五脏失调”为绝经前后诸证的主要病机,以“调和五脏”为治则,创制经验方更年方。以胞宫为中心,顺应胞宫藏泻有序的特点,绝经前分经期、排卵前、排卵后辨证施以耳穴辅助治疗,绝经后顺应胞宫藏而不泻的生理特性,辅以耳穴静养阴阳。分年龄配合药膳养巢煲或养生安神煲,临证中收获佳效。

中医治疗绝经综合征情绪障碍的信号通路研究进展

绝经综合征情绪障碍是较常见的妇科疾病,其发病与年龄、易烦躁、增加负压时溢尿、失眠、多疑、尿频、颈椎疼痛、初潮年龄、外阴瘙痒、耳鸣等因素相关,主要表现为烦躁易怒、焦虑或情绪低落等。中医治疗具有多途径、多靶点干预的特点,临床效果显著,因此,积极探寻中医发挥作用的信号通路机制,以期为中医治疗提供客观依据与理论支持,为绝经综合征的治疗、临床用药的选择、药品的开发提供更开阔的思路。

罗志娟教授治疗肾阴虚型绝经综合征经验分析

绝经综合征是绝经前后妇女出现的一系列躯体及精神、心理症状,发病率高,严重影响女性生活及工作质量。中医学认为其主要的病因病机以肾虚为本,肾阴阳平衡失调所致;现代医学认为其发病机制是雌激素水平下降。罗志娟教授在治疗肾阴虚型绝经综合征时,从中西医结合的角度分析“雌激素水平下降”与“肾阴亏虚”二者导致绝经综合征的发生,来推测二者之间的联系,认为雌激素与中医所说的“天癸”物质关系密切,可能属于“肾精”“肾阴”范畴。在治疗时以补肾滋阴填精为治则,方选自拟桂罗氏五子养脏汤加减的经验分析。

基于数据挖掘探析中医药治疗绝经综合征的用药规律

目的基于数据挖掘方法研究探讨中医药治疗绝经综合征(MPS)的用药规律,为中医药治疗MPS提供理论支持。方法通过检索中国知网(CNKI)、万方数据服务平台(Wanfang)、维普数据库(VIP)及中国生物医学文献数据库(CBM)中文数据库,PubMed及Web of Science英文数据库,收集中医药治疗MPS的相关文献。然后将筛选到的文献录入Microsoft Excel 2019表格,建立MPS方药数据库,并对所有药物进行频数、性味归经分析,采用chartcool进行绘图,运用SPSS molder 18.0软件进行关联分析获得核心药物组合,再使用SPSS Statistics 25.0软件对使用频次排名前30的中药进行组间联接的聚类分析。结果共筛选到符合标准文献1162篇,涉及处方1463首,共323味中药,其中方剂使用频次≥100首的药物有56味,使用频次最多的药物是白芍,药物四气以温为主,五味以甘、辛味为主,主要归肝、肾经二经,关联规则分析得到关联较强的核心药对是“女贞子-墨旱莲”,对处方使用频次排名前30的药物进行聚类分析共得到8类药物组合。结论MPS的中医药治疗以补益肝肾为主,“女贞子-墨旱莲”可能是中医药治疗MPS的核心药对,并随证配伍行气、安神、清热之药。

岭南罗氏妇科当代传承人辨治绝经前后诸证用药规律研究

【目的】基于数据挖掘技术探讨岭南罗氏妇科当代传承人辨治绝经前后诸证的思路与用药规律。【方法】收集岭南罗氏妇科当代传承人门诊治疗绝经前后诸证的医案,采用古今医案云平台(V2.3.5)对病案数据进行频数统计、关联规则分析、聚类分析及复杂网络分析。【结果】最终纳入医案191份,处方191首,涉及中药160味。四诊信息及证型统计显示,绝经前后诸证的病机以本虚为主,正虚失调,枢机不利,多脏受累,其中肝肾阴虚证最为常见。出现频次≥40次的高频中药有26味,居前5位的中药为百合、党参、山茱萸、白芍、熟地黄。药物的性味以甘平为主,多入肝、心、肾、脾经。关联规则分析共获得15对高置信度药物组合;高频中药的聚类分析得到5类核心药物组合。复杂网络分析揭示了以熟地黄、山茱萸、菟丝子、百合、酸枣仁、丹参、珍珠母为主的核心处方。关联规则分析得到使用频次较高的药对为女贞子-山茱萸及女贞子-丹参。【结论】岭南罗氏妇科当代传承人治疗绝经前后诸证以滋养肝肾为切入点,兼养心安神、益气健脾、和解枢机,用药以“甘淡平补”为主,遣方用药与罗元恺教授之学术思想一脉相承。

名中医周惠芳基于“肾主水司二阴”论治绝经生殖泌尿综合征

绝经生殖泌尿综合征是绝经过渡期及绝经后期女性特有疾病,周惠芳教授围绕“肾主水司二阴”理论,认为此病溯本在肾,虚实夹杂,治疗上辨证施治,清补兼施,选方用药基于《傅青主女科》名方加减化裁。针对女性特殊时期出现的生殖泌尿道不适症状采用益肾清利的治疗思路,以滋肾为主,佐以清利,兼顾他脏,并提出内外同治,有效改善症状,以期为绝经生殖泌尿综合征的临床诊治提供借鉴,提高围绝经期女性的生活质量。

半夏泻心汤加减治疗绝经综合征的临证经验

绝经综合征是女性绝经前后的常见病及多发病,绝经综合征患者常见失眠、烦躁、盗汗、心悸,现代医学治疗该病的方法以激素替代治疗为主,但需要严格排除禁忌证及慎用情况。临床发现,患有绝经综合征的女性大多为“虚阳浮越”型,基于此,临床上治疗多以“辛开苦降”为基本思想,主方选用半夏泻心汤,并根据特质性进行临证加减,临床效果显著。

基于脑肠轴理论探讨针刺治疗肾阴虚型绝经综合征伴焦虑障碍的临床疗效

[目的]探讨针刺治疗肾阴虚型绝经综合征伴焦虑障碍的疗效,并基于脑肠轴理论分析其作用机制。[方法]采用随机、对照研究方法,将天津中医药大学第一附属医院于2020年1月至2020年6月收治的60例肾阴虚型绝经综合征伴焦虑障碍患者随机分组。对照组口服莉芙敏治疗,研究组患者在对照组的基础上采用针刺治疗,疗程为8周,比较两组中医证候疗效、潮热评分、焦虑症状、性激素水平及脑肠肽水平。[结果]治疗后,研究组中医证候疗效的有效率(96.67%)高于对照组(73.33%),差异有统计学意义(P<0.05);研究组患者潮热评分、改良女性绝经期自测量表评分及汉密尔顿焦虑量表(HAMA)评分均低于对照组,差异有统计学意义(P<0.05);与治疗前比较,两组治疗后血清雌二醇(E2)有升高趋势,血清促卵泡生成素(FSH)、促黄体生成素(LH)有下降趋势,且两组患者FSH、LH、E2水平比较,差异无统计学意义(P>0.05);研究组患者血清血管活性肠肽(VIP)、生长抑素(SS)、神经肽Y(NPY)、降钙素基因相关肽(CGRP)及5-羟色胺(5-HT)水平均低于对照组(P<0.05)。[结论]在西医常规治疗基础上结合针刺治疗肾阴虚型绝经综合征伴焦虑障碍能够明显缓解患者潮热、绝经及焦虑症状,改善性激素水平,其作用机制可能与针刺调节脑肠肽水平的表达有关。