基于经验辨证的更年期综合征围绝经期和绝经后期常见证候及证候要素分布

目的：通过规范专家经验辨证，提取证候要素，总结更年期综合征围绝经期和绝经后期两个阶段的常见证候及其证候要素的分布特点，并比较两者的异同。方法：纳入2006年10月～2007年6月就诊于全国7家三级甲等医院且符合疾病诊断和纳入标准的1582例更年期综合征门诊患者，对其进行临床流行病学调查，在专家经验辨证证候名称规范化的基础上，提取炳位和病性类证候要素，并进行统计学分析。结果：经初步规范后，涉及证候名称105个，常见证候是肾阴虚、肝肾阴虚、肝气郁结和肾阴阳两虚证。在此基础上提取病位类证候要素6个，病性类证候要素17个。出现较多的病位类证候要素是肾、肝、脾、心，病，胜类证候要素是阴虚、气滞、气虚、阳虚、虚。围绝经期肝气郁结、脾肾两虚及气滞的分布较绝经后期明显增多，而绝经后期则多见肾阴虚证，且病位多在肾，其余证候与证候要素的分布趋势基本相似。结论：更年期综合征的证候分布具有复杂多样的特点，证候要素分布则相对简约。围绝经期和绝经后期两阶段的证候、证候要素在总体分布上具有一致性，但在一些证候及证候要素的出现频率上存在明显差异，可为

Distribution characteristics of common syndrome types and syndrome elements extracted by experts' experience in perimenopausal and postmenopausal women

Objective： To compare the distribution characteristics of common syndrome types and syndrome elements of menopause syndrome in perimenopausal and postmenopausal women on the basis of standardized syndrome differentiation extracted by experts＇ experiences. Methods： A total of L 582 outpatients with menopause syndrome who met with the diagnosis and inclusion criteria in seven grade3 hospitals from October 2006 to June 2007 were included. A clinical epidemiological survey in the patients was carried out. The syndrome elements of disease location and characteristics were extracted and analyzed statistically by standardizing the syndrome differentiation of experts＇ experience in traditional Chinese medicine. Results： There were 105 syndrome types after initial standardization, and the common syndrome types were kidney yin deficiency, deficiency of liver and kidney yin, stagnation of liver qi, and deficiency of both kidney yin and yang. Six syndrome elements of the disease location were extracted, among which the common elements were kidney, liver, spleen and heart. Seventeen syndrome elements of the disease characteristics were extracted, among which the common elements were yin deficiency, qi stagnation, qi deficiency, yang deficiency and deficiency. Syndrome types of stagnation of liver qi, deficiency of spleen and kidney, and qi stagnation were more frequently diagnosed during perimenopausal period, while the syndrome type of kidney yin deficiency was more frequently diagnosed during postmenopausal period, and the kidney was the main disease location. The distribution characteristics of the other syndrome types and elements were similar during the two periods. Conclusion： The syndrome type distribution in women with menopause syndrome is complex, while the syndrome element distribution is simple. Generally, the syndrome type and syndrome element distributions during perimenopausal and postmenopausal periods are similar, but there are significant differences in some syndrome types and syndrome elements between the two periods. All of these can give support for revealing the distribution rule of the common syndrome types and syndrome elements and give a theoretical basis for clinical treatment of menopause syndrome.