Objective: To develop a validated questionnaire for the assessment of menopausal
syndrome in Chinese Medicine and through the analysis of the basic menopausal
syndrome classification in Chinese Medicine to explore the use of objective
hormone markers as one of the evidence for the Chinese Medicinal classification and
guidance for application of herbal medicines by Chinese Medicine Practitioners.
Methods: The major symptoms related to typical syndromes of menopause were
extracted from Chinese Medicine textbook, international diagnostic guide of Chinese
Medicine, classic and contemporary literature of Chinese Medicine and subjective
symptoms were eliminated to facilitate the administrate of a self-reported outcome
questionnaire. The symptoms related to menopause in Chinese Medicine were
identified and redefined to improve the content validity.
A total of 353 menopausal women were included in the study. Participants were
assessed through face-to-face interview by registered Hong Kong Chinese Medicine
Practitioner to complete the questionnaire and serum samples for hormones
measurement were collected after an overnight fast in the morning of the assessment
day. Serum Estradiol (E2), Testosterone (T), Progesterone (P), Luteinizing Hormone
(LH), Follicle Stimulating Hormone (FSH) and Sex-Hormone Binding Globulin
(SHBG) were measured by electrochemiluminescence immunoassays (ECLIA). Free
estradiol (fE2), non-Sex-Hormone Binding Globulin bound Estradiol (non-SHBG-E2),
free Testosterone (fT), and non-Sex-Hormone Binding Globulin bound Testosterone
(non-SHBG-T) were calculated to assess hormone availability and activity. E2/T ratio
was also calculated to investigate the balance of E2 and T in the body.
Results: Principal Component Analysis (PCA) was conducted. Symptoms related to
Deficiency of Yin and symptoms related to Deficiency of Yang were extracted and the
relationship between the syndromes and E2, T, P, LH, FSH, SHBG, fT, non-SHBG-T,
fE2, non-SHBG-E2 and E2/T ratio were investigated.
For symptoms related to Deficiency of Yin, E2 (p<0.000, p<0.000), P (p=0.004,
p<0.000), fE2 (p<0.000, p<0.000), non-SHBG-E2 (p<0.000, p<0.000), E2/T (p<0.000,
p<0.000)，SHBG (p=0.039, p=0.004) showed significant decrease while LH (p=0.013,
p<0.000), FSH (p=0.041, p<0.000) showed increase by comparing hormones of mild
or little with moderate and severe presentation of symptoms.
For symptoms related to Deficiency of Yang, SHBG (p=0.042, p=0.002, p<0.000)
showed an increase, fT (p=0.044, p=0.049, p=0.003) and non-SHBG-T (p=0.044,
p=0.049, p=0.003) showed a decrease which was significant for other three groups
while comparing to the no or little group.
Conclusion: Menopausal Syndrome Questionnaire was developed and validated in
the study. Major syndromes and symptoms involved in the diagnosis of menopausal
syndrome in Chinese Medicine were identified and good test-retest reliability was also
demonstrated. From the result, we hypothesize that the presentation of symptoms
related to Deficiency of Yin may be closely correlated with the menopausal transition
in Western Medicine and the presentation of symptoms related to Deficiency of Yang
may be related to deficiency of bio-active T in menopausal women. The study may
provide further information on the relationship between reproductive hormones and
Chinese Medicinal Classification and provide evidences and guides for effective
treatment of menopausal syndrome in Chinese Medicine. / published_or_final_version / Chinese Medicine / Master / Master of Philosophy
| Identifer | oai:union.ndltd.org:HKU/oai:hub.hku.hk:10722/146145 |
| Date | January 2011 |
| Creators | Lam, Lam., 林琳. |
| Contributors | Tong, Y, Sze, CW |
| Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
| Source Sets | Hong Kong University Theses |
| Language | English |
| Detected Language | English |
| Type | PG_Thesis |
| Source | http://hub.hku.hk/bib/B47251177 |
| Rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works., Creative Commons: Attribution 3.0 Hong Kong License |
| Relation | HKU Theses Online (HKUTO) |
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