Tratamento dos fogachos no climatério com a Medicina Tradicional Chinesa
Data
2023-03-22
Autores
Mattos, Felipe Rondini de 
Orientadores
Sartori, Marair Gracio Ferreira
Girão, Manoel João Batista Castello
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Fogacho é o sintoma mais comum no Climatério, considerado um evento
biopsicossociocultural, reduzindo a qualidade de vida e aumentando os riscos
cardiovasculares e cerebrais. A Medicina Tradicional Chinesa compreende o Climatério como
a síndrome energética ‘Deficiência do Yīn dos Rins’, sendo natural do ciclo feminino. Esta
síndrome por si só ocasiona alterações no Yīn e Yáng de todo o corpo, explicando o porquê
do fogacho ser o sintoma mais comum e frequente; outras síndromes energéticas associadas,
assim como o estilo de vida de cada mulher, interfere na intensidade, frequência e quantidade
de fogacho e outros sintomas. Este estudo prospectivo, randomizado, controlado e crossover
sem washout, objetivou avaliar o impacto de um protocolo fixo de recursos combinados da
Medicina Tradicional Chinesa (Acupunturas Sistêmica e Auricular, Meditações Coletiva e
Individual e Dietoterapia) no fogacho e na qualidade de vida no Climatério, além de verificar
o Perfil de Comportamento das pacientes durante o estudo. Foram avaliadas 32 mulheres,
sendo que de 12 delas foram obtidos dados parciais. Elas foram divididas em 2 grupos, com 3
meses em cada fase (Intervenção e Observação). A frequência das sessões foi de 1 vez por
semana durante a Intervenção. De forma autopreenchida, durante vários momentos do estudo,
utilizaramse
Instrumentos de Avaliação para avaliar os fogachos e a qualidade de vida, e
Questionários para verificar o Perfil de Comportamento. Na avaliação dos fogachos, a Escala
de Interferência Diária Relacionada aos Fogachos (HFRDIS) mostrou melhora de 56,9%,
p<0,001, com Poder de Amostra de 95,8% (alto poder para diferenciação); na avaliação da
qualidade de vida, a Escala de Classificação do Climatério (MRS) mostrou melhora de 39,9%,
p=0,057, com Poder da Amostra de 56% e o Questionário de Saúde da Mulher (WHQ)
mostrou melhora de 14,3%, p=0,170, com Poder da Amostra de 15,3% (baixos poderes para
diferenciação). Na avaliação do Perfil de Comportamento, a presença nas Acupunturas
(83,9%) e na Meditação Coletiva (80%) foi considerada favorável; a mudança nas rotinas
diárias para a Meditação Individual (56,9%) e para a Dietoterapia Chinesa (57,3%) foi
considerada razoável. As mulheres que iniciaram na Observação (apenas Dietoterapia) (grupo
1), melhoraram mais rapidamente quando mudaram para a Intervenção, em relação às
mulheres que iniciaram com a Intervenção (grupo 2), porém, ambos grupos tiveram melhoras
similares (p=0,032 e p<0,001, respectivamente). O protocolo se demonstrou eficaz para a
melhora dos fogachos, mas não foi suficiente para modificar a qualidade de vida
(provavelmente pela pouca quantidade de pacientes). Evidenciou que a meditação e mudanças
alimentares são bem aceitas pelas pacientes, no entanto, são necessárias melhores estratégias
para incentivar as mudanças em suas rotinas diárias. Avaliar por um período maior e
implementar outros métodos de avaliação podem favorecer pesquisas futuras.
Fogacho is the most common symptom in the Climacteric considered a biopsychosociocultural event, reducing the quality of life and increasing cardiovascular and brain risks. Traditional Chinese Medicine understands the Climacteric as the energetic syndrome 'Yīn Deficiency of the Kidneys', being natural of the female cycle. This syndrome alone causes changes in the Yīn and Yáng of the whole body, explaining why hot flush is the most common and frequent symptom; Other associated energy syndromes, as well as each woman's lifestyle, interfere with the intensity, frequency, and amount of hot flashes and other symptoms. This prospective, randomized, controlled and crossover study without washout aimed to evaluate the impact of a fixed protocol of combined resources of Traditional Chinese Medicine (Systemic and Auricular Acupuncture, Collective and Individual Meditations and Diet Therapy) on the hot flush and on the quality of life in the Climacteric, in addition to verifying the Behavior Profile of the patients during the study. A total of 32 women were evaluated, and partial data were obtained from 12 of them. They were divided into 2 groups, with 3 months in each phase (Intervention and Observation). The frequency of the sessions was 1 time per week during the Intervention. In a selfcompleted way, during several moments of the study, Assessment Instruments were used to assess hot flashes and quality of life, and Questionnaires to verify the Behavior Profile. In the evaluation of hot flashes, the Daily Interference Scale Related to Hot Flashes (HFRDIS) showed an improvement of 56.9%, p<0.001, with Sample Power of 95.8% (high power for differentiation); In a selfcompleted way, during several moments of the study, Assessment Instruments were used to assess hot flashes and quality of life, and Questionnaires to verify the Behavior Profile. In the evaluation of hot flashes, the Daily Interference Scale Related to Hot Flashes (HFRDIS) showed an improvement of 56.9%, p<0.001, with Sample Power of 95.8% (high power for differentiation); in the evaluation of quality of life, the Climacteric Classification Scale (MRS) showed an improvement of 39.9%, p=0.057, with Sample Power of 56% and the Women's Health Questionnaire (WHQ) showed an improvement of 14.3%, p=0.170, with Sample Power of 15.3% (low powers for differentiation). In the evaluation of the Behavior Profile, the presence in acupuncture (83.9%) and Collective Meditation (80%) was considered favorable; the change in daily routines for Individual Meditation (56.9%) and Chinese Diet Therapy (57.3%) was considered reasonable. Women who started with Observation (Diet Therapy only) (group 1) improved more rapidly when they switched to the Intervention, compared to women who started with the Intervention (group 2), however, both groups had similar improvements (p=0.032 and p<0.001, respectively). The protocol proved to be effective for the improvement of hot flashes, but it was not enough to modify the quality of life (probably due to the small number of patients). It showed that meditation and dietary changes are well accepted by patients, however, better strategies are needed to encourage changes in their daily routines. Evaluating for a longer period and implementing other evaluation methods may favor future research.
Fogacho is the most common symptom in the Climacteric considered a biopsychosociocultural event, reducing the quality of life and increasing cardiovascular and brain risks. Traditional Chinese Medicine understands the Climacteric as the energetic syndrome 'Yīn Deficiency of the Kidneys', being natural of the female cycle. This syndrome alone causes changes in the Yīn and Yáng of the whole body, explaining why hot flush is the most common and frequent symptom; Other associated energy syndromes, as well as each woman's lifestyle, interfere with the intensity, frequency, and amount of hot flashes and other symptoms. This prospective, randomized, controlled and crossover study without washout aimed to evaluate the impact of a fixed protocol of combined resources of Traditional Chinese Medicine (Systemic and Auricular Acupuncture, Collective and Individual Meditations and Diet Therapy) on the hot flush and on the quality of life in the Climacteric, in addition to verifying the Behavior Profile of the patients during the study. A total of 32 women were evaluated, and partial data were obtained from 12 of them. They were divided into 2 groups, with 3 months in each phase (Intervention and Observation). The frequency of the sessions was 1 time per week during the Intervention. In a selfcompleted way, during several moments of the study, Assessment Instruments were used to assess hot flashes and quality of life, and Questionnaires to verify the Behavior Profile. In the evaluation of hot flashes, the Daily Interference Scale Related to Hot Flashes (HFRDIS) showed an improvement of 56.9%, p<0.001, with Sample Power of 95.8% (high power for differentiation); In a selfcompleted way, during several moments of the study, Assessment Instruments were used to assess hot flashes and quality of life, and Questionnaires to verify the Behavior Profile. In the evaluation of hot flashes, the Daily Interference Scale Related to Hot Flashes (HFRDIS) showed an improvement of 56.9%, p<0.001, with Sample Power of 95.8% (high power for differentiation); in the evaluation of quality of life, the Climacteric Classification Scale (MRS) showed an improvement of 39.9%, p=0.057, with Sample Power of 56% and the Women's Health Questionnaire (WHQ) showed an improvement of 14.3%, p=0.170, with Sample Power of 15.3% (low powers for differentiation). In the evaluation of the Behavior Profile, the presence in acupuncture (83.9%) and Collective Meditation (80%) was considered favorable; the change in daily routines for Individual Meditation (56.9%) and Chinese Diet Therapy (57.3%) was considered reasonable. Women who started with Observation (Diet Therapy only) (group 1) improved more rapidly when they switched to the Intervention, compared to women who started with the Intervention (group 2), however, both groups had similar improvements (p=0.032 and p<0.001, respectively). The protocol proved to be effective for the improvement of hot flashes, but it was not enough to modify the quality of life (probably due to the small number of patients). It showed that meditation and dietary changes are well accepted by patients, however, better strategies are needed to encourage changes in their daily routines. Evaluating for a longer period and implementing other evaluation methods may favor future research.