Objective To study the correlation between TCM liver depression grade and apoptotic regulatory genes of tongue exfoliated cells in perimenopausal syndrome. Methods Fifty healthy women were enrolled into the control group and 150 cases of perimenopausal syndrome attributed to the observed group. The patients were diagnosed with the syndrome-element differentiation for liver depression grading. Tongue exfoliated cell maturation index （MI） and maturation value （MV） were examined by Papanicolaou staining

apoptosis index was detected through flow cytometer

and positive rate of apoptotic regulatory genes Fas

Bax

and Bcl-2 of tongue exfoliated cells were investigated via immunohistochemistry. Results The liver depression score of the observed group was significantly higher than that of the control group （P<0.01）. The distribution of liver depression of the observed group was significantly different from that of the control group （P<0.01）. Liver depression was positively correlated with the amount of middle layer cells of MI of tongue exfoliated cells

tongue exfoliated apoptosis index

and the positive rate of Fas and Bax of tongue exfoliated cells （P<0.01）; while it was negatively correlated with the amount of surface layer cells of MI of tongue exfoliated cells

MV of tongue exfoliated cells

and the positive rate of Bcl-2 of tongue exfoliated cells （P<0.01）. Conclusion Liver depression is one of the core pathogenesis in perimenopausal syndrome. Degree of liver depression is correlated with maturity

apoptosis index

and apoptotic regulatory genes of tongue exfoliated cells.