本文關(guān)鍵詞：補(bǔ)腎填精方治療陰虛火旺型圍絕經(jīng)期綜合征的臨床觀察　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 補(bǔ)腎填精 圍絕經(jīng)期綜合征 陰虛火旺 臨床觀察

【摘要】：目的:女性在圍絕經(jīng)期,隨著卵巢功能的逐漸減退,激素水平出現(xiàn)變化,圍絕經(jīng)期綜合征(perimenopausal syndrome,PMS)隨之出現(xiàn)。PMS是婦科臨床的常見疾病,其臨床表現(xiàn)多見月經(jīng)紊亂、烘熱汗出、煩躁失眠、心悸、眩暈等癥狀,可嚴(yán)重降低圍絕經(jīng)期女性生活質(zhì)量。因此,對(duì)PMS的治療不容忽視。雌激素水平下降是PMS的重要原因,但雌激素替代療法存在誘發(fā)癌癥的風(fēng)險(xiǎn),臨床上治療PMS需要新思路。傳統(tǒng)中醫(yī)稱PMS為經(jīng)斷前后諸證,認(rèn)為其病機(jī)為腎虛為本,分為腎陰虛型、腎陽虛型及腎陰陽俱虛型。導(dǎo)師劉昭陽主任中醫(yī)師結(jié)合多年臨床實(shí)踐經(jīng)驗(yàn)及中醫(yī)古籍的論述,認(rèn)為PMS除上述分型外,還分為陰虛火旺型,并獨(dú)創(chuàng)補(bǔ)腎填精方以治療陰虛火旺型PMS。本研究通過應(yīng)用補(bǔ)腎填精方治療陰虛火旺型PMS,觀察補(bǔ)腎填精方對(duì)陰虛火旺型PMS的臨床癥狀影響,及治療前后機(jī)體雌二醇(estrogen,E2)、卵泡刺激素(follicle-stimulating hormone,FSH)、促黃體生成素(luteinizing hormone,LH)水平的變化。方法:本研究患者均為2016年6月至2016年11月就診于北京中醫(yī)藥大學(xué)第三附屬醫(yī)院婦科門診的患者。參考PMS相關(guān)中西醫(yī)診斷標(biāo)準(zhǔn),并根據(jù)相關(guān)標(biāo)準(zhǔn)排除相應(yīng)病例后,選取中醫(yī)辨證為陰虛火旺型PMS患者55例,按隨機(jī)對(duì)照試驗(yàn)分為補(bǔ)腎填精方治療組(n=28例)和坤泰膠囊對(duì)照組(n=27例)�？诜盟�,以8周為一個(gè)療程,填寫研究觀察表,觀察比較各組患者治療前后的國內(nèi)改良Kupperman積分、中醫(yī)證候積分和E2、FSH、LH水平的變化情況。結(jié)果:1.綜合療效:補(bǔ)腎填精方治療組:28例,痊愈2例(7.14%),顯效14例(50%),有效10例(35.71%),無效2例(7.14%),總有效率92.86%;坤泰膠囊對(duì)照組:27例,治療后痊愈1例(3.70%),顯效5例(18.52%),有效13例(48.15%),無效8例(29.63%),總有效率70.37%;治療組療效優(yōu)于對(duì)照組(P0.05)。2.國內(nèi)改良Kupperman評(píng)分結(jié)果:治療組評(píng)分均值標(biāo)準(zhǔn)差由29.79±7.52下降到8.79±4.69,對(duì)照組均值標(biāo)準(zhǔn)差由27.33±8.75下降至14.52±9.35,兩組患者治療后均有效果,且補(bǔ)腎填精方療效優(yōu)于對(duì)照組(P0.05)。3.中醫(yī)癥狀評(píng)分結(jié)果:兩組癥狀比較,治療組評(píng)分均值標(biāo)準(zhǔn)差由17.32±6.41下降到4.79±2.85,對(duì)照組均值標(biāo)準(zhǔn)差由16.74±7.19下降到9.63±6.82,兩組患者治療后均有效果,治療組較對(duì)照組評(píng)分降低明顯(P0.05),其中治療組在改善患者烘熱汗出、心煩易怒、手足心熱、大便秘結(jié)、心悸氣短及失眠中醫(yī)癥候方面療效優(yōu)于對(duì)照組。4.血清激素水平結(jié)果:兩組患者治療后E2水平均有所上升,治療組均值標(biāo)準(zhǔn)差由30.26±19.56 上升到 46.66±33.81,較對(duì)照組 28.18±17.74 增至 34.75±26.73 上升明顯,(P0.05)說明存在差異;FSH、LH均有下降,治療后兩組組間比較,(P0.05)說明存在差異,治療組效果高于對(duì)照組。結(jié)論:補(bǔ)腎填精方治療陰虛火旺型圍絕經(jīng)期綜合征臨床療效顯著,能夠明顯改善陰虛火旺型PMS患者的臨床癥狀及性激素水平,具有較好臨床應(yīng)用價(jià)值。
[Abstract]:Objective: during the peri-menopausal period, with the gradual decline of ovarian function, hormone level changes, peri-menopausal syndrome perimenopausal syndrome. PMS.PMS is a common gynecological clinical disease, its clinical manifestations are more menstrual disorders, hot sweating, restless insomnia, palpitations, vertigo and other symptoms. Therefore, the treatment of PMS can not be ignored. The decrease of estrogen level is an important cause of PMS, but estrogen replacement therapy has the risk of inducing cancer. Clinical treatment of PMS needs a new way of thinking. Traditional Chinese medicine call PMS as the syndrome before and after meridian break, think that its pathogenesis is kidney deficiency, divided into kidney yin deficiency type. Director Liu Zhaoyang combined with many years of clinical experience and the discussion of ancient Chinese medicine books, think that PMS in addition to the above classification, but also divided into Yin deficiency fire flourishing type. In this study, the effect of Bushen filling essence prescription on the clinical symptoms of Yin deficiency and fire flourishing type PMS was observed through the application of Bushen filling essence recipe in treating Yin deficiency Fire and flourishing PMSs. And before and after treatment, estradiol estradiol estrogenin E2N, follicle-stimulating hormone follicle-stimulating hormone (FSHs). Luteinizing hormone. LH). Changes in levels-methods:. All the patients in this study were admitted to the gynecological clinic of the third affiliated Hospital of Beijing University of traditional Chinese Medicine from June 2016 to November 2016. We refer to the diagnostic criteria of traditional Chinese and Western medicine related to PMS. And according to the relevant criteria exclude the corresponding cases, select Chinese medicine syndrome differentiation as Yin deficiency fire flourishing type of PMS patients 55 cases. According to the randomized controlled trial, 28 cases were divided into the treatment group of tonifying kidney and filling essence prescription (n = 28) and the control group of Kun Tai capsule (n = 27). Observe and compare the domestic improved Kupperman score, TCM syndrome score and E2FSH before and after treatment. Results 1. Comprehensive curative effect: 28 cases in the treatment group of tonifying kidney and filling essence prescription, 2 cases were cured 7.14%, 14 cases had remarkable effect, 10 cases were effective (35.71%). The total effective rate was 92.86%; There were 27 cases in the control group of Kun Tai capsule, 1 case was cured 3.70%, 5 cases had remarkable effect and 18.522%, 13 cases were effective and 48.15%, and 8 cases were ineffective (29.63%). The total effective rate was 70.37; The curative effect of the treatment group was better than that of the control group (P0.05). 2.The domestic modified Kupperman score: the standard deviation of the mean score of the treatment group decreased from 29.79 鹵7.52 to 8.79 鹵4.69. The mean standard deviation of the control group decreased from 27.33 鹵8.75 to 14.52 鹵9.35. Both groups were effective after treatment. The curative effect of tonifying kidney and filling essence prescription was better than that of control group (P 0.05N. 3). Results of TCM symptom score: the two groups were compared with each other. The mean standard deviation of score in the treatment group decreased from 17.32 鹵6.41 to 4.79 鹵2.85, and that in the control group decreased from 16.74 鹵7.19 to 9.63 鹵6.82. Two groups of patients after treatment were effective, the treatment group than the control group scores significantly decreased P0.05, which in the treatment group in the improvement of heat sweating, irritability, hot hands and feet, big constipation knot. The curative effect of TCM symptom of heart palpitation shortness of breath and insomnia was better than that of control group .4.The result of serum hormone level: after treatment, E2 level in both groups were increased. The mean standard deviation of the treatment group increased from 30.26 鹵19.56 to 46.66 鹵33.81. Compared with the control group (28.18 鹵17.74, 34.75 鹵26.73), the difference was significant (P 0.05). The decrease of FSHN LH in both groups showed that there was a difference between the two groups after treatment (P 0.05). Conclusion: the clinical effect of Bushen filling essence prescription in treating peri-menopausal syndrome of Yin deficiency and fire flourishing type is significant and can obviously improve the clinical symptoms and sex hormone level of PMS patients with Yin deficiency and fire flourishing type. It has good clinical application value.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R271.116

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