本文關鍵詞：輸卵管炎性不孕癥臨床分型、用藥規(guī)律分析及實驗觀察　出處：《黑龍江中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關文章： 輸卵管炎性不孕 氣滯血瘀 血液流變學 膈下逐瘀湯

【摘要】：研究目的觀察臨床輸卵管炎性不孕患者的分型、用藥規(guī)律及療效;通過相關實驗研究,分析膈下逐瘀湯加減方對氣滯血瘀型輸卵管炎性不孕大鼠模型的作用機理及效果。研究方法1、按照輸卵管炎性不孕癥診斷和排除標準,臨床共納入患者225例。統(tǒng)計分析患者的證型、用藥規(guī)律及療效。2、實驗選擇雌性大鼠作為研究對象,隨機分四組:正常組、病證模型組、康婦炎組、膈下逐瘀湯組,采用復合刺激聯(lián)合輸卵管注菌的方法,制造符合中醫(yī)證候特點的氣滯血瘀型輸卵管炎性不孕大鼠模型,分析用藥后的相關指標變化。研究結果1、臨床輸卵管炎性不孕證型分別為:氣滯血瘀型、濕熱瘀阻型、腎虛血瘀型、寒凝瘀阻型和氣虛血瘀型,各型比例分別為44.89%、29.33%、16.44%、5.78%、3.56%。2、方藥使用上,共用藥116味,藥次3004次,涉及18個類型。3、經治療后,氣滯血瘀型、腎虛血瘀型、濕熱瘀阻型、氣虛血瘀型、寒凝瘀阻型患者的療效總有效率依次為94.06%,91.89%,90.91%,87.50%,84.62%。4、在動物實驗中,與病證模型組相比,中藥組的癥候積分有顯著性差異(P0.01);中藥組和康婦炎組的積分進行比較,差異有統(tǒng)計學意義(P0.05)。5、與模型組和康婦炎組比較,中藥組血液黏度存在差異,且有統(tǒng)計學意義(P0.05)。6、與模型組比較,中藥組的IFN-γ表達存在差異,且有統(tǒng)計學意義(P0.01);與康婦炎組比較,中藥組的IFN-y存在差異,且有統(tǒng)計學意義(P0.05)。7、合籠后觀察受孕情況,受孕率從高到低依次為:正常組、中藥組、康婦炎組、病證模型組,分別為100%、50.0%、33.3%、16.7%。研究結論臨床觀察:1、在輸卵管炎性不孕證型中,氣滯血瘀型占44.89%,證明氣滯血瘀型所占比例最多,膈下逐瘀湯加減方使用頻率最高。2、方藥使用上,活血化瘀類型藥物頻率最大、頻次最多,為26.10%。3、通過對療效有效率的統(tǒng)計,膈下逐瘀湯加減方有效率最高。實驗研究:1.和模型組大鼠比較,膈下逐瘀湯加減方能改善氣滯血瘀型輸卵管炎性不孕大鼠的行為體征,有效降低血液黏度、IFN-γ的水平,提高受孕率。2.和康婦炎組比較,中藥組的體征、血液黏度、IFN-γ表達存在差異,且有統(tǒng)計學意義,證明膈下逐瘀湯加減方對于氣滯血瘀型輸卵管炎性不孕的治療效果優(yōu)于康婦炎組。
[Abstract]:Objective to observe the classification, drug use and curative effect of salpingitis infertility. Through the relevant experimental studies, the article analyzed the mechanism and effect of Gexia Zhuyu decoction on the model of Qi-stagnation and blood-stasis type salpingitis infertility in rats. 1. According to the diagnosis and exclusion criteria of salpingitis infertility. A total of 225 patients were included in the clinical. Statistical analysis of the patients' syndrome types, drug use and efficacy. 2. Female rats were selected as the study object, randomly divided into four groups: normal group, disease syndrome model group, Kangfu group. Gexiazhuyu decoction group, using compound stimulation combined with fallopian tube injection of bacteria method, to create Qi-stagnation blood stasis type of salpingoinflammatory infertility rat model in accordance with the characteristics of TCM syndromes. Analysis of the changes of related indicators after medication. 1. Clinical tubal inflammatory infertility type are: Qi stagnation blood stasis type, damp-heat stasis type, kidney deficiency and blood stasis type, cold coagulation stasis type and Qi deficiency and blood stasis type. The proportions of each type were 44.89 and 29.33, respectively, and 16.445.785.785.56and 3.56. in the use of traditional Chinese medicine, 116 kinds of drugs were used, 3004 times. After treatment, the total effective rate of patients with Qi stagnation and blood stasis, kidney deficiency and blood stasis, dampness and heat stasis, qi deficiency and blood stasis, and cold coagulation stasis was 94.06 / 91.89%. In animal experiment, compared with the model group of disease and syndrome, the symptom integral of the traditional Chinese medicine group was significantly different from that of the model group (P 0.01). The scores of traditional Chinese medicine group and Kangfuyan group were compared, the difference was statistically significant (P 0.05). Compared with model group and Kangfuyan group, the blood viscosity of traditional Chinese medicine group was different. Compared with the model group, the expression of IFN- 緯 in the traditional Chinese medicine group was different, and the expression of IFN- 緯 in the traditional Chinese medicine group was significantly higher than that in the model group. Compared with Kangfuyan group, the IFN-y of TCM group was different, and there was statistical significance (P0.05. 7). The pregnant rate was observed from high to low in order of normal group and traditional Chinese medicine group. Kangfuyan group and disease syndrome model group were 100% 50.03 and 16.7g respectively. Conclusion Clinical observation 1 is in the type of salpingitis infertility. Qi stagnation and blood stasis type accounted for 44.89, which proved that Qi stagnation and blood stasis type accounted for the most proportion, Gexia Zhuyu decoction used frequency is the highest, the prescription used, the type of blood circulation and blood stasis type medicine frequency is the largest, the frequency is the most. Through the statistics of effective rate, the effective rate of Gexixuyu decoction was the highest. The experimental study was compared with that of the model group. Gexia Zhuyu decoction can improve the behavior and signs of inflammatory infertility rats with Qi-stagnation and blood-stasis type, effectively reduce the level of blood viscosity and IFN- 緯, and increase the pregnancy rate of .2.Compared with Kangfuyan group. The physical signs, blood viscosity and IFN- 緯 expression of TCM group were different, and there was statistical significance. It was proved that the treatment effect of Gexia Zhuyu decoction on oviduct inflammation infertility with qi stagnation and blood stasis type was better than that of Kangfuyan group.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R271.9

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