發(fā)布時(shí)間：2018-03-09 00:35

  本文選題：消積活血調(diào)周法　切入點(diǎn)：補(bǔ)佳樂　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對(duì)比分析治療前后月經(jīng)改善情況、中醫(yī)證候積分、子宮內(nèi)膜厚度及炎癥細(xì)胞因子、纖維細(xì)胞生成因子的變化,來判定消積活血調(diào)周法聯(lián)合補(bǔ)佳樂治療濕熱瘀結(jié)型宮腔粘連的臨床療效,并進(jìn)一步闡述其療效機(jī)制。方法:將符合研究標(biāo)準(zhǔn)的45例濕熱瘀結(jié)型宮腔粘連患者隨機(jī)分成治療組、對(duì)照A組和對(duì)照B組各15例,均行宮腔鏡下粘連分離術(shù),術(shù)后治療組以消積活血調(diào)調(diào)周法聯(lián)合補(bǔ)佳樂治療,對(duì)照A組予消積活血方聯(lián)合補(bǔ)佳樂治療,對(duì)照B組單用補(bǔ)佳樂治療。以3個(gè)月經(jīng)周期為一個(gè)療程,觀察一個(gè)療程后三組患者月經(jīng)及中醫(yī)證候等臨床癥狀的改善情況,子宮內(nèi)膜厚度的變化及對(duì)炎癥細(xì)胞因子、纖維細(xì)胞生成因子兩項(xiàng)血清學(xué)指標(biāo)的影響。結(jié)果:(1)治療后三組的總有效率分別為93.33%、86.67%、60.00%,治療組、對(duì)照A組均顯著優(yōu)于對(duì)照B組(P0.017),但治療組和對(duì)照A組差異無統(tǒng)計(jì)學(xué)意義(P0.017)。(2)經(jīng)治療三組月經(jīng)證候各項(xiàng)總有效率分別為:經(jīng)期86.67%、80.00%、53.33%;經(jīng)量 93.33%、93.33%、60.00%;色質(zhì) 93.33%、86.67%、53.33%。治療組在調(diào)節(jié)經(jīng)期、改善經(jīng)量、色質(zhì)方面,均優(yōu)于對(duì)照B組,差異具有統(tǒng)計(jì)學(xué)意義(P0.017)。治療組對(duì)月經(jīng)總體改善情況雖略優(yōu)于對(duì)照A組,但無統(tǒng)計(jì)學(xué)意義(P0.017)。(3)經(jīng)治療后三組中醫(yī)證候總有效率分別為93.33%、86.67%、60.00%,中醫(yī)證候積分均較前降低,治療組最優(yōu),對(duì)照A組次之,對(duì)照B組最差。差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)經(jīng)治療三組腫瘤壞死因子(TNF-α)水平均較前下降,組間比較治療組、對(duì)照A組均顯著優(yōu)于對(duì)照B組(P0.05),但治療組和對(duì)照A組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(5)治療前后對(duì)比,三組轉(zhuǎn)化生長因子(TGF-β)水平均較前下降,治療組、對(duì)照A組在下調(diào)TGF-β方面雖無統(tǒng)計(jì)學(xué)差異(P0.05),但均優(yōu)于對(duì)照B組(P0.05)。(6)經(jīng)治療三組子宮內(nèi)膜厚度均較前增加,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:消積活血調(diào)周法聯(lián)合補(bǔ)佳樂能有效改善月經(jīng)證候及臨床癥狀、降低炎癥反應(yīng)、抑制纖維組織增生、幫助子宮內(nèi)膜增生修復(fù)、調(diào)節(jié)全身內(nèi)分泌等,是治療濕熱瘀結(jié)型宮腔粘連一種安全有效的方法。
[Abstract]:Objective: to compare and analyze the changes of menstrual improvement, TCM syndromes score, endometrial thickness, inflammatory cytokines and fibroblast factors before and after treatment. To determine the clinical effect of Xiaoji Huoxue Tiao Zhou method combined with Bujialao in treating intrauterine adhesions of dampness and heat stasis type, and to further explain its therapeutic mechanism. Methods: 45 cases of hygrothermal stasis type uterine adhesions were randomly divided into treatment group. 15 cases in control group A and 15 cases in control group B were treated with hysteroscopic adhesion separation. After operation, the treatment group was treated with Xiaoji Huoxue Tiao Zhou method combined with Bujialao, and control group A was treated with Xiaoji Huoxue prescription combined with Bujialao. Control group B was treated with Bujialao alone. Three menstrual cycles were used as a course of treatment. The improvement of clinical symptoms such as menstruation and TCM syndromes, the changes of endometrial thickness and inflammatory cytokines were observed in three groups after a course of treatment. Results the total effective rates of the three groups after the treatment were 93.33 and 86.670.The total effective rates of the three groups were 93.33 and 86.67, respectively. Control group A was significantly better than control group B (P 0.017), but there was no significant difference between treatment group and control group A (P 0.017).) the total effective rates of menstrual syndrome in treatment group were: menstrual period 86.67 + 80.005: 53.33; quantity 93.333360.00; color 93.333386.6753.33.The treatment group was able to adjust menstrual period, improve the menstrual volume, improve the menstrual volume, improve the menstrual symptoms, improve the menstrual syndromes, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual syndromes. In terms of color and quality, all of them were superior to the control group B, and the difference was statistically significant (P 0.017). The overall improvement of menstruation in the treatment group was slightly better than that in the control group A, But after treatment, the total effective rate of TCM syndromes in the three groups were 93.33 and 86.67 respectively. The scores of TCM syndromes were all lower than before, the treatment group was the best, the control group was the second. The level of TNF- 偽 in the treated group was lower than that in the previous group, and the levels of TNF- 偽 in the treatment group were significantly lower than those in the control group. The level of TGF- 尾 in group A was significantly higher than that in group B, but there was no significant difference between group A and group A before and after treatment. The level of TGF- 尾 in treatment group was lower than that in control group, and the level of TGF- 尾 in treatment group was significantly lower than that in control group, but there was no significant difference between group A and group A before and after treatment. Although there was no significant difference in down-regulation of TGF- 尾 in control group A, it was better than that of control group B in decreasing TGF- 尾. Conclusion: Xiaoji Huoxue Tiao Zhou method combined with Bujialao can effectively improve menstrual syndrome and clinical symptoms, reduce inflammatory reaction, inhibit fibrous hyperplasia, help endometrial hyperplasia repair, regulate the whole body endocrine, and so on. It is a safe and effective method for the treatment of dampness and heat stasis type intrauterine adhesion.
【學(xué)位授予單位】：南京中醫(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)】：R711.74

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本文編號(hào)：1586255