本文選題：多囊卵巢綜合征 + 痰濕型　； 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的旨在運用補腎健脾化痰方與達英-35加來曲唑?qū)Ρ戎委熖禎裥蚉COS,觀察其臨床療效及相關(guān)指標,歸納總結(jié)經(jīng)驗為以后治療該病作參考。方法選取在湖北省中醫(yī)院的婦科門診就診的痰濕型PCOS的患者,均在育齡期的婦女,經(jīng)篩選排除后納入66例,經(jīng)過患者知情同意,選用隨機數(shù)字表法進行分組,在治療過程中出現(xiàn)4例脫落病例,最后補腎健脾化痰方中藥治療組(n=35例),西藥對照組(n=27例)。用藥療程6個月經(jīng)周期,分別在治療第6個周期及停藥3個月觀察兩組治療前后及停藥后的體重指數(shù)(BMI)、腰臀比(WHR)、基礎(chǔ)體溫(BBT)、月經(jīng)周期、卵巢多囊樣改變的情況及子宮內(nèi)膜的厚度、多毛及痤瘡、性激素水平、妊娠、中醫(yī)癥狀療效積分、總體療效等情況。結(jié)果1.兩組患者在年齡、病程及初潮年齡、體重指數(shù)(BMI)、腰臀比(WHR)、基礎(chǔ)體溫(BBT)、月經(jīng)周期、卵巢體積及卵泡發(fā)育、子宮內(nèi)膜厚度、性激素水平、主要癥狀及體征這些方面均差異無統(tǒng)計學(xué)意義(P0.05),具有可比性。2.兩組均能有效降低BMI,但治療后組間比較差異無統(tǒng)計學(xué)意義;在停藥3個月后,兩組均沒有BMI值回升的情況。兩組治療WHR有輕度降低,有一定的療效,但是與治療前比較均差異無統(tǒng)計學(xué)意義,停藥3個月后也無明顯變化。3.治療后兩組基礎(chǔ)體溫均有雙相率升高恢復(fù)的情況,分別與治療前比較明顯升高,差異均有統(tǒng)計學(xué)意義,但組間比較差異無統(tǒng)計學(xué)意義;停藥3個月后治療組的雙相率優(yōu)于對照組,差異有統(tǒng)計學(xué)意義。4.治療3個周期后兩組月經(jīng)周期改善例數(shù)均有一定的增加,對照組的改善程度優(yōu)于治療組;治療6個周期后,兩組療效差異不大;在停藥3個月后,治療組月經(jīng)規(guī)律人數(shù)變化小,對照組月經(jīng)規(guī)律人數(shù)明顯減少。5.治療后兩組的卵巢體積及卵泡數(shù)均有減小,兩組子宮內(nèi)膜厚度均有增厚,但均組間差異不大。停藥3個月后,兩組的卵巢體積均有小幅度的回升,差異無統(tǒng)計學(xué)意義;治療組卵泡數(shù)增多不明顯,維持優(yōu)于對照組,差異有統(tǒng)計學(xué)意義。6.治療后治療組多毛及痤瘡程度評分均有下降,對照組的痤瘡評分在治療前后有差異,但多毛程度的評分差異不大。治療組改善痤瘡的程度優(yōu)于對照組。7.中藥治療組降低激素水平(LH值、T值、LH/FSH比值)的效果能達到西藥效果,且停藥3個月后維持激素水平(LH值、T值)的效果優(yōu)于西藥對照組。8.兩組均可以有效地改善中醫(yī)癥狀,較治療前癥候積分值均有明顯下降,差異均具有統(tǒng)計學(xué)意義(P0.05);治療后治療組的效果優(yōu)于對照組,差異無顯著性(P0.05)。停藥3個月后,治療組的中醫(yī)癥狀積分未見明顯變化,與其治療后比較差異無顯著性(P0.05);對照組的中醫(yī)癥狀積分有所回升,與其治療后比較差異有統(tǒng)計學(xué)意義(P0.05)。停藥3個月后,治療組維持中醫(yī)癥狀積分的效果優(yōu)于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。9.在停藥3個月后,兩組的總體治療效果均可,中藥治療組能夠達到與西藥對照組相當(dāng)?shù)寞熜?且略優(yōu)于西藥對照組。治療組的不良反應(yīng)(胃腸道反應(yīng))發(fā)生率低。結(jié)論補腎健脾化痰方中藥治療組和西藥對照組均可以改善痰濕型多囊卵巢綜合征癥狀,建立規(guī)律的月經(jīng)周期,還能改善性激素水平(降低T值、LH值、LH/FSH比值),降低BMI、WHR,改善子宮內(nèi)膜厚度及卵巢多囊樣改變。在綜合療效方面,中藥補腎健脾化痰方和西藥治療本病療效相差不大,但是中藥治療組停藥3個月后在維持正常月經(jīng)周期和性激素水平方面較穩(wěn)定,中藥治療組在治療痤瘡及停藥3個月后卵泡數(shù)及BBT雙相率效果優(yōu)于對照組。中藥治療組無明顯的毒副作用出現(xiàn),中藥補腎健脾化痰之法既病防變,作為PCOS中藥調(diào)理周期防治結(jié)合的方法易被患者接受使用。
[Abstract]:Objective to use the prescription of invigorating the kidney, invigorating the phlegm and phlegm with -35 calazole to treat the phlegm wet PCOS, observe its clinical curative effect and related indexes, sum up the experience for the future treatment of the disease. Methods the patients with phlegm wet type PCOS in the gynecologic outpatient department of Hubei Provincial Traditional Chinese Medical Hospital were selected and excluded after screening and exclusion. In 66 cases, after informed consent of the patients, the patients were divided into groups by random digital table. In the course of the treatment, there were 4 cases of exfoliated cases, and finally the treatment group (n=35 cases) and the western medicine control group (n=27). The treatment course was 6 menstrual cycles, the sixth cycles of treatment and the 3 months of stopping medicine were observed before and after the treatment and stopping medicine. The post body mass index (BMI), the waist to hip ratio (WHR), the basal body temperature (BBT), the menstrual cycle, the polycystic change of the ovary and the thickness of the endometrium, the hairy and acne, the sex hormone level, the pregnancy, the TCM symptom curative effect integral, the overall effect, etc. results 1. two groups were in age, course and age of menarche, body mass index (BMI), waist to hip ratio (WHR), base The basal body temperature (BBT), menstrual cycle, ovarian volume and follicle development, endometrial thickness, sex hormone level, major symptoms and signs were not statistically significant (P0.05). The comparability of.2. two groups could effectively reduce BMI, but there was no statistical difference between the groups after treatment. The two groups had no BMI value after 3 months of drug withdrawal. There was a slight decrease in the treatment of WHR in the two groups, but there was no significant difference between the two groups, but there was no significant difference between the two groups before the treatment. After 3 months of withdrawal, there was no significant change in the recovery of the basal body temperature in the two groups after the treatment of.3., and the difference was significantly higher than that before the treatment, and the difference was statistically significant, but the difference was poor between the groups. After 3 months of drug withdrawal, the biphasic ratio of the treatment group was better than that of the control group. The difference was statistically significant in the 3 cycles of.4. treatment. The improvement of the two groups had a certain increase, the improvement of the control group was better than the treatment group; the two groups had no significant difference after the treatment of 6 cycles. After 3 months of drug withdrawal, the menstrual law of the treatment group was in the treatment group. The number of people was small, the number of ovarian follicles in the two groups of the two groups decreased significantly after the treatment of the control group. The thickness of the endometrium in the two groups was thickened, but there was little difference between the groups. After 3 months of stopping the drug, the ovarian volume of the two groups had a small increase, the difference was not statistically significant, and the number of follicles in the treatment group increased not significantly. The difference was statistically significant, the difference was statistically significant, the scores of hair and acne in the treatment group decreased after.6. treatment. The acne scores in the control group were different before and after treatment, but the difference in the degree of hairy was not significant. The improvement of acne in the treatment group was better than that of the control group.7. in the treatment group (LH, T, LH/FSH ratio). The effect can reach the effect of Western medicine, and after 3 months of withdrawal, the effect of maintaining hormone level (LH value, T value) is better than that in the group.8. two of the western medicine control group, which can effectively improve the symptoms of traditional Chinese medicine. Compared with the score of the symptoms before treatment, the difference is statistically significant (P0.05). The effect of the treatment group after treatment is better than that of the control group, and the difference is not significant. Sex (P0.05). After 3 months of drug withdrawal, the TCM symptom score of the treatment group had not changed significantly, and there was no significant difference between the treatment group and the treatment group (P0.05). The score of TCM symptoms in the control group was higher than that of the treatment group (P0.05). After 3 months of stopping the medicine, the curative effect of the treatment group was better than the control group, and the difference was better than the control group. The difference was statistically significant (P0.05).9. after 3 months of drug withdrawal, the overall treatment effect of the two groups can be achieved, the Chinese medicine treatment group can reach the same effect as the western medicine control group, and slightly better than the western medicine control group. The adverse reaction (gastrointestinal reaction) in the treatment group is low. Conclusion the treatment group of tonifying kidney, spleen and phlegm prescription and Western medicine control group are all To improve the symptoms of phlegm wet polycystic ovary syndrome, establish regular menstrual cycle, improve the level of sex hormone (T value, LH value, LH/FSH ratio), reduce BMI, WHR, improve the thickness of endometrium and ovarian polycystic change. The treatment group was more stable after 3 months of stopping the normal menstrual cycle and the level of sex hormone. The effect of the number of follicles and the BBT birate after 3 months of treatment of acne and stopping drugs in the Chinese medicine treatment group was better than that of the control group. There was no obvious toxic and side effects in the Chinese medicine treatment group. The method of combining treatment is easy to be used by the patient.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.75

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