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右歸丸聯(lián)合雌—孕激素治療腎陽虛型圍絕經(jīng)期功能失調(diào)性子宮出血的臨床研究

發(fā)布時間:2018-08-03 10:30
【摘要】:目的:通過觀察右歸丸加減聯(lián)合雌-孕激素序貫療法治療腎陽虛型圍絕經(jīng)期功能失調(diào)性子宮出血的臨床效果,初步探討中西醫(yī)結(jié)合治療圍絕經(jīng)期功血的有效性,為本病提供有效的臨床治療方法。 方法:將68例經(jīng)過篩選符合標(biāo)準的患者隨機分為治療組與對照組。在月經(jīng)第5天起或診刮術(shù)后1周內(nèi),治療組口服戊酸雌二醇,第11天加服地屈孕酮,自服藥第1天起,同時口服右歸丸隨癥加減治療;對照組口服戊酸雌二醇,第11天加服地屈孕酮。21天為1個周期,3個周期為1療程,連續(xù)觀察1個療程。觀察兩組患者近期止血療效,治療后月經(jīng)主癥、腎陽虛中醫(yī)癥候改善情況,貧血糾正及子宮內(nèi)膜厚度改變情況,并隨訪半年復(fù)發(fā)情況。 結(jié)果:治療組與對照組相比,有較好的近期止血療效,其差異有統(tǒng)計學(xué)意義(P0.05)。通過對兩組患者月經(jīng)改善情況,中醫(yī)癥狀積分、中醫(yī)癥候療效、血紅蛋白測定、子宮內(nèi)膜厚度測量結(jié)果比較,其差異均有顯著性(P0.05)。治療組的臨床總療效明顯優(yōu)于對照組,其差異有統(tǒng)計學(xué)意義(P0.05)。治療組中治療效果與病程長短有關(guān),病程短治療效果好,其差異有統(tǒng)計學(xué)意義(P0.05)。其療效與疾病輕重程度無關(guān),其差異不明顯,無統(tǒng)計學(xué)意義。兩組比較復(fù)發(fā)率有顯著差異,其差異有統(tǒng)計學(xué)意義(P0.05),治療組半年內(nèi)復(fù)發(fā)率明顯低于對照組。 結(jié)論:右歸丸聯(lián)合雌-孕激素序貫療法治療腎陽虛型圍絕經(jīng)期功血患者,有較好的止血效果并可改善貧血狀態(tài),在調(diào)整月經(jīng)周期、改善腎陽虛中醫(yī)癥候方面具有顯著療效,同時不增加子宮內(nèi)膜病變的風(fēng)險,其臨床總有效率良好,臨床復(fù)發(fā)率較低,值得臨床進一步推廣。
[Abstract]:Objective: to observe the clinical effect of the treatment of dysfunctional uterine bleeding in the peri-menopausal period of Kidney-Yang deficiency type by adding and subtracting Yougui Pill combined with estrogen and progesterone, and to explore the efficacy of integrated traditional Chinese and Western medicine in the treatment of peri-menopausal dysfunctional uterine bleeding. To provide effective clinical treatment for this disease. Methods: 68 patients were randomly divided into treatment group and control group. On the 5th day of menstruation or within 1 week after curettage, the treatment group was treated with estradiol valerate, plus diproprogesterone on the 11th day, and the control group was treated with estradiol valerate as well as with the symptoms from the first day of taking the medicine, and the control group was treated with estradiol valerate, and the control group was treated with estradiol valerate. On the 11th day, 1 cycle and 3 cycles were added with Diproprogesterone for 21 days, and one course of treatment was observed continuously. To observe the recent hemostatic effect of the two groups, the main menstrual symptoms after treatment, the improvement of traditional Chinese medicine syndrome of kidney-yang deficiency, anemia correction and endometrial thickness change, and follow up for half a year recurrence. Results: compared with the control group, the treatment group had better recent hemostatic effect, the difference was statistically significant (P0.05). Through the two groups of patients menstrual improvement, TCM symptom score, TCM symptom efficacy, hemoglobin measurement, endometrial thickness measurement results, there were significant differences (P0.05). The total clinical efficacy of the treatment group was significantly better than that of the control group, the difference was statistically significant (P0.05). In the treatment group, the therapeutic effect was related to the duration of the disease, the short course of treatment was good, the difference was statistically significant (P0.05). Its curative effect is not related to the severity of the disease, its difference is not obvious, there is no statistical significance. There was a significant difference in the recurrence rate between the two groups (P0.05). The recurrence rate in the treatment group was significantly lower than that in the control group within half a year. Conclusion: Yougui Pill combined with estrogen and progesterone Sequential Therapy has a good hemostatic effect and can improve anemia status in patients with kidney yang deficiency in perimenopausal period. It has remarkable curative effect in regulating menstrual cycle and improving TCM syndrome of kidney-yang deficiency. At the same time, the risk of endometrial lesions is not increased, the total clinical effective rate is good, the clinical recurrence rate is low, it is worthy of further clinical promotion.
【學(xué)位授予單位】:黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2014
【分類號】:R711.52

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