本文關(guān)鍵詞：滋腎寧心方治療腎陰虧虛、心肝火旺型月經(jīng)過少的臨床研究　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的：對(duì)滋腎寧心方治療腎陰虧虛、心肝火旺型月經(jīng)過少進(jìn)行研究。通過觀察患者月經(jīng)量、中醫(yī)癥狀、子宮內(nèi)膜厚度、排卵直徑及性激素等情況的改善,評(píng)價(jià)其治療效果,探討滋腎寧心湯改善月經(jīng)量的可能作用機(jī)制,為臨床應(yīng)用提供依據(jù),并通過與龜膠地黃湯的對(duì)比研究,探索寧心與陰長(zhǎng)的關(guān)系,驗(yàn)證夏桂成教授“心(腦)-腎-子宮軸”學(xué)說。方法：選擇2015年1月——2015年12月就診于南京中醫(yī)藥大學(xué)附屬醫(yī)院江蘇省中醫(yī)院門診60例月經(jīng)過少患者,中醫(yī)辨證屬腎陰虧虛、心肝火旺型。將這些病例隨機(jī)分為兩組各30例,觀察組采用自擬滋腎寧心方,對(duì)照組采用龜膠地黃湯。兩組均于經(jīng)后期第5天起服中藥,第10天起隔日監(jiān)測(cè)卵泡發(fā)育,待排卵后停服。觀察各組治療前一月與治療后第一個(gè)月經(jīng)周期的月經(jīng)量、臨床癥狀、排卵日子宮內(nèi)膜厚度、卵泡發(fā)育情況及性激素素水平等改善情況,并比較組間療效差異。結(jié)果：觀察組總有效率93%,對(duì)照組總有效率80%,觀察組優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；兩組均能明顯改善月經(jīng)量,但觀察組優(yōu)于對(duì)照組(P0.05)。兩組組均能明顯改善中醫(yī)證候,但觀察組優(yōu)于對(duì)照組(P0.05)。兩組均能顯著增大卵泡直徑,但觀察組優(yōu)于對(duì)照組(P0.05)；兩組均能明顯增厚排卵時(shí)子宮內(nèi)膜厚度,但觀察組優(yōu)于對(duì)照組(P0.05)；兩組均能明顯升高E2水平,但觀察組優(yōu)于對(duì)照組(P0.05)；觀察組可顯著降低PRL水平,對(duì)照組無明顯變化；觀察組和對(duì)照組FSH、LH均無明顯變化。結(jié)論：滋腎寧心方和龜膠地黃湯治療腎陰虧虛、心肝火旺型月經(jīng)過少患者,均可顯著改善其月經(jīng)量、中醫(yī)證候,增大排卵期卵泡直徑和排卵期子宮內(nèi)膜厚度,升高早卵泡期E2水平,但滋腎寧心方明顯優(yōu)于龜膠地黃湯。滋腎寧心方可降低患者PRL水平,而龜膠地黃湯無此療效。本研究一方面說明了經(jīng)后期運(yùn)用滋陰養(yǎng)血法在治療腎陰虧虛、心肝火旺型月經(jīng)過少中具有顯著療效；另一方面證明了寧心清肝在陰長(zhǎng)中的作用,驗(yàn)證了夏老“心(腦)-腎-子宮軸”理論的正確性。
[Abstract]:Objective: to study the effect of Zishen Ningxin recipe on deficiency of kidney yin and excessive menstruation of heart, liver and fire. The improvement of menstrual volume, TCM symptoms, endometrial thickness, ovulation diameter and sex hormone were observed. To evaluate its therapeutic effect, to explore the possible mechanism of Zishen Ningxin decoction to improve menstrual volume, to provide the basis for clinical application, and to explore the relationship between Ningxin and Yin-long through comparative study with Guijiao Dihuang decoction. Verification of Professor Xia Guicheng's "Heart (brain)" Methods: from January 2015 to December 2015, 60 patients with menorrhagia were selected from the outpatient clinic of Jiangsu Provincial Hospital of traditional Chinese Medicine, affiliated Hospital of Nanjing University of traditional Chinese Medicine. TCM syndrome differentiation belongs to deficiency of kidney yin and flourishing of heart and liver fire. These cases were randomly divided into two groups (30 cases each) and the observation group was treated with Zishen Ningxin recipe. The control group was treated with Guijiao Dihuang decoction. The two groups were treated with traditional Chinese medicine on the 5th day after the end of the period and the follicular development was monitored every other day from the 10th day. The menstrual volume, clinical symptoms, endometrial thickness on the day of ovulation, follicle development and sex hormone level were observed before and after treatment. Results: the total effective rate of the observation group was 933.The total effective rate of the control group was 80%, and the observation group was superior to the control group (P 0.05). Both groups can obviously improve menstrual volume, but the observation group is better than the control group (P0.05). Both groups can obviously improve TCM syndrome. However, the observation group was superior to the control group (P 0.05). Both groups could significantly increase the follicle diameter, but the observation group was superior to the control group (P 0.05). The endometrial thickness of both groups was significantly thickened and ovulation, but the observation group was superior to the control group (P 0.05). The level of E2 was significantly increased in both groups, but the observation group was superior to the control group (P 0.05). The level of PRL was significantly decreased in the observation group, but not in the control group. Conclusion: Zishen Ningxin recipe and Guijiao Dihuang decoction can significantly improve the menstrual volume and TCM syndrome in the patients with deficiency of kidney yin and excessive menstruation of heart-liver-fire flourishing type. Increase follicle diameter and endometrial thickness in ovulation phase, increase E2 level in early follicular phase, but Zishen Ningxin prescription is better than Guijiao Dihuang decoction. Zishenning Xin decoction can reduce PRL level in patients. On the one hand, this study showed that the method of nourishing yin and nourishing blood was effective in the treatment of deficiency of kidney yin and excessive menstruation of heart, liver and fire. On the other hand, it proves the role of Ningxin Qinggan in Yin-long, and verifies the correctness of Xia Lao's theory of heart (brain, kidney and uterus axis).
【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】：2016
【分類號(hào)】：R271.111

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