本文關鍵詞：基于氣精互化理論氣精雙補方治療黃體功能不健型功血的臨床研究　出處：《北京中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 黃體功能不健型功血 卵泡期 氣精互化理論 氣精雙補方

【摘要】：研究目的：本研究采用自身前后對照的研究方法,以46例黃體功能不健型功血患者作為研究對象,給予氣精雙補方治療。觀察治療前后黃體功能不健型功血患者的臨床癥狀改善情況,以及其對卵泡發(fā)育、基礎體溫、性激素等指標的影響,并探討其可能的作用機理,豐富臨床治療方法,為黃體功能不健型功血的臨床治療提供參考,同時對導師學術思想及用藥特點進行總結。研究方法：收集2014年12月至2015年12月北京中醫(yī)藥大學第三附屬醫(yī)院婦科門診符合納入標準的黃體功能不健型功血患者46例,年齡在18-40歲,同意參加本試驗,并簽署知情同意書者,填寫研究觀察表。采用自身前后對照的研究方法,以氣精雙補為法,給予導師經(jīng)驗方口服,具體處方為：黨參15g、龜膠12g、黃芪40 g、當歸10 g、白術15 g、熟地12 g、枸杞子30g、山萸肉12g、鹿角膠l0g、甘草12g。服藥方法：取上藥濃煎200m1,每日1劑,分2次,早晚溫服,于月經(jīng)第5天開始服藥,連服2周,用藥3個月經(jīng)周期后評價療效。療程結束后,對比治療前后患者中醫(yī)癥狀積分、基礎體溫、血清內分泌激素水平、卵泡發(fā)育等指標的變化。建立Excel數(shù)據(jù)庫,采用SPSS20.0統(tǒng)計軟件進行數(shù)據(jù)處理,計量資料采用均數(shù)±標準差(X±S)表示,計數(shù)資料用構成比(%)表示。計量資料組間比較采用t檢驗(方差不齊采用秩和檢驗),計數(shù)資料采用X2檢驗,等級資料用秩和檢驗。P0.05時差異有統(tǒng)計學意義。研究結果：1.應用氣精雙補方治療46例黃體功能不健型功血患者,在卵泡期給藥,通過自身前后對照,結果顯示痊愈8例(17.39%),顯效20(43.49%),有效15例(32.6%),無效3例(6.52%),總有效率達93.48%。2.治療前后中醫(yī)癥狀積分比較,月經(jīng)周期短、經(jīng)期延長、腰膝酸軟、四肢倦怠、畏寒肢冷等癥狀顯著改善。3.治療前后血清孕酮值的比較,治療后黃體中期血清孕酮值較前提高,差異有統(tǒng)計學意義(P0.01)。4.治療前后排卵前卵泡最大直徑比較,卵泡直徑較前明顯增大,差異有統(tǒng)計學意義(P0.01)。5.治療后基礎體溫HPS評分提高,高溫相維持天數(shù)延長、高低溫差較前改善,差異有統(tǒng)計學意義(P0.01)。研究結論：1.氣精雙補方治療黃體功能不健型功血的臨床療效確切,能夠改善患者的臨床癥狀,促進卵泡發(fā)育,改善基礎體溫及提高黃體期血清孕激素水平。2.氣精雙補方間接證明氣虛精虧是黃體功能不健型功血的病因病機之一,驗證了“精”、“氣”在卵泡、黃體發(fā)育中的作用及在卵泡期用藥的合理性。3.氣精雙補方可能通過影響卵泡發(fā)育,促進顆粒細胞的不斷增殖,從而促使黃體功能恢復正常。
[Abstract]:Objective: This study adopted the method of self-control, 46 patients with luteal phase type dub patients as the research object, give gas double fill treatment. Observed before and after treatment of hypoluteoidism clinical symptom type dub patients to improve the situation, and its effect on follicular development, basal body temperature, sex hormone influence etc. the index, and to explore its possible mechanism, rich clinical treatment methods, provide the reference for the clinical treatment of luteal phase type dub. The academic thought and treatment characteristics of mentors were summarized. Methods: collected from December 2014 to December 2015 in Beijing University of Chinese Medicine affiliated hospital gynecology clinic third met the inclusion criteria of 46 cases of hypoluteoidism type dub patients, at the age of 18-40, agreed to participate in the test, and signed the informed consent form, fill in the questionnaire by the self controlled study. The method to make up for double gas refining method, give the tutor experience of oral, specific prescription: dangshen 15g, 12g 40 g Huangqi, tortoise, angelica 10 g, 15 g 12 g Atractylodes, rehmannia, medlar 30g, Cornus 12g, antler glue L0g, licorice 12g. medication method: drug concentration fried 200m1, 1 daily, 2 times, sooner or later. On the fifth day of menstruation, taking the medicine, even for 2 weeks, evaluate the therapeutic effect of 3 menstrual cycles. After the end of treatment, compared before and after treatment in patients with symptoms of TCM, basal body temperature, hormone levels in serum, the change of follicular development. The establishment of index the Excel database, using SPSS20.0 statistical software for data processing, measurement data using the mean and standard deviation (X + S) said the count data with constituent ratio (%). Measurement data were compared by using t test (missingvariance Wilcoxon test was used), count data using X2 test, rank data using rank test.P0.05 The difference was statistically significant. Results: 1. application of gas fine tonifying Decoction "in Treating 46 cases of luteal phase type dub patients, administered during the follicular phase, through self control, results showed that 8 cases were cured (17.39%), 20 (43.49%), effective in 15 cases (32.6%), 3 cases were invalid (6.52%), the total effective rate of TCM symptom score before and after treatment of 93.48%.2., short menstrual cycle, menstruation, Yaoxisuanruan, lassitude, aversion to cold symptoms significantly improved serum progesterone value before and after.3. treatment, after the treatment of mid luteal serum progesterone value better than before, the difference was statistically significant (P0.01) before and after.4. treatment the largest preovulatory follicle diameter, follicle diameter significantly increased, the difference was statistically significant (P0.01) after.5. treatment, HPS score increase of basal body temperature, high temperature phase to maintain longer days, high and low temperature difference was better than before, the difference was statistically significant (P0.01). Conclusion: 1. kinds of essence tonifying Decoction in the treatment of luteal phase clinical effect of dysfunctional uterine bleeding is effective, can improve symptoms, promote follicular development, improve the basal body temperature and Tonifying Qi double indirect evidence that sperm loss is one of the pathogenesis of luteal phase serum progesterone level.2. type dub luteal phase to improve the precision of gas verify, "fine", "Qi" in the role of follicle, corpus luteum development and in the follicular phase of the rationality of drug use.3. gas double fill prescription may affect follicular development, promote the proliferation of granulosa cells, thus contributing to the luteal function returned to normal.

【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.9

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