本文關鍵詞： 補氣活血法 GnRHa 巧囊術后復發(fā)率 臨床療效　出處：《廣西中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:通過觀察補氣活血法及其聯(lián)合GnRHa(注射用醋酸亮丙瑞林微球)干預卵巢巧克力囊腫(簡稱為“巧囊”)術后復發(fā)的臨床療效,揭示中醫(yī)藥治療該病的優(yōu)勢所在,彌補西醫(yī)藥在該領域的不足,同時證明中西醫(yī)的協(xié)同作用和療效疊加性,從而尋求一種更好的中西醫(yī)結(jié)合治療該病的方法。方法:選擇2014年09月—2015年04月在廣西中醫(yī)藥大學第一附屬醫(yī)院婦科門診及病房就診的符合卵巢巧克力囊腫術后診斷,并符合納入標準的患者60人為受試者。按隨機分組法分成3組,即A組(中藥組)20例;B組(西藥組)20例,C組(中藥組+西藥組)20例。3組患者均從術后第7天開始用藥,1個月為1個療程,共治療3個療程,停藥后隨訪6個月。觀察3組受試者的臨床療效、癥狀緩解情況及中醫(yī)證候評分、婦科B超變化(包塊大小),CA125檢測(均指血清CA125),再應用統(tǒng)計學軟件進行相關處理,得出結(jié)論。結(jié)果:(1)在改善患者癥狀方面取得了良效:其中中藥組總數(shù)20例,痊愈1例,顯效14例,有效2例,無效3例,總有效率為85%;西藥組總數(shù)20例,痊愈0例,顯效1例,有效15例,無效4例,總有效率為80%;中西醫(yī)結(jié)合組總數(shù)20例,痊愈2例,顯效14例,有效3例,無效1例,總有效率為95%。三組患者組間比較情況:三組患者兩兩之間比較均具有統(tǒng)計學差異(P0.05),根據(jù)總有效率可知,在改善患者癥狀方面,中西醫(yī)結(jié)合組療效最好,中藥組次之,西藥組療效相對較差。(2)完成隨訪后進行試驗結(jié)果總結(jié):經(jīng)B超提示為巧克力囊腫,并在B超引導下穿刺抽取囊液,根據(jù)對囊液性狀分析證實為巧囊復發(fā)的中藥組有3例,西藥組有2例,中西醫(yī)結(jié)合組0例;在中醫(yī)證候評價方面,中藥組無效數(shù)為3例,西藥組無效數(shù)為4例,中西醫(yī)結(jié)合組無效數(shù)為1例;術后各組患者的CA125均較術前下降,后復出現(xiàn)上升者,中藥組有3例,西藥組有2例,中西醫(yī)結(jié)合組0例。故各組復發(fā)率分別為15%、10%、0%。由此證明,在防治巧克力囊腫術后復發(fā)方面,中西醫(yī)結(jié)合組療效最好,西藥組次之,中藥組療效相對較差。(3)綜上所述,在改善患者癥狀方面,中西醫(yī)結(jié)合組療效最好,中藥組次之,西藥組療效相對較差。在防治巧克力囊腫復發(fā)方面,中西醫(yī)結(jié)合組療效最好,西藥組次之,中藥組療效相對較差�？梢娭形麽t(yī)聯(lián)合使用是治療該病的最佳治療方式,同時中藥組在改善患者癥狀方面有著其特有的優(yōu)勢,是值得在臨床應用和推廣的。結(jié)論:研究表明:補氣活血法通過益氣補虛,活血化瘀的功效對改善患者下腹痛和痛經(jīng)、性交痛等癥狀及降低術后復發(fā)率有較顯著作用,其與GnRHa聯(lián)合使用提高臨床療效的同時,更降低了GnRHa的臨床副作用,充分體現(xiàn)了中西醫(yī)結(jié)合的優(yōu)勢所在。
[Abstract]:Objective: to observe the clinical effect of invigorating qi and activating blood circulation method and combining with GnRHatreated microspheres to prevent the recurrence of chocolate cyst of ovary (abbreviated as "skillful cyst"). To reveal the advantages of traditional Chinese medicine in the treatment of the disease, to make up for the lack of western medicine in this field, and to prove the synergy of traditional Chinese and western medicine and the superposition of curative effect. So as to seek a better combination of traditional Chinese and Western medicine for the treatment of the disease. Methods:. From September 2014 to April 2015 in the first affiliated Hospital of Guangxi University of traditional Chinese Medicine gynecological outpatients and wards were selected in accordance with the diagnosis of chocolate cyst of ovary. 60 patients who met the inclusion criteria were randomly divided into three groups: group A (group A, n = 20); Group B (western medicine group, n = 20), group C (group C, n = 20) (group C, n = 20). All the patients in group B (n = 20) were treated with drugs from the 7th day after operation, one month as a course of treatment, and a total of three courses of treatment. The clinical efficacy, symptom relief, TCM syndrome score and gynecological B-ultrasound changes were observed in the three groups (mass size, CA125 (all referred to as serum CA125)). Then the statistical software was used to deal with the correlation, and the conclusion was drawn. Results: 20 cases of TCM group, 1 case of cure, 14 cases of remarkable effect and 2 cases of effective were obtained in improving the symptoms of the patients. 3 cases were ineffective, the total effective rate was 85%; There were 20 cases in western medicine group, 0 cases were cured, 1 case was remarkable effect, 15 cases were effective, 4 cases were ineffective, the total effective rate was 80%. There were 20 cases in the group of integrated traditional Chinese and western medicine, 2 cases were cured, 14 cases were effective, 3 cases were effective, and 1 case was ineffective. The total effective rate was 95. The comparison among the three groups of patients: there was statistical difference between the two groups. According to the total effective rate, we can know that it can improve the symptoms of the patients. Combination of traditional Chinese and Western medicine group the best curative effect, Chinese medicine group, Western medicine group relatively poor efficacy. 2) after the completion of follow-up results: B ultrasonic hint for chocolate cyst, and under the guidance of B-ultrasound puncture to extract sac fluid. According to the analysis of the cystic fluid, there were 3 cases in the Chinese medicine group, 2 cases in the western medicine group and 0 cases in the integrated Chinese and western medicine group. In the evaluation of TCM syndromes, the invalid number of TCM group was 3 cases, that of western medicine group was 4 cases, and that of integrated Chinese and western medicine group was 1 case. After the operation, the CA125 of the patients in each group was lower than that before operation, and then increased again. There were 3 cases in the Chinese medicine group, 2 cases in the western medicine group and 0 cases in the integrated Chinese and western medicine group. The recurrence rate of each group was 15% and 10% respectively. This proved that in the prevention and treatment of chocolate cyst recurrence, the combination of traditional Chinese and Western medicine group is the best, Western medicine group, the Chinese medicine group is relatively poor, in summary, in improving the symptoms of patients. In the prevention and treatment of chocolate cyst recurrence, the combination of traditional Chinese and western medicine group is the best, the western medicine group is the second. It can be seen that the combination of traditional Chinese and Western medicine is the best way to treat the disease, and the traditional Chinese medicine group has its unique advantages in improving the symptoms of patients. Conclusion: the method of invigorating qi and activating blood circulation can improve the pain of lower abdomen and dysmenorrhea through the effect of supplementing qi and tonifying deficiency and activating blood circulation and removing blood stasis. Sexual intercourse pain and other symptoms and reduce the recurrence rate has a significant effect, combined with the use of GnRHa to improve the clinical efficacy, but also reduce the clinical side effects of GnRHa. Fully reflect the advantages of integrated Chinese and western medicine.
【學位授予單位】：廣西中醫(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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