本文關(guān)鍵詞： 自擬止血方 肝腎陰虛 圍絕經(jīng)期功血 臨床觀察　出處：《湖北中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:圍絕經(jīng)期功血是困擾圍絕經(jīng)期婦女的一種多發(fā)疾患,患者由于長期反復(fù)出血常常伴有貧血,嚴重影響圍絕經(jīng)期婦女的健康及正常生活。雖然西醫(yī)在治療本病方面具有止血療效好、實驗室檢查豐富的優(yōu)勢,但是不可避免的是激素類藥物帶來的副作用以及手術(shù)治療的不便,使中醫(yī)在治療本病時顯示出了顯著的優(yōu)勢。本研究采用隨機對照的臨床研究方法針對臨床上常見的肝腎陰虛型圍絕經(jīng)期功血,采用口服自擬止血方加減治療。觀察臨床各項癥狀的改善情況及藥物的安全性。結(jié)果表明自擬止血方加減可以有效、安全的治療肝腎陰虛型功血,為臨床推廣提供依據(jù)。方法:1.收集資料:將符合中西醫(yī)診斷標(biāo)準的60例患者,隨機分為治療組30例,對照組30例。2.治療方法:治療組:出血期口服自擬止血方(女貞子、麥冬、白芍、太子參、墨旱蓮、茜草、甘草、益母草、續(xù)斷、補骨脂、五味子、三七、生地、熟地、仙鶴草。)每日1劑,水煎,早晚分服,血止期:自擬止血方減茜草、仙鶴草,加黨參、白術(shù)、枸杞子、何首烏,連續(xù)服用至下個出血周期開始,于出血周期第4日開始繼續(xù)服用自擬止血方,服藥方法同前,連續(xù)服用3個出血周期,中藥統(tǒng)一由我院中藥房煎藥室機器煎煮。對照組:口服婦康片(上海信誼康捷藥業(yè)有限公司,國藥準字H31021769,0.625mg*100s/瓶)首次劑量為5mg,每8小時1次,血止后每隔3日遞減1/3的藥量,直到每日2.5mg的維持劑量,自血止日算起,共服20日停藥,等撤退性出血,自出血開始第5日開始第2個周期的治療,治療3個周期。觀察患者治療前后癥狀改善情況及中醫(yī)證候積分變化,觀察服藥開始到服藥后血止所需的時間,治療前及治療后血紅蛋白含量,治療前及治療后的血清性激素水平,治療停止后隨訪3個月了解患者的復(fù)發(fā)情況,以及服藥過程中的不良反應(yīng)。結(jié)果:1.兩組止血療效比較,治療組及對照組總有效率分別為80%、86.67%,經(jīng)檢驗兩組止血療效差異無顯著意義(P0.05)。2.兩組治療前后證候療效比較,治療組及對照組總有效率分別為93.33%、70%,經(jīng)統(tǒng)計學(xué)檢驗兩組治療前后證候療效有顯著差異(P0.05),治療組證候療效優(yōu)于對照組。3.兩組治療前后癥狀積分比較,經(jīng)檢驗分析治療組與對照組治療前積分比較無顯著差異(P0.05),具有可比性;治療組治療后積分較治療前降低,差異有顯著性(P0.01);對照組治療后積分較治療前降低,差異有顯著性(P0.01);治療組與對照組治療后癥狀積分組間比較有顯著性差異(P=0.0010.01)。4.治療前治療后血清FSH、LH、E2比較,經(jīng)檢驗分析治療組治療前后FSH水平無顯著變化(P0.05);治療組治療前后LH水平無明顯變化(P0.05);治療組治療后E2較治療前升高,差異有顯著性(P0.01);對照組治療前后FSH水平無顯著變化(P0.05);對照組治療前后LH水平無顯著變化(P0.05);對照組治療前后E2無明顯變化(P0.05)。5.兩組血紅蛋白治療前及治療后變化,經(jīng)檢驗分析治療前治療組血紅蛋白含量與對照比較無顯著差異(P0.05)。治療后治療組與對照組血紅蛋白含量比較有顯著差異(P0.05)。治療組治療前后血紅蛋白含量比較有顯著差異(P0.05)。對照組治療前后血紅蛋白含量比較有顯著差異(P0.05)。6.兩組治療后隨訪3個月后復(fù)發(fā)率的比較,治療組復(fù)發(fā)率為6.7%,對照組復(fù)發(fā)率為33.3%,經(jīng)分析兩組復(fù)發(fā)率比較有顯著差異(P0.05),治療組復(fù)發(fā)率明顯低于對照組。結(jié)論自擬止血方在治療肝腎陰虛型圍絕經(jīng)期功血疾病是有顯著的療效,與對照組相比較,不僅可以止血,改善患者的臨床癥狀,調(diào)節(jié)患者的內(nèi)分泌,增加患者的血紅蛋白含量,且在副作用方面較西藥小,值得臨床推廣。
[Abstract]:Objective: perimenopausal dysfunctional uterine bleeding in perimenopausal women was plagued by a multiple diseases, patients with long-term repeated hemorrhage often accompanied by anemia, seriously affected the normal life and health of perimenopausal women. Although western medicine in the treatment of this disease has good hemostatic effect, laboratory examination of the advantages of the rich but inevitably is the side effect of steroid the drug and the inconvenience of surgical treatment, the Chinese medicine in the treatment of this disease shows significant advantages. This study adopts randomized controlled clinical research methods for common clinical liver deficiency of kidney yin, using oral hemostatic decoction treatment. To observe the safety and improve the clinical symptoms the results show that the self hemostatic decoction can effectively treat liver and kidney yin deficiency type safe blood, to provide the basis for clinical application. Methods: 1. collect data: 60 cases with traditional Chinese medicine and Western medicine diagnostic criteria were randomly divided into treatment group 30 cases, 30 cases in the control group.2. treatment: the treatment group: oral hemorrhage with hemostatic recipe (Ligustrum lucidum, ophiopogon root, Radix Paeoniae Alba, Radix Pseudostellariae, Eclipta, madder, licorice, motherwort, teasel root, Schisandra chinensis, Fructus Psoraleae, 37 students. 1). Moreover, agrimony agent, water decoction daily, morning and evening service points, blood check period: with hemostatic reduction with madder, agrimony, Codonopsis, Atractylodes, medlar, Radix Polygoni Multiflori, taking to the next cycle began to hemorrhage, bleeding period beginning fourth days to continue taking the medication with hemostatic, with continuous. Take 3 blood cycle, unified medicine by traditional Chinese medicine decocting room real machine decoction. The control group: oral Norlutin (Shanghai Xinyi Jie Kang Pharmaceutical Co. Ltd., Zhunzi H31021769,0.625mg*100s/ bottle) the first dose is 5mg, every 8 hours for 1 times every 3 days after the cessation of blood, decreasing the dose of 1/3 2.5mg, until the daily maintenance dose, blood check date, serving a total of 20 days of withdrawal, such as withdrawal bleeding, bleeding from the beginning to fifth at the beginning of the second treatment cycles, 3 cycles of treatment. Patients were observed before and after treatment the improvement of symptoms and TCM syndrome score changes, observation of medication required to start after taking the blood stopping time, hemoglobin content before and after treatment, serum sex hormone levels before and after treatment, after treatment were followed up for 3 months to understand the recurrence of patients with adverse reactions, and the process of medicine. Results: 1. compared with two groups of hemostatic efficacy, the treatment group and control group total the efficiency was 80%, 86.67%, the difference in efficacy test of two group was no significant (P0.05) compared the syndromes of.2. before and after treatment in the two groups, the treatment group and the control group total effective rate was 93.33%, 70%, the statistical test of the two groups before and after treatment of syndrome curative effect significantly The difference (P0.05), the treatment group than the control group before and after the syndromes of.3. treatment in the two groups symptoms integral comparison, by analysis of treatment group and control group before treatment showed no significant difference (P0.05), comparable; the treatment group scores after treatment than before treatment decreased, the difference was significant (P0.01); the control group scores after treatment than before treatment decreased, there was significant difference (P0.01); there were significant differences between treatment group and control group after treatment symptom scores between the groups (P=0.0010.01.4.) before treatment and after treatment of serum FSH, LH, E2, the results showed no significant changes before and after treatment, the level of FSH (P0.05); no significant changes in LH level of treatment group before and after treatment (P0.05); the treatment group after treatment than before treatment E2 increased significantly (P0.01); no significant changes in FSH level of control group before and after the treatment (P0.05); no significant changes in LH level of control group before and after the treatment of (P0.05); As the group before and after treatment there was no significant change in E2 (P0.05).5. changes in two groups of hemoglobin before and after treatment, by analysis of pre treatment group and control the content of HB showed no significant difference (P0.05). After treatment, the treatment group and the control group there was a significant difference between the content of hemoglobin (P0.05). The treatment group before and after treatment, hemoglobin content there was a significant difference (P0.05). The control group before and after treatment, the hemoglobin content had significant difference (P0.05) between the two groups after treatment were followed up for.6. 3 months after recurrence, the recurrence rate of treatment group was 6.7%, the recurrence rate of control group was 33.3%, by the analysis of the recurrence rate of the two groups had significant difference (P0.05). The recurrence rate of treatment group was significantly lower than the control group. Conclusion with hemostatic prescription in the treatment of liver and kidney yin deficiency perimenopausal dysfunctional uterine bleeding disease is a significant effect, compared with the control group, not only can improve the clinical symptoms of patients with bleeding It regulates the endocrine of the patient, increases the hemoglobin content of the patient, and is smaller in side effects than western medicine. It is worth promoting in clinical practice.

【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】：2016
【分類號】：R271.116

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