本文選題：子午流注納甲法　切入點(diǎn)：針灸　出處：《云南中醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究采用臨床小樣本隨機(jī)對(duì)照研究,運(yùn)用子午流注納甲法配合普通針刺對(duì)多囊卵巢綜合征(PCOS)排卵障礙的患者進(jìn)行治療,并設(shè)普通針刺組對(duì)照進(jìn)行觀察比較,客觀評(píng)價(jià)子午流注納甲法治療PCOS患者排卵障礙的臨床療效,初步探索子午流注納甲法治療PCOS排卵障礙的機(jī)理。方法:按照納入標(biāo)準(zhǔn)選擇病例,采用隨機(jī)數(shù)字表法把60例患者隨機(jī)分為治療組和對(duì)照組,每組各30例。治療組采用子午流注納甲法開穴配合普通針刺治療,對(duì)照組采用普通針刺治療,治療3個(gè)療程后觀察兩組的療效,進(jìn)行統(tǒng)計(jì)學(xué)分析并做出療效評(píng)價(jià)。結(jié)果:(1)治療后,治療組總有效率86.7%,對(duì)照組總有效率為70%,兩組患者總療效比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),結(jié)果顯示:兩種方法治療PCOS均有效,治療組總體療效優(yōu)于對(duì)照組。(2)兩組治療前后中醫(yī)癥狀總積分比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。治療后兩組間進(jìn)行比較,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)果表明:兩組治療方法都能改善中醫(yī)癥狀,治療組在改善中醫(yī)癥狀方面較對(duì)照組明顯。(3)治療后,兩組LH、T、LH/FSH均有下降,E2均有升高,治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組間比較,治療組中LH、T、LH/FSH三項(xiàng)數(shù)值下降的幅度較對(duì)照組明顯(P0.05),E2兩組間比較則無明顯統(tǒng)計(jì)學(xué)意義(P0.05)。FSH治療前后及組間對(duì)照均沒有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)果表明:兩種治療方法對(duì)LH、T、LH/FSH有降低作用,對(duì)E2有升高作用,治療組對(duì)LH、T、LH/FSH的改善較對(duì)照組明顯。(4)治療后,兩組空腹血糖、空腹胰島素水平、胰島素抵抗指數(shù)、體重指數(shù)較治療前均有下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療后組間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)果表明:兩種治療方法對(duì)空腹血糖、空腹胰島素水平、胰島素抵抗指數(shù)、體重指數(shù)均有改善作用,治療組療效較對(duì)照組明顯。(5)治療后,兩組子宮內(nèi)膜厚度及最大卵泡直徑均有改善,治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療后進(jìn)行療效比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)果表明:兩種治療方法對(duì)子宮內(nèi)膜厚度及最大卵泡直徑均有改善作用,治療組療效較對(duì)照組明顯。(6)治療組總的觀察周期為117個(gè),排卵周期為87個(gè),排卵率為72.4%;對(duì)照組總的觀察周期為112個(gè),排卵周期為68個(gè),排卵率為64.8%。比較兩組排卵率,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。統(tǒng)計(jì)結(jié)果表明:兩種治療方法均能改善患者排卵情況,治療組排卵率高于對(duì)照組。(7)治療組中有16例患者備孕,經(jīng)治療后妊娠6例,未妊娠10例,妊娠率37.5%;對(duì)照組中備孕患者有15例,治療后妊娠3例,未妊娠12例,妊娠率17.6%。比較兩組妊娠率,差異雖沒有統(tǒng)計(jì)學(xué)意義(P0.05),但治療組妊娠率有高于對(duì)照組的趨勢(shì)。結(jié)論:本研究表明兩組所采用的治療方法均能改善PCOS患者臨床癥狀、體征及生化指標(biāo)。兩組患者治療前后血清性激素、空腹血糖、空腹胰島素、婦科B超檢查的比較,顯示在改善性激素、胰島素抵抗指數(shù)、體重指數(shù)、子宮內(nèi)膜厚度、卵泡發(fā)育及排卵方面,治療組優(yōu)于對(duì)照組。提示子午流注納甲法治療PCOS排卵障礙療效較好,臨床上值得深入研究。本課題子午流注納甲法治療PCOS排卵障礙的機(jī)理可能是通過子午流注納甲法開穴,通過針刺值日經(jīng)敏感穴,順應(yīng)人體的自然節(jié)律,調(diào)節(jié)“下丘腦-垂體-卵巢-子宮”軸生理功能,引起下丘腦對(duì)內(nèi)分泌的良性調(diào)節(jié),改善卵巢功能,從而促進(jìn)卵泡的生長(zhǎng)發(fā)育,誘發(fā)排卵。
[Abstract]:Objective: the clinical randomized controlled study was used in this study, the use of Ziwuliuzhu Najia method with ordinary acupuncture on polycystic ovary syndrome (PCOS) ovulation disorder patients were treated with common acupuncture group were observed and compared, objective evaluation of clinical efficacy of Ziwuliuzhu Najia method in the treatment of ovulation disorders in PCOS patients, preliminary exploration the mechanism of Ziwuliuzhu Najia method of ovulation PCOS. Methods: according to the criteria for selected cases, randomly 60 patients were randomly divided into treatment group and control group, 30 cases in each group. The treatment group used acupuncture Ziwuliuzhu Najia method with ordinary acupuncture treatment, the control group with normal acupuncture treatment to observe the curative effect of the two groups, after 3 courses of treatment, statistical analysis and evaluate the curative effect. Results: (1) after treatment, the total effective rate of treatment group 86.7%, control group total effective rate was 70%, two groups of patients The total curative effect comparison, the difference was statistically significant (P0.05). The results show that two methods are effective in the treatment of PCOS. The overall efficacy of the treatment group than control group. (2) the TCM symptoms total score before and after treatment in the two groups, the difference was statistically significant (P0.01). After treatment between the two groups were compared with statistical significance the difference (P0.01). The results showed that the two groups of treatment can improve the TCM symptoms, the treatment group than the control group significantly in symptoms. (3) after treatment, two groups of LH, T, LH/FSH were decreased, E2 increased before and after treatment, there was statistically significant difference between the two groups (P0.05). In the treatment group, LH, T, LH/FSH decreased three numerical magnitude significantly compared with the control group (P0.05), E2 of the two groups had no statistical significance (P0.05) before and after.FSH treatment and the control group had no statistical significance (P0.05). The results showed that: two kinds of treatment methods of LH, T. LH/FSH down Low, rise the function of E2, the treatment group of LH, T, LH/FSH were better than the control group. (4) after treatment, two groups of fasting blood glucose, fasting insulin, insulin resistance index, body mass index were decreased compared with before treatment, the difference was statistically significant (P0.05). The two groups after treatment comparison, the difference was statistically significant (P0.05). The results showed that: two kinds of treatment methods on the fasting blood glucose, fasting insulin, insulin resistance index, body mass index were improved, the curative effect of the treatment group than the control group obviously. (5) after treatment, two groups of endometrial thickness and the diameter of the largest follicle were improved significantly significant differences before and after the treatment (P0.05). The therapeutic effects were compared after the treatment in the two groups, the difference was statistically significant (P0.05). The results show that the two methods both have effect on improving the endometrial thickness and the diameter of the largest follicle, the efficacy of the treatment group than the control group obviously .(6)娌葷枟緇勬，

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