本文選題：補(bǔ)腎調(diào)周化瘀　切入點(diǎn)：巧克力囊腫　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

【摘要】：目的：本課題通過運(yùn)用補(bǔ)腎調(diào)周化瘀法對卵巢子宮內(nèi)膜異位(Ovarian endometriosis cyst,OEC)患者腹腔鏡保守手術(shù)術(shù)后預(yù)防復(fù)發(fā)的干預(yù)治療,并與抑那通治療對照,觀察兩組患者術(shù)后的復(fù)發(fā)率、痛經(jīng)及妊娠的情況,探討補(bǔ)腎調(diào)周化瘀法用于巧克力囊腫患者術(shù)后輔助治療的可行性,找尋能夠鞏固手術(shù)治療效果,降低術(shù)后的復(fù)發(fā)率,并且副作用較小的治療方法。方法：收集2014年10月至2015年6月江蘇省中醫(yī)院門診及住院部符合納入標(biāo)準(zhǔn)的巧囊腹腔鏡術(shù)后的患者45例,分為治療組30例、對照組15例。治療組予補(bǔ)腎調(diào)周化瘀法,服用中醫(yī)治療,對照組予抑那通皮下注射,3個月為一個療程。觀察兩組病例治療前、治療3個月后、停藥3個月后、停藥6個月后痛經(jīng)的程度、臨床癥狀、復(fù)發(fā)率、妊娠率、CA125水平以及血液流變學(xué)指標(biāo)的變化,將兩組數(shù)據(jù)用統(tǒng)計學(xué)方法進(jìn)行處理、分析。結(jié)果：臨床療效：治療組與對照組的復(fù)發(fā)率分別為16.7%、13.3%,無明顯的差異(P0.05)；兩組患者治療后痛經(jīng)癥狀均有非常明顯的改善(P0.01),但組間比較無明顯差異(P0.05)；兩組患者痛經(jīng)、盆腔痛、性交痛、肛門墜痛的臨床癥狀改善無明顯的差異(P0.05)。治療組與對照組治療后血清CA125及血液流變學(xué)指標(biāo)均顯著降低(P0.01),但組間比較無明顯差異(P0.05)。安全性觀察：治療組在治療過程中無明顯不良反應(yīng)及毒副作用,對照組患者用藥后出現(xiàn)肝功能損害的概率為20%(3/15),出現(xiàn)陰道干燥、陰道不規(guī)則出血等副反應(yīng)發(fā)生概率合計為46.7%(7/15)。結(jié)論：補(bǔ)腎調(diào)周化瘀法能夠有效的預(yù)防巧克力囊腫患者術(shù)后的復(fù)發(fā),具有緩解患者痛經(jīng)等臨床癥狀,提高妊娠率等多重效應(yīng),能明顯降低患者的血清CA125水平,降低血液粘稠度,未發(fā)現(xiàn)明顯不良反應(yīng)及毒副作用。
[Abstract]:Objective: to observe the recurrence rate of patients with ovarian endometriosis after laparoscopic conservative surgery by using the method of tonifying the kidney and regulating the weeks and removing blood stasis, and to observe the recurrence rate of the two groups. To explore the feasibility of tonifying kidney and regulating Zhou and removing blood stasis in postoperative adjuvant treatment in patients with chocolate cyst in order to consolidate the effect of operation and reduce the recurrence rate. Methods: from October 2014 to June 2015, 45 cases of out-patient and inpatient department of Jiangsu Provincial Hospital of traditional Chinese Medicine (TCM) were collected and divided into treatment group (n = 30). In the control group, 15 cases were treated with tonifying kidney, regulating the week and removing blood stasis. The control group was given subcutaneous injection of Yonatong, and the control group was given subcutaneous injection for 3 months as a course of treatment. Before treatment, 3 months after treatment, 3 months after stopping the treatment, the patients in the two groups were treated. The changes of the degree of dysmenorrhea, clinical symptoms, recurrence rate, pregnancy rate, CA125 level and hemorheology index were analyzed by statistical method. Results: clinical efficacy: the recurrence rate of the treatment group and the control group were 16.7g / 13.3, respectively, and there was no significant difference between the two groups (P0.05), the symptoms of dysmenorrhea in the two groups were significantly improved (P0.01D), but there was no significant difference between the two groups (P0.05A), the patients in the two groups had dysmenorrhea, pelvic pain, pelvic pain, and no significant difference between the two groups in the treatment of dysmenorrhea and pelvic pain. Intercourse pain, There was no significant difference in the improvement of clinical symptoms of anus drop pain. The serum CA125 and hemorheological indexes of the treatment group and the control group were significantly decreased after treatment, but there was no significant difference between the two groups. Safety observation: the treatment group in the treatment process. There were no obvious adverse reactions and side effects. In the control group, the probability of liver function damage was 20 / 15, and the probability of vaginal dryness and irregular vaginal bleeding was 46.7 / 15. Conclusion: the method of tonifying kidney and regulating Zhou and removing blood stasis can effectively prevent the recurrence of chocolate cyst patients after operation. It can alleviate clinical symptoms such as dysmenorrhea and increase pregnancy rate. It can significantly reduce serum CA125 level and blood viscosity without obvious adverse reactions and side effects.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R271.9

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