本文選題：慢性盆腔痛　切入點(diǎn)：舒盆湯　出處：《廣西中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本課題采用舒盆湯保留灌腸的方法治療濕熱瘀阻型慢性盆腔痛,通過統(tǒng)計(jì)分析,比較治療前、治療后及停藥后1月盆腔疼痛VAS評分、中醫(yī)證候積分,觀察患者盆腔疼痛程度及臨床癥狀改善情況,科學(xué)評價(jià)其臨床療效,并探討其作用機(jī)制,為慢性盆腔痛患者提供更為有效的醫(yī)療舉措,造福于眾多患者,推進(jìn)中醫(yī)藥在臨床的推廣及應(yīng)用。方法:本課題選取符合納入標(biāo)準(zhǔn)的65例慢性盆腔痛患者,中醫(yī)辨證為濕熱瘀阻型,將其隨機(jī)分為治療組與對照組,治療組33例,對照組32例。治療過程中,因各種因素共有4例病例中途中止治療,治療組2例,對照組2例,實(shí)際治療組完成31例研究病例,對照組完成30例研究病例。治療組給予舒盆湯保留灌腸治療,對照組用紅藤湯保留灌腸治療,兩組均在月經(jīng)干凈后3天開始灌腸,每日1次,經(jīng)前1周至經(jīng)期停用,10天為1個(gè)療程,連用3個(gè)療程。觀察治療后及停藥后1月,比較兩組病例的盆腔疼痛VAS評分及中醫(yī)證候的變化。于治療前后行血、尿、糞常規(guī)、肝腎功能及心電圖等檢查以作安全性評價(jià),觀察并及時(shí)記錄不良反應(yīng)。用SPSS17.0統(tǒng)計(jì)軟件分析數(shù)據(jù)。所有病例均來源于廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院(國家三級甲等醫(yī)院)婦科門診。結(jié)果:1兩組患者在年齡、病程、生育情況、盆腔疼痛VAS評分和中醫(yī)證候積分差異無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。2舒盆湯保留灌腸治療組總有效率達(dá)96.77%,紅藤湯保留灌腸對照組總有效率達(dá)93.33%,兩組總有效率相當(dāng),但療效分級比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3兩組治療后盆腔疼痛VAS評分均較治療前下降,組內(nèi)自身前后比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組組內(nèi)分別進(jìn)行治療后與停藥后1月的盆腔疼痛VAS評分比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);兩組組間分別進(jìn)行治療后、停藥后1月的盆腔疼痛VAS評分比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4兩組治療后中醫(yī)證候積分均較治療前下降,組內(nèi)自身前后比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組組內(nèi)分別進(jìn)行治療后與停藥后1月的盆中醫(yī)證候積分比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);兩組組間分別進(jìn)行治療后、停藥后1月的中醫(yī)證候積分比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者在臨床治療中及治療后均未出現(xiàn)明顯不良反應(yīng),血、尿、糞便常規(guī)、肝腎功能及心電圖等安全性指標(biāo)檢查結(jié)果顯示均未見異常。結(jié)論:1舒盆湯保留灌腸能減輕濕熱瘀阻型慢性盆腔痛患者的盆腔疼痛程度,降低中醫(yī)證候積分,改善臨床癥狀,提高生活質(zhì)量,是治療慢性盆腔痛的有效方法之一。2中藥保留灌腸局部給藥濃度高,能提高藥物的生物利用率,無明顯毒副作用,且操作簡便,患者易于堅(jiān)持,療效顯著,值得臨床推廣。
[Abstract]:Objective: to treat chronic pelvic pain of dampness and heat stasis type by reserving enema with Shupan decoction. Through statistical analysis, the VAS score and TCM syndromes score of pelvic pain were compared before, after treatment and after drug withdrawal on January. To observe the degree of pelvic pain and the improvement of clinical symptoms, to evaluate the clinical efficacy scientifically, and to explore the mechanism of its action, to provide more effective medical measures for patients with chronic pelvic pain, and to benefit many patients. Methods: 65 patients with chronic pelvic pain were selected and divided into treatment group (n = 33) and control group (n = 33). In the course of treatment, there were 4 cases who stopped treatment, 2 cases in the treatment group, 2 cases in the control group, 31 cases in the actual treatment group. The treatment group was treated with Shupan decoction and the control group was treated with Hongteng decoction. The two groups began enema 3 days after menstruation, once a day. During the first week to menstrual period, 10 days were used as a course of treatment, followed by 3 courses of treatment. The VAS score of pelvic pain and the changes of TCM syndromes were compared between the two groups after treatment and on January. Routine blood, urine and feces were performed before and after treatment. Liver and kidney function and electrocardiogram were examined for safety evaluation. Adverse reactions were observed and recorded in time. Data were analyzed by SPSS17.0 software. All cases were from gynecological outpatient department of Ruikang Hospital (National Grade 3A Hospital) affiliated to Guangxi University of traditional Chinese Medicine. Results two groups of patients were in age and course of disease. There was no significant difference in the VAS score of pelvic pain and the score of TCM syndromes. There was no significant difference between the two groups. 2 the total effective rate of Shupan decoction retention enema treatment group was 96.77777.The total effective rate of Hongteng decoction retention enema control group was 93.33. The total effective rate of the two groups was similar. However, there was significant difference in the grade of curative effect between the two groups. The VAS scores of pelvic pain in the two groups were lower than those before and after treatment, and there was a significant difference between the two groups before and after the treatment. There was no significant difference in the VAS scores of pelvic pain between the two groups after treatment and January after drug withdrawal. The VAS scores of pelvic pain were compared between the two groups after treatment and January after withdrawal. The difference was statistically significant (P 0.05). 4 after treatment, the scores of TCM syndromes in the two groups were all decreased compared with those before and after treatment, and the differences were statistically significant before and after treatment in the two groups. There was no significant difference between the two groups after treatment, the difference was statistically significant between the two groups on January after the treatment, the difference was statistically significant (P 0.05). There were no significant adverse reactions, blood and urine in the two groups during and after the treatment. The results of routine stool examination, liver and kidney function and electrocardiogram showed that there was no abnormality. Conclusion the retention enema of 1% Shupan decoction can alleviate the degree of pelvic pain and reduce the integral of TCM syndrome in the patients with damp-heat stasis type chronic pelvic pain. Improving clinical symptoms and quality of life is one of the effective methods for the treatment of chronic pelvic pain. 2. The traditional Chinese medicine retention enema has high local administration concentration, can improve the bioavailability of drugs, has no obvious side effects, and is easy to operate, and the patients are easy to adhere to. The curative effect is remarkable and worth popularizing clinically.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R271.9

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