本文選題：健脾理濕益氣養(yǎng)陰方　切入點：多囊卵巢綜合征　出處：《黑龍江省中醫(yī)藥科學院》2016年碩士論文　論文類型：學位論文

【摘要】：目的:旨在觀察健脾利濕益氣養(yǎng)陰方對多囊卵巢伴有胰島素抵抗的病患內(nèi)分泌、代謝、排卵情況等影響,探討其治療多囊卵巢綜合征伴有胰島素抵抗療效機理。方法:臨床研究采用對照和隨機的研究方法,將符合多囊卵巢綜合征伴有胰島素抵抗的病患,按1:1對照的原則,隨機分為治療組與對照組。在基礎(chǔ)治療之上,治療組給予中藥配方顆粒每日1劑,分早晚兩次飯后服用;對照組給予二甲雙胍500mg,每天2次,飯后服用。以1個月經(jīng)周期為1個療程,連續(xù)觀察3個療程。兩組在治療前后分別評價多囊卵巢伴有胰島素抵抗的臨床癥狀、其體征變化及實驗室指標。全部數(shù)據(jù)都以SPSS16.0統(tǒng)計軟件進行統(tǒng)計學的分析。結(jié)果:1.臨床療效方面:治療組總有效率為93.33%。對照組總有效率為73.33%。治療組優(yōu)于對照組(P0.05)。2.中醫(yī)癥候方面:治療組癥候積分療后較療前明顯下降(P0.01);對照組癥候積分較治療前無明顯改變(P0.05),治療組優(yōu)于對照組(P0.01),療后三個月治療組優(yōu)于對照組(P0.01)。3.臨床癥狀及體征方面:(1)治療后兩組患者月經(jīng)情況均有改善(P0.01),治療組優(yōu)于對照組(P0.05),療后三個月月經(jīng)改善穩(wěn)定情況治療組優(yōu)于對照組(P0.05)。(2)治療后兩組患者BMI較治療前均有所下降(P0.01),治療組優(yōu)于對照組(P0.05),療后三個月治療組優(yōu)于對照組(P0.01)。(3)療后、療后三個月治療組患者多毛情況、痤瘡較治療前有所改善(P0.01),對照組改善情況不明顯(P0.05),治療組優(yōu)于對照組(P0.01)。(4)治療后兩組患者黑棘皮情況均有改善(P0.01),兩組改善程度無差異(P0.05),療后三個月治療組優(yōu)于對照組(P0.01)。4.性激素水平方面:(1)治療后兩組患者的T值均較治療前有所下降(P0.05),治療組雄激素下降程度優(yōu)于對照組(P0.05)。(2)治療后兩組患者LH值、LH/FSH值較治療前均有所下降(P0.01),且治療組下降程度優(yōu)于對照組(P0.05)。(3)治療前后兩組患者FSH值、E2值無明顯差異(P0.05)。5.胰島素相關(guān)指標方面:治療后兩組患者FINS值、ISI值較治療前均有改善(P0.05),治療組改善程度與對照組無差異(P0.05)。治療前后兩組患者FPG無明顯差異。6.彩超影像學方面:治療后兩組患者竇卵泡數(shù)目較治療前有所下降(P0.05),且治療組竇卵泡數(shù)減少量優(yōu)于對照組(P0.05)。7.排卵情況(基礎(chǔ)體溫測定)方面:療后、療后三個月兩組患者基礎(chǔ)體溫雙相率分別為40%、16.67%、33.33%、10%,治療組效果優(yōu)于對照組(P0.05)。8.安全性指標方面:治療前后兩組患者血、尿、便常規(guī)及肝、腎功能均在正常范圍之內(nèi)。兩組均未見明顯不良反應。結(jié)論:1.健脾利濕益氣養(yǎng)陰方結(jié)合基礎(chǔ)治療可改善胰島素抵抗(主要為降低FINS)。治療效果與二甲雙胍結(jié)合基礎(chǔ)治療相當。2.健脾利濕益氣養(yǎng)陰方結(jié)合基礎(chǔ)治療可顯著改善多囊卵巢綜合征癥候群,且療后三個月復發(fā)率低。治療效果優(yōu)于二甲雙胍結(jié)合基礎(chǔ)治療。
[Abstract]:Objective: to observe the effects of invigorating spleen, dampness and supplementing qi and nourishing yin on endocrine, metabolism and ovulation in patients with polycystic ovary accompanied by insulin resistance. Methods: control and randomized methods were used to treat patients with polycystic ovary syndrome with insulin resistance according to the principle of 1: 1 control. The treatment group was divided into treatment group and control group at random. On the basis of basic treatment, the treatment group was given 1 dose of traditional Chinese medicine prescription granule daily, taken after two meals in the morning and evening, while the control group was given metformin 500 mg twice a day, One menstrual cycle was used as a course of treatment, and three consecutive courses of treatment were observed. The clinical symptoms of polycystic ovary with insulin resistance were evaluated before and after treatment. All the data were analyzed statistically by SPSS16.0 software. Results: 1. Clinical efficacy: the total effective rate of the treatment group was 93.33. The total effective rate of the control group was 73.33. The treatment group was superior to the control group (P0.05. 2). The symptom score of the treatment group was significantly lower than that of the control group after treatment, while that of the control group had no significant change compared with that before treatment, the treatment group was superior to the control group, and the treatment group was superior to the control group three months after treatment. The clinical symptoms and signs of the treatment group were better than that of the control group. (1) after treatment, the menstrual status of the two groups was improved, the treatment group was superior to the control group (P 0.05), the treatment group was superior to the control group in improving menstrual stability three months after treatment, and the control group was superior to the control group (P 0.05). After treatment, the BMI of the two groups was lower than that of the control group (P 0.01), and the treatment group was better than that of the control group (P 0.01). The treatment group was superior to the control group (P 0.05), and the treatment group was superior to the control group (P 0.01) three months after treatment. Three months after treatment, the patients in the treatment group suffered from hirsutism. The acnes in the treatment group was better than that in the control group (P 0.01). There was no difference in the degree of improvement between the two groups. The treatment group was superior to the control group in three months after treatment, and the treatment group was superior to the control group. After the treatment, the T value of the two groups was lower than that before treatment. The decrease of androgen in the treatment group was better than that in the control group (P 0.05. 0. 2) after treatment, the LH value and the LH / FSH value of the two groups were lower than those before treatment, and the treatment group had a decrease in the value of LHP / FSH, and the treatment group had a lower value of LH / FSH than that of the control group (P < 0. 05, P < 0. 05, P < 0. 05). Before and after treatment, there was no significant difference in FSH value and E2 value between the two groups. Insulin related indexes: after treatment, the FINS value of the two groups was improved compared with that of the control group (P 0.05), and the improvement degree of the treatment group was higher than that of the control group. There was no significant difference in FPG between the two groups before and after treatment. 6. Color Doppler Imaging: the number of antral follicles in the two groups was lower than that before treatment, and the number of antral follicles in the treatment group was lower than that in the control group. Basic body temperature measurement): after treatment, Three months after treatment, the biphasic rates of basic body temperature in the two groups were 40 ~ 16.67 ~ 33.33 and 10, respectively. The effect of the treatment group was better than that of the control group (P 0.05) .8. the safety indexes were as follows: before and after treatment, the patients in the two groups had blood, urine, stool routine and liver. The renal function was within normal range. There were no obvious adverse reactions in the two groups. Conclusion 1. The combination of tonifying spleen, dampness and supplementing qi and nourishing yin can improve insulin resistance (mainly reducing FINSN). The therapeutic effect is based on metformin. 2. The combination of invigorating spleen, dampness and supplementing qi and nourishing yin can significantly improve the syndrome of polycystic ovary syndrome. The recurrence rate was low 3 months after treatment and the therapeutic effect was better than metformin combined with basic treatment.
【學位授予單位】：黑龍江省中醫(yī)藥科學院
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.9

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