發(fā)布時間：2018-03-19 15:40

  本文選題：黃李平教授　切入點：學(xué)術(shù)思想　出處：《廣西中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:黃李平教授是第五批全國名老中醫(yī),擅長于中醫(yī)婦科疾病的治療,對月經(jīng)病的治療具有豐富的臨床經(jīng)驗和獨特的見解,對中醫(yī)后學(xué)者有非常大的幫助和指導(dǎo)意義。本課題擬通過收集整理黃李平教授治療月經(jīng)病的病案,歸納總結(jié)出黃李平教授診治月經(jīng)病的常用方劑、常用藥物等,從中提煉出其治療月經(jīng)病的學(xué)術(shù)思想,并采用自身治療前后對照方法,對黃李平教授的經(jīng)驗方"理平調(diào)經(jīng)湯"治療肝郁型月經(jīng)先后無定期進(jìn)行初步的臨床研究,以評價其有效性及安全性,為黃李平教授治療月經(jīng)病的學(xué)術(shù)理論及經(jīng)驗方提供科學(xué)依據(jù),以期為黃李平教授治療月經(jīng)病的學(xué)術(shù)思想及經(jīng)驗方的臨床應(yīng)用提供依據(jù),同時為進(jìn)一步更深入的學(xué)術(shù)理論研究提供依據(jù)。方法:首先,通過跟師臨床實踐,歸納、整理病案資料,系統(tǒng)總結(jié)出黃李平教授治療月經(jīng)病的學(xué)術(shù)思想及經(jīng)驗方;其次,采用非隨機(jī)自身前后對照法,對"理平調(diào)經(jīng)湯治療肝郁型月經(jīng)先后無定期"進(jìn)行臨床研究。選擇2015年1月至2016年1月廣西醫(yī)科大學(xué)第一附屬醫(yī)院中醫(yī)婦科門診符合肝郁型月經(jīng)先后無定期,經(jīng)各項檢查排除器質(zhì)性病變(子宮肌瘤、子宮腺肌病、垂體腫瘤等)患者80例。予理平調(diào)經(jīng)湯水煎劑(方藥:柴胡10g,當(dāng)歸15g,白芍15g,郁金10g,澤蘭15g,蒼術(shù)10g,冤絲子30g,甘草6g)辨證加味:月經(jīng)期加益母草、香附;月經(jīng)后期加枸杞子、熟地或生地;月經(jīng)間期加懷牛膝、枳殼;月經(jīng)前期加肉蓯蓉、淫羊藿。每日1劑,分2次水煎服。復(fù)診時隨證加減,連續(xù)用藥3個月經(jīng)周期;停藥后隨訪3個月經(jīng)周期。采用月經(jīng)情況及中醫(yī)證候評分表對理平調(diào)經(jīng)湯治療月經(jīng)先后無定期進(jìn)行臨床觀察,采用SPSS16.0建立數(shù)據(jù)庫并進(jìn)行統(tǒng)計學(xué)分析。研究結(jié)果:1.黃李平教授診治月經(jīng)病注重病證結(jié)合,因時制宜,突出中醫(yī)整體辨證思路,崇尚經(jīng)方;提出治經(jīng)必治血,肝脾腎同治以肝為主,認(rèn)為女子以血為用,以肝為先天,肝郁血虛是影響女子月經(jīng)不調(diào)的關(guān)鍵病機(jī);主張月經(jīng)病從肝論治,治療當(dāng)以疏肝解郁,養(yǎng)血柔肝為主。2.臨床研究結(jié)果:(1)本研究符合納入標(biāo)準(zhǔn)患者80例。其中,完整接受治療和隨訪患者共69例,脫落病例11例(因不能堅持服藥退出者9例,妊娠退出者2例)。(2)69例受試者,痊愈18例,顯效25例,有效14例,無效12例,總有效率為82.61%。(3)理平調(diào)經(jīng)湯治療前后月經(jīng)情況積分比較,P0.05,差異有統(tǒng)計學(xué)意義;(4)治療前后中醫(yī)證候比較:經(jīng)行腹痛,胸脅、乳房脹痛,噯氣食少,情志抑郁或煩躁易怒,善太息,治療前后比較P0.05,差異有統(tǒng)計學(xué)意義;脈弦癥狀,治療前后比較P0.05,差異無統(tǒng)計學(xué)意義。結(jié)論:1.理平調(diào)經(jīng)湯治療肝郁型月經(jīng)先后無定期療效顯著,能夠明顯改善患者月經(jīng)情況(月經(jīng)周期、經(jīng)量、經(jīng)(質(zhì))色)及中醫(yī)證候(肝郁證癥候)。2.理平調(diào)經(jīng)湯治療肝郁型月經(jīng)先后無定期有效且安全,這一初步的臨床研究結(jié)果,為黃李平教授從肝論治月經(jīng)病的學(xué)術(shù)思想及經(jīng)驗方的臨床應(yīng)用提供依據(jù),同時為進(jìn)一步更深入的研究提供依據(jù)。3.黃李平教授治療月經(jīng)病從肝論治的學(xué)術(shù)思想獨特,經(jīng)驗方安全有效,可以應(yīng)用于臨床,并且具有更深入研究的價值。
[Abstract]:Objective: Professor Huang Liping is the fifth batch of the old Chinese medicine, treatment of gynecological diseases is good at traditional Chinese medicine, has rich clinical experience and unique insights into the treatment of menstrual disorders, there is a very big help and guidance for Chinese scholars. After this project intends to organize Huang professor Li Ping treatment of menstrual disorders by collecting medical records, summary summarize the prescriptions of Professor Huang Liping on the treatment of menstrual disorders, commonly used drugs, to refine the academic thought from the treatment of menstrual disorders, and self control method was used before and after the treatment, the experience of Professor Li Ping's flat by Huang Decoction "in the treatment of liver stagnation menstruation has no regular clinical study was performed to evaluate the preliminary. Effectiveness and safety, and provide scientific basis for academic theory and experience of Professor Huang Liping in the treatment of menstrual disorders, in order to clinical academic thoughts and experience of Professor Huang Liping in the treatment of menstrual disorders. Provide the basis for further application, and provide the basis for further academic research. Methods: first, with the division of clinical practice, induction, consolidation of medical records, the system summed up the academic thought and experience of Professor Huang Liping in the treatment of menstrual disorders; secondly, using non random self control method, has no regular clinical "study on the" Ping Tiaojing Decoction in the treatment of liver stagnation menstruation. The First Affiliated Hospital of Guangxi Medical University in January 2016 January 2015 to the gynecology clinic with liver stagnation has no regular menstruation, after the examination to exclude organic disease (uterine leiomyoma, adenomyosis, pituitary tumor) in 80 patients. To the management level of the decoction (decoction Bupleurum 10g, angelica 15g, Radix Paeoniae Alba 15g, Radix Curcumae 10g, Eupatorium 15g, Atractylodes 10g, Cuscuta 30g, licorice 6g) with syndrome differentiation: menstrual period and Herba Leonuri, Rhizoma Cyperi; menstruation plus medlar, or raw Rehmannia Menstrual interval; and Achyranthes, Fructus aurantii; premenstrual and Cistanche epimedium, 1. 2 times daily, Shuijianbi. Visit with syndrome, continuous medication for 3 menstrual cycles; follow-up after discontinuation of 3 menstrual cycles. The menstruation and the TCM syndrome score of clinical observation the level of decoction has no regular menstruation, using SPSS16.0 to establish a database and analyzed statistically. Results: 1. with Professor Huang Liping on the treatment of menstrual disease disease injection time, highlighting the whole Chinese dialectical thinking, advocating classics and classical prescription; put forward will cure the blood, spleen and kidney Tongzhi mainly in liver, that women with blood for use, the liver is the congenital deficiency is the key pathogenesis of stagnation of liver qi, affect female irregular menstruation; advocate on the treatment of menstrual disease from the liver, treatment with liver qi stagnation, nourishing blood and liver.2. clinical research results: (1) this study met the inclusion criteria of 80 patients. A total of 69 cases, treatment and follow-up of patients undergoing complete, off 11 cases (2 cases for medication adherence exit 9 cases, pregnancy quittters). (2) of 69 subjects, 18 cases were cured, 25 cases markedly effective, 14 cases effective, 12 cases ineffective, the total effective rate was 82.61%. (3) Li Ping Tiaojing decoction, menstruation score after treatment of P0.05, the difference was statistically significant; (4) comparison of TCM syndromes before and after treatment: the abdominal pain, chest, breast pain, belching less food, emotional depression or irritability, deep sigh, before and after treatment with P0.05, the difference was statistically significant; pulse string of symptoms before and after treatment with P0.05, the difference was not statistically significant. Conclusion: 1. flat Tiaojing Decoction in the treatment of liver stagnation has no regular menstruation curative effect, can significantly improve patients' menstruation (menstrual cycle, the amount of the (quality) color) and TCM syndrome (liver stagnation syndrome).2. flat Tiaojing Decoction the treatment of liver type has no fixed period Effective and safe, the preliminary clinical results, provide the basis for clinical application of Professor Huang Liping s academic thought and experience of treating the menstrual disease from the liver, while further research provides the basis for the.3. of Professor Huang Liping in treating menstrual disease from the liver to the unique academic thought, the experience can be safe and effective. In clinical application, and has a more in-depth study.

【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】：2016
【分類號】：R249;R271.11

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