本文選題：經(jīng)期延長　切入點：異常子宮出血　出處：《北京中醫(yī)藥大學》2017年碩士論文

【摘要】：研究目的:經(jīng)期延長病是婦科常見內(nèi)分泌疾病,現(xiàn)代醫(yī)學對于經(jīng)期延長病無明確定義,且研究數(shù)據(jù)甚少;治療方面激素用藥及手術(shù)治療患者接受率低,復發(fā)率高。本試驗通過分析對比不同發(fā)病原因引起經(jīng)期延長的兩組患者,服用益氣滋陰經(jīng)驗方前后受試者行經(jīng)時間、性激素六項、中醫(yī)證候積分變化,以及遠期復發(fā)率回訪,一方面為了提高經(jīng)期延長患者生活質(zhì)量,另一方面旨在探討益氣滋陰經(jīng)驗方治療氣陰兩虛型經(jīng)期延長病的作用及機制,總結(jié)導師治療經(jīng)期延長的臨床經(jīng)驗,豐富臨床對于經(jīng)期延長的診斷及治療思路,為經(jīng)期延長的研究提供臨床數(shù)據(jù)。研究方法:收集2015年9月至2016年8月來自我院婦科門診,符合氣陰兩虛型經(jīng)期延長病,具有正常月經(jīng)周期,自愿加入本試驗并簽署知情同意書的患者36例,根據(jù)臨床病因分為AUB.O(排卵障礙)組及AUB.E(子宮內(nèi)膜局部異常)組,同時給予益氣滋陰經(jīng)驗方治療,從月經(jīng)第5天開始服藥,連續(xù)服用10天。以3個月經(jīng)周期為1個療程,治療1個療程。觀察患者行經(jīng)時間、性激素六項、中醫(yī)癥狀量表的改變情況,停藥3個月經(jīng)周期后進行遠期復發(fā)率電話回訪。對收集到的臨床數(shù)據(jù)用Excel進行錄入、整合,建立數(shù)據(jù),并用SPSS23統(tǒng)計軟件進行數(shù)據(jù)分析。研究結(jié)果:①益氣滋陰法可明顯縮短AUB.O組患者的行經(jīng)天數(shù),AUB.O組中66.7%的患者治療后月經(jīng)經(jīng)期恢復正常天數(shù),對比AUB.E組中25.0%恢復正常行經(jīng)天數(shù)的患者P＜0.05,有統(tǒng)計學意義;②益氣滋陰法可提高兩組患者血清孕酮水平,兩組患者治療前后P＜0.05,差異有統(tǒng)計學意義;③益氣滋陰法對于全身氣陰兩虛癥狀有顯著改善,治療前后對比P＜0.05,但對于治療脫發(fā)無明顯效果P＞0.05,且兩組間對比統(tǒng)計學差異P＞0.05;④在整個治療周期中,尚未有患者發(fā)生不良事件;⑤3個月后,在恢復正常的17例患者中僅有1例患者復發(fā)。研究結(jié)論:①益氣滋陰經(jīng)驗方可能通過調(diào)節(jié)下丘腦-垂體-卵巢軸,促進卵泡發(fā)育,增強黃體功能,從而增加血清孕酮水平,縮短由AUB.O引起的經(jīng)期延長行經(jīng)時間;②益氣滋陰方間接驗證了氣陰兩虛是經(jīng)期延長病的常見證型之一,印證了"氣、精"理論對于經(jīng)期延長及全身氣陰兩虛癥狀治療的可行性;③本試驗驗證了在卵泡期用藥,可促進卵泡發(fā)育從而增強黃體功能的合理性。
[Abstract]:Objective: menstrual prolongation disease is a common endocrine disease in gynecology. There is no clear definition of menstrual prolongation disease in modern medicine. By analyzing and comparing the two groups of patients with prolonged menstrual period caused by different causes, the subjects' menstrual time, sex hormones, TCM syndromes and long term recurrence rate before and after taking Yiqi Ziyin experience prescription were analyzed and compared. On the one hand, in order to improve the quality of life of the patients with prolonged menstrual period, on the other hand, the purpose of the study was to explore the effect and mechanism of invigorating qi and nourishing yin experience prescription in the treatment of prolonged menstrual period disease of Qi and Yin deficiency, and summarize the clinical experience of tutor in treating prolonged menstr@@. To enrich the clinical diagnosis and treatment of menstrual prolongation, and to provide clinical data for the study of menstrual prolongation. Methods: from September 2015 to August 2016, gynecological outpatients of our hospital were collected, which were consistent with the prolonged menstrual period disease of deficiency of Qi and Yin. Thirty-six patients with normal menstrual cycle who volunteered to join the trial and sign informed consent were divided into two groups according to their clinical etiology: AUB.O group and AUB.E group, and were treated with Yiqi Ziyin experience prescription. Take medicine from the 5th day of menstruation, take it continuously for 10 days. Take 3 menstrual cycles as a course of treatment and treat for 1 course. Observe the patient's menstrual time, six items of sex hormone, the change of TCM symptom scale, After three menstrual cycles, the long term recurrence rate was returned by telephone. The collected clinical data were input, integrated and established with Excel. The statistical software of SPSS23 was used to analyze the data. The results showed that the menstrual period of 66.7% of the patients in the AUB.O group was significantly shorter than that in the AUB.O group, and the menstrual period returned to normal days in 66.7% of the patients in the AUB.O group. In AUB.E group, 25.0% of the patients returned to normal menstrual days (P < 0.05). There was a significant difference in serum progesterone level between the two groups with the method of tonifying qi and nourishing yin. Before and after treatment, there was a significant difference between the two groups (P < 0.05), and the difference was statistically significant (P < 0.05). The contrast before and after treatment was P < 0.05, but there was no significant effect on alopecia (P > 0.05), and there were no adverse events in the whole treatment cycle between the two groups (P > 0.05). Among the 17 patients who returned to normal, only one patient recurred. Conclusion the prescription may promote follicular development and enhance luteal function by regulating hypothalamus-pituitary-ovary axis, thus increasing serum progesterone level. Shortening the menstrual period and prolonging the menstrual period caused by AUB.O indirectly validates that deficiency of Qi and Yin is one of the common syndromes of prolonged menstrual period disease, which confirms "Qi, Qi, Qi and Qi," The feasibility of "essence" theory for prolonging menstrual period and treating the symptoms of deficiency of qi and yin in the whole body. 3. This experiment verifies the reasonableness of using drugs in follicular phase to promote follicular development and enhance luteal function.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R271.111

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