本文選題：中醫(yī)　切入點(diǎn)：圍絕經(jīng)期綜合征　出處：《湖南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：[目的]觀察更年湯配合心理疏導(dǎo)治療圍絕經(jīng)期綜合征腎虛肝郁證的臨床療效,為臨床應(yīng)用提供依據(jù)。[資料和方法]本研究在湖南中醫(yī)藥大學(xué)第一附屬醫(yī)院門(mén)診展開(kāi)。病例采集時(shí)間:2014年6月1日-2015年3月1日,納入60例符合觀察條件的圍絕經(jīng)期綜合征腎虛肝郁證的患者。使用隨機(jī)、陽(yáng)性藥物平行對(duì)照設(shè)計(jì)方法,受試者隨機(jī)分為治療者和對(duì)照組各30例。治療前,兩組患者的年齡、病程比較無(wú)明顯差異。治療組予以更年湯配合心理疏導(dǎo),對(duì)照組予以坤泰膠囊配合心理疏導(dǎo),共服用3個(gè)月經(jīng)周期為完成本療程。詳細(xì)觀察治療組和對(duì)照組治療前后的癥狀體征、中醫(yī)證候積分、中醫(yī)療效積分,女性內(nèi)分泌激素的改變并進(jìn)行對(duì)比,密切觀察患者用藥過(guò)程中有無(wú)不良反應(yīng)。[結(jié)果]治療組臨床痊愈4例,顯效6例,有效16例,無(wú)效4例,總有效率86.6%;對(duì)照組臨床痊愈2例,顯效3例,有效15例,無(wú)效10例,總有效率66.7%,兩組間療效比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組病例、年齡相似,具有可比性;本方治療后患者癥狀積分較治療前下降,說(shuō)明本方具有良好的治療效果,對(duì)改善患者主證潮熱汗出、次癥急躁易怒、腰膝酸軟、頭暈耳鳴、失眠多夢(mèng)的臨床癥狀方面療效顯著,具有統(tǒng)計(jì)學(xué)意義(P0.05);病情輕重對(duì)療效有關(guān)系,有統(tǒng)計(jì)學(xué)意義(P0.05);病程長(zhǎng)短對(duì)療效無(wú)影響,無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組病例治療前后FSH、LH、E2的比較,經(jīng)統(tǒng)計(jì)學(xué)分析,無(wú)顯著差異(P0.05),表面治療組和對(duì)照組兩組藥物在治療圍絕經(jīng)期綜合征患者時(shí),對(duì)FSH、LH、E2無(wú)顯著影響。[結(jié)論]1.更年配合心理疏導(dǎo)療法是治療圍絕經(jīng)期綜合征腎虛肝郁證的有效方法,能夠改善臨床癥狀,提高患者生活治療。2.此次更年湯配合心理疏導(dǎo)療法在治療前和治療后中醫(yī)臨床癥狀總積分、改良Kupperman量表評(píng)分及各項(xiàng)臨床癥狀評(píng)分比較差異具有顯著統(tǒng)計(jì)學(xué)意義。3.更年湯在治療患者過(guò)程中未發(fā)現(xiàn)有任何不良反應(yīng)和毒副作用,說(shuō)明本方的實(shí)用價(jià)值,值得在臨床中推廣。
[Abstract]:[objective] to observe the clinical effect of Gannian decoction combined with psychological guidance in the treatment of kidney deficiency and liver depression syndrome in perimenopausal syndrome. This study was carried out in the outpatient clinic of the first affiliated Hospital of Hunan University of traditional Chinese Medicine. Case collection time: June 1, 2014-March 1, 2015, Sixty cases of peri-menopausal syndrome with kidney deficiency and liver depression were included. The subjects were randomly divided into two groups: 30 patients and 30 patients in the control group. There was no significant difference in the course of disease. The treatment group was given Gannian decoction with psychological guidance, and the control group was given Kuntai capsule with psychological guidance. Three menstrual cycles were taken to complete the course. The changes of symptoms and signs, TCM syndromes integral, TCM curative effect score, female endocrine hormones were observed and compared before and after treatment in the treatment group and the control group. [results] in the treatment group, 4 cases were cured, 6 cases were effective, 16 cases were effective, 4 cases were ineffective, and the total effective rate was 86.6 cases, while in the control group, 2 cases were cured, 3 cases were effective, 15 cases were effective, 10 cases were ineffective. The total effective rate was 66.7%, and the difference between the two groups was statistically significant (P 0.05). The patients in the two groups were of similar age and comparable. The symptom score of the patients after the treatment was lower than that of the patients before treatment, which indicated that it had a good therapeutic effect. It has a significant effect on improving the clinical symptoms of patients with main syndrome, such as hot tidal sweating, irritability and irritability, sore waist and soft knees, dizziness and tinnitus, insomnia and many dreams, and has statistical significance (P 0.05), and the severity of the disease is related to the curative effect. The course of disease had no effect on the curative effect, there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment. There was no significant difference between the two groups in the treatment of peri-menopausal syndrome. [conclusion] 1.Gannian combined with psychological dredging therapy is an effective method for the treatment of kidney deficiency and liver-depression syndrome in perimenopausal syndrome, and there is no significant difference between the two groups in the treatment of peri-menopausal syndrome patients with peri-menopausal syndrome. Can improve clinical symptoms, improve patients' life treatment .2.The total score of clinical symptoms of traditional Chinese medicine before and after treatment can be improved by Gannian decoction combined with psychological dredging therapy. There were significant differences in the scores of modified Kupperman scale and clinical symptoms. 3. Gannian decoction did not find any side effects and side effects in the course of treatment, which indicated the practical value of the prescription and was worth popularizing in clinic.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R271.116

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