本文選題：PCOS + 肥胖��； 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:探討肥胖型PCOS的內(nèi)分泌代謝特征;觀察調(diào)經(jīng)毓麟加味方治療肥胖型PCOS所致月經(jīng)后期(腎虛痰濕證)的臨床療效,并探討其作用機(jī)理。方法:90例研究對象均來源于山東中醫(yī)藥大學(xué)附屬醫(yī)院婦科門診。其中,肥胖型PCOS患者30例作為治療組;非肥胖型PCOS患者30例及月經(jīng)正常者30例分別為對照1組和對照2組。比較三組的初潮年齡及內(nèi)分泌指標(biāo),并比較治療組與對照1組的代謝指標(biāo);治療組自月經(jīng)或黃體酮撤藥性出血第7天服用調(diào)經(jīng)毓麟加味方,連續(xù)治療6個(gè)月后,觀察其臨床療效,并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:(1)治療組、對照1組平均初潮年齡與對照2組比較,差異均有極顯著性(P0.01);(2)治療組、對照1組LH、LH/FSH、T值與對照2組比較,差異均有極顯著性(P0.01);治療組LH值與對照1組比較,差異有極顯著性(P0.01);治療組E2值與對照2組比較,差異有極顯著性(P0.01);治療組TC、TG、HDL、LDL、INS值與對照1組比較,差異均有極顯著性(P0.01);(3)治療組患者疾病療效痊愈率20%,顯效率33.33%,有效率26.67%,無效率20%,總有效率80%;(4)頭暈耳鳴的中醫(yī)證候積分與治療前比較差異有顯著性(P0.05),其余癥狀的中醫(yī)證候積分與治療前比較差異均有極顯著性(P0.01);(5)治療組患者中醫(yī)證候總分治療前后比較,差異有極顯著性(P0.01);(6)治療組患者中醫(yī)證候療效痊愈率20%,顯效率16.67%,有效率43.33%,無效率20%,總有效率80%;(7)治療組患者BBT與治療前比較有顯著變化,經(jīng)治療患者排卵率明顯升高;(8)治療組患者治療前后BMI比較,差異有極顯著性(P0.01)。結(jié)論:PCOS患者平均初潮年齡大于月經(jīng)正常者;肥胖型PCOS患者的內(nèi)分泌代謝紊亂程度更為嚴(yán)重;調(diào)經(jīng)毓麟加味方具有溫腎化痰,調(diào)經(jīng)助孕之功,治療肥胖型PCOS月經(jīng)后期(腎虛痰濕證)安全有效,值得臨床推廣及進(jìn)一步研究。
[Abstract]:Objective: To investigate the endocrine and metabolic characteristics of obesity type PCOS, and to observe the clinical effect of regulating menstruation Yulin Jiawei Recipe on the late menstrual period (kidney deficiency dampness syndrome) caused by obesity type PCOS and explore its mechanism. Methods: 90 subjects were all derived from the gynecologic outpatient of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Among them, 30 cases of obese PCOS patients were treated as the treatment. Group: 30 cases of non obese PCOS patients and 30 cases with normal menstruation were compared 1 groups and 2 control groups respectively. Compare the age of menarche and endocrine index in the three groups and compare the metabolic indexes of the treatment group and the control 1 groups; the treatment group took the menstruation or progesterone withdrawal bleeding for seventh days to take the Yulin Jiawei recipe for 6 months after continuous treatment and observed the clinical effect. Results and statistical analysis. Results: (1) in the treatment group, the average age of menarche in the 1 groups was significantly higher than that of the control group (P0.01). (2) the treatment group, the control 1 groups of LH, LH/FSH, T and the control 2 groups were significantly different (P0.01); the LH value of the treatment group was significantly different from that of the control group (P0.01); the E2 value of the treatment group was E2. Compared with the control group, the difference was very significant (P0.01), and the value of TC, TG, HDL, LDL and INS in the treatment group was significantly different from that of the control group (P0.01); (3) the cure rate of the treatment group was 20%, the effective rate was 33.33%, the effective rate was 26.67%, the inefficiency was 20%, the total effective rate was 80%, and (4) the TCM syndrome score of the dizziness tinnitus was different from that before the treatment. (4) the difference of the TCM syndrome score of the dizziness tinnitus was different from before the treatment. Significance (P0.05), the other symptoms of TCM syndrome scores and the difference before treatment were very significant (P0.01); (5) before and after the treatment group of TCM syndromes before and after treatment, the difference was very significant (P0.01); (6) the treatment group of TCM syndrome curative effect recovery rate of 20%, significant efficiency of 16.67%, effective rate of 43.33%, the total efficiency of 80%; (7) There was a significant change in the BBT in the treatment group and before the treatment, and the rate of ovulation was significantly higher in the treated patients. (8) the difference in the BMI in the treatment group was very significant (P0.01). Conclusion: the average age of the menarche in the PCOS patients was greater than that of the normal menstruation; the degree of endocrine and metabolic disorders in the obese PCOS patients was more serious; the adjustment of Yulin Jiawei prescription in the treatment of the patients was more serious. It has the function of warming kidney and eliminating phlegm, regulating menstruation and helping pregnant women. It is safe and effective in treating obese PCOS menstrual period (kidney deficiency and phlegm dampness syndrome), which is worthy of clinical promotion and further study.

【學(xué)位授予單位】：山東中醫(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)】：R271.9

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