本文關(guān)鍵詞：中藥周期療法治療脾腎陽虛型黃體功能不全所致月經(jīng)失調(diào)的臨床研究，，由筆耕文化傳播整理發(fā)布。

        黃體功能不全(LPD)是一種婦科常見病,其主要以月經(jīng)周期縮短、經(jīng)期延長、月經(jīng)量或多或少、經(jīng)前點滴出血等月經(jīng)失調(diào)為特點,�？蓪е虏辉胁挥�、自然流產(chǎn),甚則復發(fā)性流產(chǎn)。古代醫(yī)籍并無“黃體功能不全”的記載,根據(jù)它所表現(xiàn)出來的癥狀將其歸屬于中醫(yī)“月經(jīng)先期”、“經(jīng)期延長”、“不孕不育”、“胎漏”、“胎動不安”等范疇,中醫(yī)多認為其病機在于腎虛、脾腎陽虛、肝腎陰虛、肝郁脾虛、血瘀等。本文包括文獻綜述和臨床觀察二部分,其中文獻綜述包括黃體功能不全的中西醫(yī)研究進展。中醫(yī)研究概況側(cè)重于它的病因病機、辨證分型及治療,而西醫(yī)研究概況則從病因、診斷及治療方面著手；臨床觀察研究從中藥周期療法的角度治療脾腎陽虛型黃體功能不全所致月經(jīng)失調(diào),采取受試者自身前后對照的方法,觀察受試者臨床癥狀的變化,并將其BBT升高7-8天的血清孕酮值、雌二醇值、HPS評分、高溫相持續(xù)時間、高低溫差、移行期及中醫(yī)癥狀積分進行統(tǒng)計學分析,判斷差異的意義,評價療效并進一步探討脾腎陽虛型黃體功能不全所致月經(jīng)失調(diào)的發(fā)病機理。希望通過中藥周期療法為黃體功能不全所致月經(jīng)失調(diào)的患者提供一個可行有效的方法,從而證明傳統(tǒng)中醫(yī)藥在治療黃體功能不全所致月經(jīng)失調(diào)的患者方面有明顯的優(yōu)勢和特點。方法收集40例符合脾腎陽虛型黃體功能不全所致月經(jīng)失調(diào)的受試者,填寫知情同意書后開始中藥周期療法。具體方案如下：月經(jīng)第1-3天予養(yǎng)血調(diào)經(jīng)湯加減,月經(jīng)第4天起予育胞湯加減,服至見透明拉絲白帶停；后服促排卵湯4付；繼服兩固湯加減至月經(jīng)來潮停；循環(huán)治療3個月經(jīng)周期,期間隨癥稍作加減,觀察治療前后其月經(jīng)周期、量、色、質(zhì)、基礎(chǔ)體溫等,根據(jù)療效評價標準判斷療效；并判斷年齡及病程是否與療效相關(guān)；比較治療前后中醫(yī)癥狀積分、單項中醫(yī)癥狀、HPS評分、高溫相持續(xù)天數(shù)、高低溫差、移行期天數(shù)、基礎(chǔ)體溫升高7-8天血清孕酮值及雌二醇值、并用配對t檢驗判定其差異是否具有統(tǒng)計學意義。結(jié)果本研究中治療前后受試者的月經(jīng)先期、經(jīng)期延長等月經(jīng)失調(diào)的情況均得到明顯改善。其中經(jīng)治療后臨床癥狀明顯減輕,P<0.05,差異有統(tǒng)計學意義,說明此研究可減輕經(jīng)期或經(jīng)期前后的一些癥狀；HPS評分經(jīng)過3個月經(jīng)周期的治療后較治療前明顯增加,P<0.05,差異有統(tǒng)計學意義,且治療后HPS的均值大于5,說明此方法可改善黃體功能,提高HPS評分；基礎(chǔ)體溫高溫相持續(xù)時間經(jīng)治療后延長,P<0.05,差異有統(tǒng)計學意義,說明該研究可增加高溫相持續(xù)時間；移行期天數(shù)經(jīng)治療后呈下降趨勢,但P>0.05,差異無統(tǒng)計學意義,說明此方法使移行期天數(shù)下降的幅度不明顯；高低溫差經(jīng)治療后明顯提高,P<0.05,差異有統(tǒng)計學意義,說明該研究可使基礎(chǔ)體溫高低溫差加大；黃體中期血清孕酮值(BBT上升7-8天)在治療后顯著增加, P<0.05,差異有統(tǒng)計學意義,說明該研究可提高黃體期血清孕酮值,使黃體功能得到改善；治療后黃體中期血清雌二醇值呈上升趨勢,P<0.05,差異有統(tǒng)計學意義,說明中藥周期療法可提高黃體中期血清雌二醇水平。結(jié)論對于脾腎陽虛型黃體功能不全所致月經(jīng)失調(diào)的患者,中藥周期療法可有效減輕經(jīng)期或經(jīng)期前后的一些癥狀,中醫(yī)癥狀積分也得到了提高,升高HPS評分,延長基礎(chǔ)體溫高溫相持續(xù)時間,使基礎(chǔ)體溫高低溫差加大,也可使黃體中期血清孕酮值和雌二醇水平顯著提高,且通過統(tǒng)計學分析,其療效與年齡與病程無明顯相關(guān)性。

    Luteal phase defect (LPD) is a gynecology department common disease. It can shorten menstrual cycles, prolong period, have a hemorrhage before menstrual cramps and so on. Belong to the Chinese medicine "advanced menstruation","menstrual extension","threatened abortion","habitual abortion". The Chinese medicine believes that its pathogenesis is deficiency of the kidney, stagnation of liver qi and spleen deficiency, phlegmatic hygrosis and soon.Object:40patients with luteal phase defect menstrual disorder, TCM differentiation for yang deficiency of spleen and kidney were volunteers to participate in the study. The total course lasted for three months. Symptorm score of TCM, the amelioration of clinical symptom, the sex hormone:estradiol (E2), progesterone (P), and the change of basal body temperature. We compared the results before and after the treatments in order to observe the effect of the cycle treatment with TCM.Methods:We provide self-made Yangxue Tiaojing Decoction on the one from three days menstrual period, self-made Yubao Decoction on the fourth day until you found that the leucorrhea could be drawing, self-made Cu Pailuan Decoction4pairs, self-made Lianggu Decoction until menstrual cramps. We compared with their results by setting a self control group before and after, such as progesterone and estradiol values in serum after the BBT curve rising7-8days, HPS and the TCM symptoms integral.Results:In this study, before and after treatment, progesterone and estradiol values in serum after the BBT curve rising7-8days were increased, indicating that the cycle treatment with TCM on luteal phase defect menstrual disorder had curative effect. The scores of HPS also had been improved after the therapy of3months, P<0.05, it suggested that this therapy had an important positive effects on luteal phase defect. The high temperature phase had been prolongated after the therapy, the temperature difference of the BBT also had been widened. However, the time from high to low temperature phase was decreased, P>0.05, it showed that the effect for this was not very good.At the same time, the TCM symptoms integral became decreased after the therapy, P<0.05, demonstrating that it could improve the symptoms of luteal phase defect menstrual disorder.Conelus i on:The cycle treatment with TCM in the treatment of obese patients with luteal phase defect menstrual disorder, can effectively improve the level of progesterone and estradiol in serum after the BBT curve rising7-8days, increase the score of HPS, moreover, widen the high temperature phase and the temperature difference, it also can reduce the TCM symptoms integral after the therapy of3months.

中藥周期療法治療脾腎陽虛型黃體功能不全所致月經(jīng)失調(diào)的臨床研究

中文摘要4-6ABSTRACT6第一部分 文獻綜述9-30    綜述一9-20        1. 病因病機9        2. 主要證型9-10        3. 臨床表現(xiàn)10-11        4. 治療方法11-17        參考文獻17-20    綜述二20-30        1. 黃體功能不全的病因20-23        2. 診斷23-24        3. 治療方案24-27        參考文獻27-30第二部分：臨床研究30-44    一、前言30    二、診療標準30-31    三、研究方案31-32    四、結(jié)果32-38    五、討論38-43    參考文獻43-44附表144-46附表246-48致謝48-49個人簡歷49

  本文關(guān)鍵詞：中藥周期療法治療脾腎陽虛型黃體功能不全所致月經(jīng)失調(diào)的臨床研究，由筆耕文化傳播整理發(fā)布。