本文選題：痛經(jīng)方 + 原發(fā)性痛經(jīng)��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)觀察痛經(jīng)方治療脾腎兩虛型原發(fā)性痛經(jīng)的痛經(jīng)改善情況、癥狀積分變化情況等來(lái)探討其臨床療效;通過(guò)檢測(cè)血栓素(TXB2)和前列環(huán)素(6-Keto-PGF1α)含量,探討痛經(jīng)方治療原發(fā)性痛經(jīng)的療效機(jī)制。方法:收集2016年1月至2017年1月在江蘇省中醫(yī)院婦科門(mén)診就診的脾腎兩虛型原發(fā)性痛經(jīng)患者60例,隨機(jī)分為治療組和對(duì)照組各30例。治療組:經(jīng)期前兩天至經(jīng)期結(jié)束痛經(jīng)方湯劑,200ml,口服,1劑/日,早晚分服;非經(jīng)期健脾補(bǔ)腎湯劑,200ml,口服,1劑/日,早晚分服。對(duì)照組:經(jīng)期前兩天至經(jīng)期結(jié)束服用痛經(jīng)寶顆粒劑,1袋/次,2次/日,溫開(kāi)水沖服;非經(jīng)期治療同上。3個(gè)月經(jīng)周期為一個(gè)療程,觀察1個(gè)療程。觀察治療前后兩組患者痛經(jīng)改善情況、癥狀積分變化及血漿TXB2和6-keto-PGF1α含量,采用SPSS21.0軟件,進(jìn)行數(shù)據(jù)處理,統(tǒng)計(jì)分析結(jié)果。結(jié)果:1.痛經(jīng)療效:治療組痊愈13例,顯效10例,有效5例,無(wú)效2例,總有效率為93.3%;對(duì)照組痊愈5例,顯效7例,有效11例,無(wú)效7例,總有效率為76.7%,治療組療效優(yōu)于對(duì)照組(PO.O5)。2.中醫(yī)證候療效:治療組痊愈10例,顯效12例,有效6例,無(wú)效2例,總有效率為93.3%;對(duì)照組痊愈4例,顯效7例,有效11例,無(wú)效8例,總有效率為73.3%,治療組優(yōu)于對(duì)照組(P0.05)。3.各個(gè)癥狀改善情況:治療組優(yōu)于對(duì)照組P0.05,其中在改善月經(jīng)量、色質(zhì),畏寒肢冷、腰膝酸軟方面治療組顯著優(yōu)于對(duì)照組。4.綜合療效:治療組痊愈3例,顯效10例,有效15例,無(wú)效2例,總有效率為93.3%;對(duì)照組痊愈2例,顯效6例,有效10例,無(wú)效12例,總有效率為60.0%,治療組優(yōu)于對(duì)照組(P0.05)。5.TXB2值比較:治療組治療后明顯低于治療前(P0.05);對(duì)照組治療前后無(wú)明顯變化(PO.O5);兩組組間比較治療組TXB2值降低明顯優(yōu)于對(duì)照組(P0.05)6.6-keto-PGF1α值比較:治療組治療后高于治療前(P0.05);對(duì)照組治療前后無(wú)明顯變化(P0.05);兩組組間比較治療組6-keto-PGF1α值升高優(yōu)于對(duì)照組(P0.05)。7.TXB2/6-keto-PGF1α值比較:治療組明顯低于對(duì)照組(P0.05)。8.安全性指標(biāo):通過(guò)觀察血常規(guī)、肝腎功能(ALT、AST、BUN、Scr)、心電圖兩組均未發(fā)現(xiàn)有異常。結(jié)論:痛經(jīng)方治療原發(fā)性痛經(jīng)的臨床療效確切,不僅能緩解痛經(jīng)癥狀,還能明顯改善全身癥狀,綜合臨床療效達(dá)93.3%,且安全無(wú)毒副作用;痛經(jīng)方的療效機(jī)制可能與升高血漿6-keto-PGF1α的水平,降低TXB2的水平及TXB2/6-keto-PGF1α的比值,改善胞宮微血管舒縮狀態(tài)有關(guān)。
[Abstract]:Objective: to investigate the clinical efficacy of Tongjing recipe in the treatment of primary dysmenorrhea with deficiency of spleen and kidney, and to detect the contents of TXB2 and 6-Keto-PGF 1 偽. To explore the therapeutic mechanism of Tongjing prescription in treating primary dysmenorrhea. Methods: from January 2016 to January 2017, 60 patients with primary dysmenorrhea with deficiency of spleen and kidney were randomly divided into treatment group (n = 30) and control group (n = 30). Treatment group: two days before the menstrual period to the end of menstrual period Tongjing decoction 200 ml, oral 1 dose / day, morning and evening, divided; non-menstrual period tonifying kidney decoction 200 ml, orally take 1 dose / day, morning and evening. Control group: 2 days before the menstrual period to the end of menstrual period taking Tongjingbao granule 1 bag / twice a day, warm boiled water, unmenstrual period treatment is equal. 3 menstrual cycle as a course of treatment, observe a course of treatment. The improvement of dysmenorrhea, the change of symptom score and the contents of TXB2 and 6-keto-PGF1 偽 in plasma were observed before and after treatment. The data were processed by SPSS21.0 software, and the results were analyzed statistically. The result is 1: 1. The curative effect of dysmenorrhea: in the treatment group, 13 cases were cured, 10 cases were effective, 5 cases were effective, 2 cases were ineffective, the total effective rate was 93.33.In the control group, 5 cases were cured, 7 cases were effective, 11 cases were effective, 7 cases were ineffective, and the total effective rate was 76.70.The curative effect of the treatment group was better than that of the control group (P < 0.05). The curative effect of TCM syndromes: in the treatment group, 10 cases were cured, 12 cases were effective, 6 cases were effective, 2 cases were ineffective, the total effective rate was 93.3.The treatment group was superior to the control group (P 0.05g 路3), while the control group was cured in 4 cases, markedly effective in 7 cases, effective in 11 cases, ineffective in 8 cases, and the total effective rate was 73.3%. The improvement of symptoms: the treatment group was better than the control group (P0.05), especially in improving menstrual volume, color, cold limbs, waist and knee sore and soft, the treatment group was significantly better than the control group. 4. In the treatment group, 3 cases were cured, 10 cases were effective, 15 cases were effective, 2 cases were ineffective, and the total effective rate was 93.33.In the control group, 2 cases were cured, 6 cases were effective, 10 cases were effective, 12 cases were ineffective. The total effective rate was 60. 0. The treatment group was superior to the control group (P 0. 05). 5. TXB2: after treatment, the treatment group was significantly lower than that before and after treatment (P 0. 05); the control group had no significant change before and after treatment; the TXB2 value of the treatment group was significantly lower than that of the control group (P 0. 05 and P 0. 05 keto-PGF 1 偽) before and after treatment. After treatment, the 6-keto-PGF1 偽 in the treatment group was higher than that in the control group (P 0.05), and no significant change was found in the control group before and after treatment, and the increase of 6-keto-PGF1 偽 in the treatment group was better than that in the control group (P 0.05) .7.TXB _ 2 / 6-keto-PGF _ 1 偽: the treatment group was significantly lower than the control group (P 0.05). Safety index: according to blood routine examination, liver and kidney function were not abnormal in both groups. Conclusion: Tongjing prescription is effective in treating primary dysmenorrhea. It can not only relieve dysmenorrhea symptoms, but also improve systemic symptoms. The therapeutic mechanism of Tongjing recipe may be related to increasing the level of plasma 6-keto-PGF1 偽, decreasing the level of TXB2 and the ratio of TXB2/6-keto-PGF1 偽, and improving the state of vasomotor and contraction of microvessels in the uterus.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R271.113

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