本文選題：中醫(yī) + 中西醫(yī)結(jié)合��； 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:本研究共分為兩部分。第一部分分析和總結(jié)近五年治療多囊卵巢綜合征(PCOS)的文獻(xiàn),了解PCOS的研究近況,包括發(fā)病機(jī)制、辨證分型、使用藥物三方面;第二部分對(duì)其中補(bǔ)腎活血法治療PCOS的文獻(xiàn)進(jìn)行系統(tǒng)評(píng)價(jià),評(píng)價(jià)其有效性和安全性,為臨床治療PCOS排卵障礙提供循證依據(jù)和診療思路。方法:第一部分檢索中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(CNKI)2011年01月至2015年12月中醫(yī)、中西醫(yī)結(jié)合治療PCOS的文獻(xiàn),運(yùn)用Excel軟件建立數(shù)據(jù)庫,總結(jié)本病的病機(jī)、辨證分型、用藥規(guī)律。第二部分依據(jù)Cochrane協(xié)作網(wǎng)提供的工作手冊(cè),對(duì)文獻(xiàn)進(jìn)行系統(tǒng)評(píng)價(jià),Meta分析采用Revman5.3軟件進(jìn)行。結(jié)果:第一部分搜集到PCOS病機(jī)25種,總頻次為540;涉及辨證分型57類(單一證型12類,兼夾證型45類),總頻次為358;涉及273味中藥,總頻次為7734,使用頻率較高的藥物共29味。第二部分共納入13篇文獻(xiàn),系統(tǒng)評(píng)價(jià)顯示納入文獻(xiàn)質(zhì)量有待進(jìn)一步提高,Meta分析顯示補(bǔ)腎活血藥及其聯(lián)合促排卵藥可改善PCOS所致的排卵障礙,且未發(fā)現(xiàn)明顯的副作用。發(fā)表性風(fēng)險(xiǎn)偏倚評(píng)估表明存在發(fā)表性偏倚。結(jié)論:近五年文獻(xiàn)中涉及PCOS的病機(jī)主要有腎虛、肝郁、痰瘀互結(jié)、血瘀、脾腎虧虛等。證型主要有腎虛血瘀證、痰濕證、腎虛肝郁證、腎虛證、脾虛痰濕證等。藥物應(yīng)用以補(bǔ)虛藥最多,其次是活血化瘀藥、理氣藥、清熱藥、利水滲濕藥;補(bǔ)虛藥中補(bǔ)陽藥應(yīng)用最多,補(bǔ)陽藥中補(bǔ)腎陽者出現(xiàn)次數(shù)居首位;藥物歸經(jīng)于肝經(jīng)者最多,入腎經(jīng)、脾經(jīng)的藥物次之。系統(tǒng)評(píng)價(jià)顯示納入文獻(xiàn)質(zhì)量有待提高,Meta分析顯示補(bǔ)腎活血藥及其聯(lián)合促排卵藥治療PCOS所致排卵障礙的療效肯定,且未發(fā)現(xiàn)明顯的副作用。
[Abstract]:Objective: this study is divided into two parts. The first part is to analyze and summarize the literature on the treatment of polycystic ovary syndrome (PCOS) in recent five years, and to understand the recent research situation of PCOS, including pathogenesis, syndrome differentiation and drug use. In the second part, the literature on the treatment of PCOS by tonifying kidney and activating blood circulation was systematically evaluated, and its efficacy and safety were evaluated, which provided evidence-based basis and diagnosis and treatment for clinical treatment of PCOS ovulation disorder. Methods: in the first part, we searched the Chinese academic journal full text database (CNKI) from January 2011 to December 2015. We used Excel software to establish the database of TCM and western medicine for PCOS treatment, and summarized the pathogenesis, syndrome differentiation and drug use law of the disease. In the second part, according to the work manual provided by Cochrane Cooperative Network, the systematic evaluation of the literature was carried out by Revman5.3 software. Results: in the first part, 25 kinds of PCOS pathogenesis were collected, the total frequency was 540, 57 kinds were involved in syndrome differentiation (12 types of single syndrome type, 45 types of clip syndrome type, the total frequency was 358), and 273 kinds of traditional Chinese medicine were involved, the total frequency was 7734, and there were 29 kinds of drugs in high frequency. In the second part, 13 articles were included. The systematic evaluation showed that the quality of the literature should be further improved. Meta-analysis showed that tonifying kidney and activating blood circulation drugs and combined ovulation promoting drugs could improve the ovulation disorder induced by PCOS, and no obvious side effects were found. The evaluation of published risk bias indicated the presence of publication bias. Conclusion: the pathogenesis of PCOS in recent five years is mainly kidney deficiency, liver depression, phlegm and blood stasis, deficiency of spleen and kidney and so on. The main syndromes are kidney deficiency and blood stasis syndrome, phlegm dampness syndrome, kidney deficiency liver depression syndrome, kidney deficiency syndrome, spleen deficiency phlegm dampness syndrome and so on. The drugs were mostly used as tonifying drugs, followed by the drugs of activating blood circulation and removing blood stasis, regulating qi, clearing heat, promoting water and infiltrating dampness; of the drugs of tonifying deficiency, the drugs of tonifying yang were the most, and those of tonifying yang of the drugs of tonifying yang were the first, the most of which were the meridians of the liver and the meridian of the kidney, Spleen meridian drugs followed. Systematic evaluation showed that the quality of literature should be improved. Meta-analysis showed that the therapeutic effect of tonifying kidney and activating blood and combined ovulation promoting drugs on ovulation disorder caused by PCOS was positive, and no obvious side effects were found.
【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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