本文選題：仙河更年顆粒 + 腎陽(yáng)虛�。� 參考：《山西中醫(yī)學(xué)院》2016年碩士論文

【摘要】：目的:本研究旨在觀察仙河更年顆粒治療腎陽(yáng)虛型絕經(jīng)綜合征的臨床療效及治療前后性激素水平的變化,并對(duì)結(jié)果進(jìn)行統(tǒng)計(jì)分析,為其臨床應(yīng)用提供客觀依據(jù)。方法:依據(jù)隨機(jī)雙盲對(duì)照原則,選取符合絕經(jīng)綜合征(MPS)西醫(yī)診斷標(biāo)準(zhǔn)及腎陽(yáng)虛型證候診斷標(biāo)準(zhǔn)的患者60例,設(shè)仙河更年顆粒治療組30例和右歸飲顆粒對(duì)照組30例,每組連續(xù)給藥4周。以Kuperman評(píng)分表與腎陽(yáng)虛證候積分表作為療效評(píng)價(jià)指標(biāo),觀察兩組患者治療前后的疾病癥狀、證候評(píng)分,來研究自擬仙河更年顆粒治療腎陽(yáng)虛型絕經(jīng)前后諸證的臨床療效及證候改善情況、治療前后血E2、FSH、LH水平的改變情況。結(jié)果:1.疾病療效:根據(jù)治療前后Kupperman評(píng)分表總積分,仙河更年顆粒治療組總有效率90.00%,右歸飲顆粒對(duì)照組總有效率80.00%,兩組比較總有效率有統(tǒng)計(jì)學(xué)差異(P㩳O.O5),仙河更年顆粒臨床療效的優(yōu)于右歸飲顆粒。2.中醫(yī)證候療效:根據(jù)治療前后證候評(píng)分表,治療組總有效率93.33%,對(duì)照組總有效率為83.33%。兩組比較總有效率有統(tǒng)計(jì)學(xué)差異(P㩳O.O5),故在中醫(yī)證候改善方面,仙河更年顆粒的療效優(yōu)于右歸飲顆粒。3.仙河更年顆粒治療MPS前后改良Kupperman積分比較:Kupperman積分均有明顯下降(P㩳0.01),且治療組優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P㩳O.O5),說明在改善臨床癥狀方面,仙河更年顆粒的療效優(yōu)于右歸飲顆粒。4.仙河更年顆粒治療MPS前后中醫(yī)證候積分比較:治療后中醫(yī)證候積分均有下降(P㩳0.05),且治療組優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P㩳O.O5),說明在改善絕經(jīng)綜合征患者的中醫(yī)癥狀方面,仙河更年顆粒的療效優(yōu)于右歸飲顆粒。5.仙河更年顆粒治療MPS前后疾病主要癥狀療效:依據(jù)治療前后改良Kuperman評(píng)分表主要癥狀積分差,兩組組間進(jìn)行對(duì)比,在改善潮熱汗出、失眠、易激動(dòng)癥狀有統(tǒng)計(jì)學(xué)差(P0.05),而對(duì)感覺異常、泌尿系癥狀、性交痛癥狀無(wú)明顯差異(P0.05),提示仙河更年顆粒在改善潮熱汗出、失眠、易激動(dòng)癥狀療效優(yōu)于右歸飲顆粒,在感覺異常、泌尿系癥狀、性交痛癥狀仙河更年顆粒與右歸飲顆粒療效相當(dāng)。6.仙河更年顆粒治療MPS前后主要證候癥狀療效:依據(jù)治療前后腎陽(yáng)虛證候積分表中主要癥狀積分差異,兩組組間進(jìn)行對(duì)比,在改善形寒肢冷、關(guān)節(jié)冷痛方面有統(tǒng)計(jì)學(xué)差異(P0.05),而對(duì)精神萎靡、小便清長(zhǎng)、夜尿頻數(shù)癥狀無(wú)明顯差異(P0.05),提示仙河更年顆粒在改善形寒肢冷、關(guān)節(jié)冷痛方面療效優(yōu)于右歸飲顆粒,在精神萎靡、小便清長(zhǎng)、夜尿頻數(shù)方面仙河更年顆粒與右歸飲顆粒療效相當(dāng)。7.仙河更年顆粒治療MPS前后對(duì)性激素水平影響:兩組的血清雌二醇(E2)均較治療前略有升高,卵泡刺激素(FSH)、黃體生成素(LH)略有下降,但統(tǒng)計(jì)學(xué)分析P0.05,說明不存在顯著性差異,提示兩組藥物對(duì)E2、FSH、LH影響不大。結(jié)論:仙河更年顆粒治療腎陽(yáng)虛型絕經(jīng)綜合征臨床療效優(yōu)越,明顯改善證候癥狀情況,且均優(yōu)于傳統(tǒng)方右歸飲顆粒;尤其對(duì)在潮熱汗出、失眠、易激動(dòng)疾病癥狀及對(duì)形寒肢冷、關(guān)節(jié)冷痛證候癥狀改善明顯,且服用安全可靠,無(wú)明顯不良反應(yīng)。但對(duì)E2、FSH、LH影響不大。
[Abstract]:Objective: the purpose of this study was to observe the clinical effect and the changes of sex hormone levels before and after the treatment of kidney yang deficiency syndrome in Xianhe, and to provide an objective basis for its clinical application. Methods: according to the principle of randomized double blind control, the diagnostic criteria of Western medicine and kidney Yang in accordance with MPS were selected. 60 patients with virtual syndrome diagnostic criteria were set up in 30 cases in Xianhe more annual particle treatment group and 30 cases of right Gui Yin granule control group, each group was given 4 weeks. The Kuperman score table and the kidney yang deficiency syndrome score table were used as the evaluation index of the curative effect. The symptoms of the two groups before and after treatment and the syndrome score were observed to study the self-made Xianhe more annual granule treatment. The clinical curative effect and syndrome improvement of the syndrome of kidney yang deficiency and menopause, the changes of E2, FSH and LH levels before and after treatment. Results: 1. the curative effect: according to the total integral of the Kupperman score table before and after the treatment, the total effective rate of the Xianhe granule group treatment group was 90%, the total effective rate of the right Decoction granule control group was 80%, and the total effective rate of the two groups was more effective. There were statistical differences (P? O.O5), the clinical curative effect of Xianhe's more annual granule was better than that of right Gui Yin granule. According to the syndrome score table before and after treatment, the total effective rate of the treatment group was 93.33%, the total effective rate of the control group was 83.33%. two, the total effective rate was statistically different (P? O.O5), so in the improvement of TCM syndromes, Xianhe was more granular. The curative effect was better than that of right Gui Yin granule.3. Xianhe PG in the treatment of MPS before and after the treatment of MPS (P? 0.01), and the treatment group was better than the control group, the difference was statistically significant (P? O.O5), indicating that in improving the clinical symptoms, the curative effect was better than that of the right GUI granule.4. Xianhe more annual granules. Comparison of TCM syndrome scores before and after treatment MPS: after treatment, TCM syndrome scores were decreased (P? 0.05), and the treatment group was better than the control group, the difference was statistically significant (P? O.O5), indicating that in improving the symptoms of Chinese medicine of menopause syndrome, the therapeutic effect of Xianhe granule was better than that of right Gui Yin granule,.5. Xianhe more annual granule in the treatment of MPS disease. Main symptom curative effect: according to the improved Kuperman score table before and after treatment, the main symptom score was poor, the two groups were compared, in the improvement of hot and hot sweat, insomnia, and the symptoms of easy excitement were statistically poor (P0.05), but there was no significant difference (P0.05) for the abnormal sensation, urinary system symptoms and sexual pain symptoms (P0.05), suggesting that the more annual granules in Xianhe are improving the hot hot sweat, sweating and insomnia. The effect of the irritability symptom was better than that of the right Gui Yin granule, the curative effect of Xianhe more annual granule and the right Gui Yin granule in the feeling abnormality, the urinary system symptom and the pain symptom in Xianhe was equivalent to the main symptom symptom before and after the treatment of MPS. According to the difference of the main symptom scores in the kidney yang deficiency syndrome score table before and after the treatment, the comparison between the two groups was compared. There were statistically significant differences in cold limb cold and joint cold pain (P0.05), but there was no significant difference in mental malaise, long bowel movement, and nocturnal frequency (P0.05), suggesting that Xianhe's more annual granule is better than right Gui Yin granule in improving cold limb cold and joint cold pain. It is in the spirit of dispirited, urinating and the frequency of nocturnal urine in Xianhe more annual particles and right The effect of Gui Yin granule was equivalent to the effect of.7. Xianhe's more annual Granule on the level of sex hormone before and after MPS: the serum estradiol (E2) in the two groups was slightly higher than that before the treatment, and the follicle stimulating hormone (FSH) and luteinizing hormone (LH) decreased slightly, but the statistical analysis of P0.05 showed no significant difference, suggesting that the effects of the two groups on E2, FSH and LH were not significant. The treatment of kidney yang deficiency syndrome by Xianhe granule is superior in clinical effect, obviously improving symptoms of syndrome, and superior to the traditional right Decoction granules, especially for the symptoms of hot tide sweat, insomnia, easily excited disease and cold and pain syndrome of the shape cold limbs, and it is safe and reliable, but there is no obvious adverse reaction. But to E2 FSH, LH has little effect.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【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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