本文選題：補腎疏肝方 + 高催乳素血癥�。� 參考：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過觀察補腎疏肝方治療肝郁腎虛證高催乳素血癥(Hyperprolactinemia,HPRL)患者的臨床療效,并探討其機制,為該病的臨床診治提供一些思路和方法。方法:本研究選取來自我院婦科門診就診的符合入組標準的高催乳素血癥患者,采取隨機對照試驗方法,分為中藥組24例,西藥組24例。治療組予口服中藥組方補腎疏肝方治療,西藥組予口服溴隱亭治療。兩組患者治療3個月后判定療效,并通過統(tǒng)計學(xué)方法處理后進行對比分析和總結(jié)。觀察治療前后血清泌乳素(PRL)與中醫(yī)證候改善情況,觀察停藥三個月內(nèi)復(fù)發(fā)率。結(jié)果:1.綜合療效比較:中藥組對治療肝郁腎虛證高催乳素血癥患者的總有效率為83.33%,西藥組為87.49%,差異無統(tǒng)計學(xué)意義(P0.05)。2.中醫(yī)臨床癥狀比較:兩組患者治療后中醫(yī)癥狀總積分均有明顯下降,組間比較差異有統(tǒng)計學(xué)意義(P0.05)。兩組治療后,在改善月經(jīng)稀發(fā)或閉經(jīng)、溢乳、經(jīng)行小腹脹痛、性欲減退、脅肋脹痛上,組間比較差別無統(tǒng)計學(xué)意義(P0.05);兩組在改善腰膝酸軟方面,組間比較有統(tǒng)計學(xué)差異(P0.05),中藥組優(yōu)于西藥組;中藥組在改善月經(jīng)量少、情緒抑郁或心煩易怒、乳房脹痛方面,顯著優(yōu)于西藥組(P0.01)。3.治療前后PRL水平方面比較:兩組患者治療后PRL水平均降低,有統(tǒng)計學(xué)的差異(P0.05),組間比較西藥組PRL水平對比中藥組下降幅度較大(P0.05)。4.停藥后隨訪期復(fù)發(fā)情況:兩組PRL恢復(fù)正常范圍的患者停藥后在隨訪期3個月內(nèi)PRL異常升高人數(shù),中藥組3人,西藥組8人,差異有統(tǒng)計學(xué)意義(P0.05),復(fù)發(fā)率中藥組為16.67%,西藥組為44.45%。5.不良反應(yīng)比較:兩組患者用藥治療期間,不良反應(yīng)發(fā)生率中藥組為12.50%,西藥組為41.67%,兩組不良反應(yīng)比較有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:研究結(jié)果表明,補腎疏肝方及溴隱亭對肝郁腎虛證高催乳素血癥患者出現(xiàn)的中醫(yī)癥狀均有著良好的臨床治療效果,在改善月經(jīng)量少、情緒抑郁或心煩易怒、腰膝酸軟、乳房脹痛不適方面,補腎疏肝方較溴隱亭有優(yōu)勢。溴隱亭治療HPRL雖然療效確切,但服藥后存在惡心、頭暈、便秘等不良反應(yīng),且停藥后血清PRL水平易反彈。疏肝補腎方臨床上降低PRL水平緩和,停藥后不易復(fù)發(fā),且服藥后不良反應(yīng)發(fā)生率小,安全性方面較使用溴隱亭更佳,體現(xiàn)了中藥方劑治療本病的優(yōu)勢。
[Abstract]:Objective: to observe the clinical effect of Bushen Shugan recipe in treating hyperprolactinemiaemia (HPRL) patients with liver stagnation and kidney deficiency syndrome, and to explore its mechanism, and to provide some ideas and methods for the clinical diagnosis and treatment of the disease. Methods: patients with hyperprolactinemia who were admitted to gynecological outpatient clinic in our hospital were randomly divided into Chinese medicine group (n = 24) and western medicine group (n = 24). The treatment group was treated with Bushen Shugan prescription and the western medicine group with bromocriptine. Two groups of patients after 3 months of treatment to determine the efficacy, and statistical treatment after comparative analysis and summary. To observe the improvement of serum prolactin (PRL) and TCM syndromes before and after treatment, and to observe the recurrence rate within 3 months. The result is 1: 1. Comprehensive efficacy comparison: the total effective rate of traditional Chinese medicine group in treating hyperprolactinemia patients with liver stagnation and kidney deficiency syndrome was 83.33 and that of western medicine group was 87.49.The difference was not statistically significant (P0.05). 2. Comparison of clinical symptoms of traditional Chinese medicine: the total scores of TCM symptoms in the two groups were significantly decreased after treatment, and the difference between the two groups was statistically significant (P0.05). After treatment, there was no significant difference between the two groups in the improvement of menorrhagia or amenorrhea, galactorrhea, abdominal distending pain, decreased libido and hypochondria pain between the two groups (P0.05). There was significant difference between the groups (P0.05), the Chinese medicine group was better than the western medicine group; the traditional Chinese medicine group in improving menstrual volume, emotional depression or irritability, breast pain, significantly better than the western medicine group (P0.01) .3. Comparison of PRL levels before and after treatment: the PRL level of the two groups decreased after treatment, there was a statistical difference (P0.05), the PRL level of the Western medicine group decreased significantly compared with the traditional Chinese medicine group (P0.05). 4. The recurrence of PRL in the two groups was significantly higher than that in the traditional Chinese medicine group (3 cases) and the western medicine group (8 cases) (P0.05). The recurrence rate was 16.67 in the Chinese medicine group and 44.45.5in the western medicine group. Comparison of adverse reactions: the incidence of adverse reactions was 12.50 in the traditional Chinese medicine group and 41.67 in the western medicine group. There was statistical significance between the two groups (P0.05). Conclusion: the results show that both Bushen Shugan recipe and Bromocriptine have good therapeutic effect on the symptoms of hyperprolactinemia of liver depression and kidney deficiency syndrome, which can improve menstrual volume less, emotional depression or irritability, weakness of waist and knee. Breast pain discomfort, kidney-soothing side than bromocriptine has an advantage. Bromocriptine was effective in treating HPRL, but there were adverse reactions such as nausea, dizziness, constipation and so on. Shugan Bushen prescription can reduce the level of PRL in clinic, but it is not easy to recur after withdrawal, and the incidence of adverse reactions after taking medicine is small, and the safety is better than that of bromocriptine, which reflects the advantage of traditional Chinese medicine prescription in the treatment of this disease.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

【參考文獻】

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本文編號：2092647