發(fā)布時(shí)間：2018-07-17 05:54

【摘要】：目的:觀察清熱化瘀方治療血熱夾瘀型圍絕經(jīng)期崩漏的止血療效,并探討本方止血機(jī)理。方法:收錄40例符合標(biāo)準(zhǔn)的血熱夾瘀型圍絕經(jīng)期崩漏患者,隨機(jī)分為治療組(20例)、對(duì)照組(20例)。治療組采用口服清熱化瘀湯,對(duì)照組采用口服三七血傷寧膠囊。7天為一個(gè)療程,觀察并分析治療組與對(duì)照組的臨床止血療效,并對(duì)治療前后的總體療效、中醫(yī)證候積分、血紅蛋白、PT、APTT的改變狀況。結(jié)果:.(1)總體療效評(píng)定:治療組20例患者,痊愈10例,占50%;顯效6例,占30%;有效3例,占15%;無(wú)效1例,占5%;總有效率95%;對(duì)照組20例患者,痊愈3例,占15%;顯效4例,占20%;有效6例,占30%;無(wú)效7例,占35%;總有效率65%。治療組及對(duì)照組的總體療效數(shù)值經(jīng)過(guò)比較P0.05,具有統(tǒng)計(jì)學(xué)意義,且治療組療效優(yōu)于對(duì)照組療效。(2)止血療效評(píng)定:治療組與對(duì)照組用藥后的止血天數(shù)療效比較中,治療組的總有效率為95.00%,其中速效6例,顯效11例,有效2例,無(wú)效1例;對(duì)照組的總有效率為65.0%,其中速效1例,顯效4例,有效8例,無(wú)效7例。兩組止血療效數(shù)值比較P0.05,具有統(tǒng)計(jì)學(xué)意義,且治療組療效優(yōu)于對(duì)照組療效。(3)治療前后中醫(yī)積分:治療組與對(duì)照組在中醫(yī)臨床癥狀治療中,治療組治療后與治療前相比較P0.01,治療組治療后與對(duì)照組治療后相比較P0.01,比較具有顯著性差異,說(shuō)明治療組療效優(yōu)于對(duì)照組。(4)血紅蛋白、APTT、PT:治療組于治療后血紅蛋白含量提升,APTT和PT時(shí)間縮短,比較治療前后的數(shù)值,經(jīng)t檢驗(yàn)P0.01,說(shuō)明糾正貧血、縮短出凝血時(shí)間上治療組優(yōu)于對(duì)照組。結(jié)論:血熱夾瘀型圍絕經(jīng)期崩漏患者通過(guò)清熱化瘀方取得優(yōu)良的止血療效,并對(duì)其伴隨的不適癥狀有所改善,同時(shí)對(duì)于糾正血紅蛋白以及縮短出凝血時(shí)間還有顯著的改善,收錄患者在治療期間以及治療后皆未有明顯不良反應(yīng)。采用中醫(yī)辯證施治治療本病有一定的優(yōu)勢(shì)所在,值得在臨床上更進(jìn)一步進(jìn)行推廣以及研究。
[Abstract]:Objective: to observe the hemostatic effect of Qingre Huayu recipe in treating peri-menopausal leakage of blood-heat and stasis type, and to explore its hemostatic mechanism. Methods: 40 cases of peri-menopausal leakage with blood heat and stasis were randomly divided into treatment group (20 cases) and control group (20 cases). The treatment group was treated with Qingre Huayu decoction and the control group was treated with Sanqi Xueshang Ning capsule for a course of 7 days. The clinical hemostatic effect of the treatment group and the control group was observed and analyzed, and the overall curative effect before and after treatment and the TCM syndromes integral were observed and analyzed. The change of APTT in PTT of hemoglobin. Results: (1) the overall curative effect evaluation: in the treatment group, 20 cases were cured (10 cases, 50 cases); 6 cases were markedly effective (30 cases); 3 cases were effective (15 cases); 1 case was ineffective (5 cases); the total effective rate was 952%; in the control group, 20 cases were cured, 3 cases (15%) were cured; 4 cases were remarkable effect, It was effective in 6 cases (30%), ineffective in 7 cases (35%), and total effective rate in 65 cases. The total curative effect of the treatment group and the control group was compared with that of the control group (P0.05), and the curative effect of the treatment group was better than that of the control group. (2) the evaluation of hemostatic effect: in the comparison of the days of hemostasis between the treatment group and the control group, The total effective rate was 95.00 in the treatment group, including 6 cases of quick effect, 11 cases of remarkable effect, 2 cases of effective and 1 case of ineffectiveness, while the total effective rate of control group was 65.0%, of which 1 case was quick, 4 cases were effective, 8 cases were effective and 7 cases were ineffective. The value of hemostatic effect in the two groups was significantly higher than that in the control group (P 0.05). (3) Chinese medicine integral before and after treatment: the treatment group and the control group were treated with traditional Chinese medicine (TCM) clinical symptoms. There was a significant difference between the treatment group and the control group after treatment (P 0.01), and the treatment group (P 0.01) after treatment compared with the control group (P 0.01), there was significant difference between the treatment group and the control group after treatment. It showed that the curative effect of the treatment group was better than that of the control group. (4) the hemoglobin content in the treatment group was increased after treatment and the time of APTT and PT was shortened. The values before and after treatment were compared, and the results of t test (P0.01) showed that the anemia was corrected. The treatment group was superior to the control group in shortening the clotting time. Conclusion: the patients with peri-menopausal collapse of blood heat and blood stasis can obtain excellent hemostatic effect by Qingre Huayu prescription, and improve the associated symptoms, at the same time, it can also improve the hemoglobin and shorten the time of blood clotting. There were no significant adverse reactions during and after treatment. There are some advantages in the treatment of this disease by dialectical treatment of traditional Chinese medicine, which is worth further popularizing and researching in clinic.
【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】：2016
【分類號(hào)】：R271.12

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