【摘要】：目的:通過觀察補脾胃瀉陰火升陽湯治療圍絕經(jīng)期綜合征的臨床治療效果,探討脾胃論治在治療該病的特點和思路,從而為臨床上利用中醫(yī)健脾益氣法為主對治療圍絕經(jīng)期綜合征提供可靠的依據(jù)。方法:選取2015年3月1日-2015年7月30日晉城煤業(yè)集團中醫(yī)科門診約120例圍絕經(jīng)期綜合征患者,隨機分成治療組和對照組。其中,治療組(中藥組)60例,以補脾胃瀉陰火升陽湯為主作為治療手段;對照組(西藥組)60例,以西藥HRT作為治療手段。使用實驗室的檢驗設(shè)備分別檢測兩組患者用藥前以及用藥6個月后血中的卵泡刺激素(FSH)、黃體生成素(LH)和雌二醇(E2)的含量,然后用改良Kupperman評分法評價兩組患者用藥前及用藥后臨床癥狀的改善情況,數(shù)據(jù)經(jīng)過記錄后錄入Excel表格中,應(yīng)用SPSS17.0軟件包對數(shù)據(jù)進行統(tǒng)計分析,計數(shù)資料采用χ~2檢驗,計量資料用(?)±S表示,兩種獨立樣本均采用t檢驗。結(jié)果:中藥組和西藥組的患者在用藥前及用藥6個月后分別通過實驗室檢測血中卵泡刺激素(FSH)、黃體生成素(LH)及雌二醇(E2)三種激素的含量,然后進行比較,發(fā)現(xiàn)在兩組患者用藥前FSH、LH、E2的激素含量水平是相當(dāng)?shù)?兩者之間沒有明顯的差距,沒有統(tǒng)計學(xué)差異(P0.05);而在堅持用藥6個月以后則兩組患者的FSH、LH、E2的激素含量未出現(xiàn)差距,沒有統(tǒng)計學(xué)差異(P0.05);但兩組患者的FSH、LH、E2的激素含量在治療前后均出現(xiàn)明顯差異(P0.05);說明有統(tǒng)計學(xué)意義,這就說明中藥組和西藥組在改變激素水平的治療中均具有顯著療效,但不能說明哪一組的治療更顯著。中藥組及西藥組兩組患者在用藥前及用藥6個月后進行改良Kupperman評分,兩組患者在用藥前所有患者的評分均超過14分,兩組患者之間無顯著差異,在治療6個月之后出現(xiàn)差距,中藥組有32(53%)個病人的評分仍超過14分,而西藥組則有35(58%)個的病人評分超過14分,兩組間存在差異。在兩組癥狀評分比較中,兩組治療前比較P0.05,無差異,西藥組治療前后對比P0.05,無統(tǒng)計學(xué)差異,中藥組治療前后對比,P0.01,有明顯差異,中藥組治療后和西藥組治療后比較,P0.05,有差異。說明兩組患者在臨床癥狀的改善情況方面中藥組的治療較西藥組治療是具有明顯優(yōu)勢的。根據(jù)改良Kupperman療效評價標(biāo)準,臨床總療效結(jié)果顯示,中藥組總有效率為90%;西藥組總有效率為72%。在安全性檢測中,兩組患者用藥過程中均未訴特殊不適,血、尿、便常規(guī),肝、腎系列,心電圖檢查均未見明顯異常。說明兩組患者在臨床癥狀的改善情況方面中藥組的療效較西藥組療效是具有明顯優(yōu)勢的。結(jié)論:“補脾胃瀉陰火升陽湯”在治療圍絕經(jīng)期綜合征患者時,能夠明顯減輕和改善患者的一些癥狀,并且在原定的療程后痊愈率高于西藥組,精神癥狀改善效果也優(yōu)于西藥組,它可以提高了血中E2的水平,降低了血中FSH、LH的水平,還可以有效的調(diào)節(jié)免疫功能,而且沒有明顯的毒副作用及不良反應(yīng)。本研究應(yīng)用先進的檢測方法,選擇采用改良Kupperman評分法評價兩組患者用藥前及用藥6個月之后兩組圍絕經(jīng)期綜合征患者癥狀的改善情況,客觀說明了該藥的在治療本病中取得的療效,而且還進行了詳細的機理探討,為中醫(yī)健脾益氣法為主治療圍絕經(jīng)期綜合征患者提供了有力的依據(jù)。
[Abstract]:Objective: To observe the clinical effect of Bupiwei Xieyin Huo Shengyang Decoction in treating perimenopausal syndrome, and to explore the characteristics and thinking of the treatment of perimenopausal syndrome by spleen and stomach theory, so as to provide reliable basis for clinical treatment of perimenopausal syndrome mainly by the method of invigorating spleen and supplementing qi. About 120 cases of perimenopausal syndrome were randomly divided into treatment group and control group. 60 cases were treated with Bupiwei Xieyin Huo Shengyang Decoction and 60 cases were treated with western medicine HRT. Follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were measured before and 6 months after treatment. The clinical symptoms of the two groups were evaluated by improved Kupperman scoring method. The data were recorded in Excel table and the data were scored by SPSS17.0 software package. Results: The levels of FSH, LH and E2 in the blood of the patients in the Chinese medicine group and the western medicine group were measured in the laboratory before and after 6 months respectively, and then compared. The hormone levels of FSH, LH and E2 in the two groups were similar before treatment, and there was no significant difference between the two groups (P There were significant differences before and after treatment (P 0.05), indicating that there was statistical significance, which showed that the Chinese medicine group and the Western medicine group in the treatment of hormone levels have significant effect, but can not explain which group of treatment is more significant. There was no significant difference between the two groups. The score of 32 (53%) patients in the Chinese medicine group was still over 14, while that of 35 (58%) patients in the western medicine group was over 14. There was a difference between the two groups in the symptom score before treatment (P 0.05, no difference, Western medicine group before and after treatment compared with P 0.05, no statistical difference, Chinese medicine group before and after treatment, P 0.01, there is a significant difference, Chinese medicine group after treatment and Western medicine group after treatment, P 0.05, there is a difference. According to the improved Kupperman criteria, the total clinical efficacy showed that the total effective rate was 90% in the traditional Chinese medicine group and 72% in the western medicine group. Conclusion: Bupiwei Xieyin Huo Shengyang Decoction can obviously alleviate and improve some symptoms of perimenopausal syndrome patients, and the recovery rate after the original course of treatment is higher than that of Western medicine group, and the improvement effect of mental symptoms is better than that of Western medicine. In this study, the improved Kupperman scoring method was used to evaluate the perimenopausal period of the two groups before and 6 months after treatment. The improvement of symptoms of patients with syndrome objectively illustrates the curative effect of this medicine in the treatment of the disease, and also discusses the mechanism in detail, which provides a powerful basis for the treatment of perimenopausal syndrome mainly by the method of invigorating the spleen and replenishing qi.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R271.116

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