【摘要】：目的 運用隔藥餅灸對腎虛血瘀型子宮肌瘤患者進行治療,并設(shè)口服桂枝茯苓膠囊對照組進行比較,通過觀察治療前后中醫(yī)證候總積分、肌瘤大小、各項臨床癥狀及體征積分、孕酮、雌二醇和血紅蛋白含量等指標(biāo)的變化,客觀評價隔藥餅灸治療腎虛血瘀型子宮肌瘤的臨床療效。方法按照納入標(biāo)準(zhǔn)選擇病例,采用隨機數(shù)字表法將60例子宮肌瘤患者隨機分為治療組和對照組,每組30例。治療組采用隔藥餅灸,對照組采用口服桂枝茯苓膠囊治療。根據(jù)腎虛血瘀證候評分表對中醫(yī)證候進行評分,治療3個療程后觀察療效,將所得數(shù)據(jù)進行統(tǒng)計學(xué)分析并做出療效評價。結(jié)果(1)治療后,治療組總有效率為80.00%;對照組總有效率為63.33%。兩組總療效相比,P0.05,差異有統(tǒng)計學(xué)意義,治療組的綜合療效優(yōu)于對照組。(2)治療后兩組患者中醫(yī)證候總積分較治療前均明顯下降,P0.05,差異有統(tǒng)計學(xué)意義。治療后兩組患者中醫(yī)證候總積分比較,P0.05,差異有統(tǒng)計學(xué)意義。統(tǒng)計結(jié)果表明:兩種治療方法均能降低子宮肌瘤患者中醫(yī)證候總積分,但治療組療效優(yōu)于對照組。(3)治療后兩組患者各項臨床癥狀及體征積分較治療前均明顯下降,P0.05,差異有統(tǒng)計學(xué)意義。治療后兩組患者各項臨床癥狀及體征積分比較,治療組在腰膝酸軟、耳鳴、脈象治療后評分顯著低于對照組,P0.05,差異有統(tǒng)計學(xué)意義。(4)治療后兩組患者子宮肌瘤體積較治療前均明顯下降,P0.05,差異有統(tǒng)計學(xué)意義。治療后治療組和對照組子宮肌瘤體積未見明顯差異,P0.05,差異無統(tǒng)計學(xué)意義。(5)治療后兩組患者孕酮、雌二醇含量較治療前均明顯下降,血紅蛋白含量較治療前明顯提升,P0.05,差異有統(tǒng)計學(xué)意義。治療后兩組患者血紅蛋白比較,P0.05,差異有統(tǒng)計學(xué)意義。治療后兩組孕酮、雌二醇含量比較,P0.05未見明顯差異。結(jié)論兩種治療方法均能改善子宮肌瘤患者的臨床癥狀及體征,但治療組綜合療效優(yōu)于對照組。治療組在改善患者中醫(yī)證候總積分、血紅蛋白、腰膝酸軟、耳鳴、脈象方面的療效均優(yōu)于對照組。兩組在改善子宮肌瘤大小、雌二醇、孕酮、經(jīng)量變化、經(jīng)期延長、經(jīng)色、經(jīng)質(zhì)、帶下量、小腹疼痛、小腹墜脹、乳房脹痛、舌質(zhì)方面未見明顯差異。治療前后患者肝腎功均處在正常范圍,說明隔藥餅灸治療子宮肌瘤是一種安全且有效的治療方法。
[Abstract]:Objective to treat uterine leiomyoma patients with kidney deficiency and blood stasis type by medicine-separated cake moxibustion, and set up the control group of Guizhi Fuling capsule for comparison, and observe the total integral of TCM syndromes, the size of myoma, the integration of clinical symptoms and signs before and after treatment. The changes of progesterone, estradiol and hemoglobin content were used to evaluate the clinical effect of herbal cake moxibustion in the treatment of uterine leiomyoma with kidney deficiency and blood stasis. Methods 60 cases of uterine leiomyoma were randomly divided into treatment group and control group with 30 cases in each group. The treatment group was treated with medicated cake moxibustion, the control group was treated with Guizhi Fuling capsule. According to the score table of kidney deficiency and blood stasis syndrome, TCM syndromes were scored, the curative effect was observed after three courses of treatment, the data was statistically analyzed and the curative effect was evaluated. Results (1) after treatment, the total effective rate was 80.00in the treatment group and 63.33 in the control group. Compared with the two groups, P0.05, the difference is statistically significant, the comprehensive efficacy of the treatment group is better than the control group. (2) after treatment, the total score of TCM syndromes in the two groups were significantly lower than before treatment, P0.05, the difference was statistically significant. After treatment, the total score of TCM syndromes of the two groups, P0.05, the difference was statistically significant. The statistical results show that both methods can reduce the total integral of TCM syndromes in patients with uterine leiomyoma. But the curative effect of the treatment group was better than that of the control group. (3) after treatment, the scores of clinical symptoms and signs of the two groups were significantly lower than those before treatment, P 0.05, the difference was statistically significant. After treatment, the scores of clinical symptoms and signs of the two groups were compared. Pulse score after treatment was significantly lower than that of control group (P0.05), the difference was statistically significant. (4) after treatment, the volume of uterine myoma decreased significantly in both groups, and the difference was statistically significant (P0.05). There was no significant difference in the volume of uterine leiomyoma between the treatment group and the control group (P 0.05). (5) after treatment, the contents of progesterone and estradiol in the two groups were significantly lower than those before treatment. The content of hemoglobin was significantly higher than that before treatment, P 0.05, the difference was statistically significant. There was significant difference in hemoglobin between the two groups after treatment (P 0.05). After treatment, there was no significant difference in progesterone and estradiol content between the two groups (P0.05). Conclusion both methods can improve the clinical symptoms and signs of patients with uterine leiomyoma, but the comprehensive curative effect of the treatment group is better than that of the control group. The curative effect of the treatment group was superior to that of the control group in improving the total score of TCM syndromes, hemoglobin, sore waist and knee, tinnitus and pulse. There was no significant difference between the two groups in improving the size of uterine leiomyoma, estradiol, progesterone, changes in quantity, prolongation of menstrual period, color, quality, subband, abdominal pain, abdominal distension, breast distention and tongue quality. The liver and kidney function of the patients were in normal range before and after treatment, indicating that moxibustion separated medicine cake is a safe and effective treatment method for uterine leiomyoma.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.9

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