【摘要】：目的:觀察補(bǔ)腎活血湯(《傷科大成》)用于腎虛血瘀型子宮腺肌病月經(jīng)過多的治療前后各項(xiàng)觀察指標(biāo)的變化,客觀評價補(bǔ)腎活血湯治療腎虛血瘀型子宮腺肌病引起的月經(jīng)過多的臨床療效,總結(jié)其療效特點(diǎn),并初步探索其可能的療效機(jī)制,為今后臨床運(yùn)用本方治療該病提供參考。方法:將收集符合要求的患者60例隨機(jī)分為兩組,每組30例,一組為補(bǔ)腎活血湯治療組,予補(bǔ)腎活血湯加減方藥每劑水煎300mL,早飯前晚飯后分別服用150mL,月經(jīng)來潮第一日開始服用經(jīng)期方藥,連服七天后改服非經(jīng)期方藥,以此方式連續(xù)規(guī)范服用3個月經(jīng)周期后停藥。另一組為米非司酮對照組,口服米非司酮12.5mg(華潤紫竹藥業(yè))日1次睡前口服,月經(jīng)來潮第一日開始服藥,此方法連續(xù)規(guī)范治療3個月經(jīng)周期停藥。并囑所有患者治療期間避孕,經(jīng)期使用統(tǒng)一規(guī)格衛(wèi)生巾。記錄患者各療前、療后觀察指標(biāo)。利用Microsoft Excel 2016中的資料數(shù)據(jù)表,統(tǒng)計治療組、對照組各觀察指標(biāo)療后與療前的差異,并比較治療組和對照組之間的療效差異。應(yīng)用spss17.0統(tǒng)計軟件進(jìn)行統(tǒng)計分析。結(jié)果:1.補(bǔ)腎活血湯治療組和米非司酮對照組療后患者月經(jīng)量、血清糖類抗原CA125、痛經(jīng)積分、婦科檢查積分、子宮體積較療前均具有顯著差異性(P0.05),兩組療后組間比較無顯著差異(*P0.05)。2.補(bǔ)腎活血湯治療組和米非司酮對照組療后患者中醫(yī)證候積分、血紅蛋白計數(shù)較療前均具有極顯著差異性(P0.01),兩組療后組間比較有極顯著差異(*P0.01)。3.補(bǔ)腎活血湯治療組綜合療效和中醫(yī)證候療效有效率愈顯率明顯高于米非司酮對照組(P0.05),二者在月經(jīng)過多治療方面有效率愈顯率無顯著差異(P0.05)。結(jié)論:1.補(bǔ)腎活血湯治療腎虛血瘀型子宮腺肌病月經(jīng)過多療效顯著,綜合療效有效率達(dá)85.71%,可明顯減少子宮腺肌病患者的月經(jīng)量、改善痛經(jīng)癥狀,能降低患者血清糖類抗原CA125水平、減小子宮體積、改善患者盆腔局部體征,并且在糾正子宮腺肌病患者的貧血狀態(tài)、改善患者中醫(yī)證候兩方面具有獨(dú)特優(yōu)勢。2.通過隨訪發(fā)現(xiàn),補(bǔ)腎活血湯治療腎虛血瘀型子宮腺肌病月經(jīng)過多的遠(yuǎn)期療效穩(wěn)定,復(fù)發(fā)率低。3.補(bǔ)腎活血湯可能是通過改善血液循環(huán)、增強(qiáng)機(jī)體免疫力、抗炎、止痛等機(jī)制,從而起到治療作用的。
[Abstract]:Objective: to observe the changes of observation indexes before and after the treatment of kidney deficiency and blood stasis type uterine adenomyosis with Bushen Huoxue decoction. Objective to evaluate the clinical efficacy of Bushen Huoxue decoction in treating menorrhagia caused by kidney deficiency and blood stasis type uterine adenomyosis, summarize its curative effect characteristics, and explore its possible therapeutic mechanism, so as to provide reference for the treatment of this disease in the future. Methods: a total of 60 patients were randomly divided into two groups, 30 cases in each group. One group was treated with Bushen Huoxue decoction, 300 mL per dose of Bushen Huoxue decoction, and 150 mL before and after breakfast, respectively. Menstrual cycle began to take the first day of menstrual prescription, seven days after taking non-menstrual prescription, this way to continue to regulate the use of three menstrual cycles after withdrawal. The other group was mifepristone control group, which took mifepristone 12.5mg once a day before bedtime, and began to take medicine on the first day of menstruation. All patients were told to use contraceptive during treatment and use uniform sanitary napkins during menstrual period. The observation indexes before and after treatment were recorded. The data tables of Microsoft Excel 2016 were used to analyze the differences between the observation indexes of the treatment group and the control group after treatment and before treatment, and the difference of curative effect between the treatment group and the control group was compared. Spss17.0 statistical software was used for statistical analysis. Results: 1. There were significant differences in menstrual volume, CA125, score, gynecological score and uterine volume between the treatment group and Mifepristone control group (P0.05). There was no significant difference between the two groups after treatment (* P0.05). 2. Bushen Huoxue decoction treatment group and mifepristone control group after the treatment of TCM syndrome score, hemoglobin count than before treatment have extremely significant difference (P0.01), the two groups after treatment group has a very significant difference (* P0.01). 3. The effective rate of Bushen Huoxue decoction treatment group was significantly higher than that of Mifepristone control group (P0.05). There was no significant difference in the effective rate of menorrhagia between the two groups (P0.05). Conclusion: 1. The effect of Bushen Huoxue decoction on menorrhagia of kidney deficiency and blood stasis type uterine adenomyosis is remarkable. The comprehensive effective rate is 85.71. It can obviously reduce the menstrual volume of patients with adenomyosis and improve dysmenorrhea symptoms. It can reduce the level of serum carbohydrate antigen CA125, reduce the volume of uterus, improve the pelvic local signs of patients, and has unique advantages in correcting anemia status of patients with adenomyosis and improving TCM syndromes of patients. 2. It was found that Bushen Huoxue decoction had a stable long term curative effect and a low recurrence rate in the treatment of excessive menstruation of kidney deficiency and blood stasis type of uterine adenomyosis. Bushen Huoxue decoction may play a therapeutic role by improving blood circulation, enhancing immunity, anti-inflammation, analgesia and other mechanisms.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R271.111

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