【摘要】：隨著國民經(jīng)濟的不斷發(fā)展,我國正逐步進入老齡化社會,而作為老年男性的常見病——良性前列腺增生癥(benign prostatic hyperplasia BPH)是老年男性的一種常見疾病及多發(fā)疾病,給老年男性患者的生活質(zhì)量帶來嚴重影響。盡管醫(yī)藥發(fā)展迅速,但其治療方法與治療效果仍不盡人意。中醫(yī)藥對該病的治療不僅思路更寬廣,且強調(diào)個體差異,辯證論治,相比西醫(yī)在臨床上有更明顯優(yōu)勢。我的導師陳其華教授,從事中醫(yī)男科學多年,經(jīng)過反復臨床實踐與探索,總結(jié)出治療良性前列腺增生癥從腎論治,自擬“益腎通癃膠囊”治療BPH。臨床上獲得良好效果,值得進一步推廣與研究。目的:通過臨床觀察驗證和探討“益腎通癃膠囊”治療前列腺增生癥(腎虛血瘀型)的臨床療效及可能的作用機理;研究出一種有較好臨床療效的中成藥;以期為當?shù)刂嗅t(yī)藥治療BPH提供具有價值的方法和藥物。方法:臨床收集BPH患者84例,年齡50~70周歲,記錄IPSS評分,中醫(yī)證候評分,QOL評分,并B超檢查其前列腺大小、殘余尿量的測定,尿流率。1、對符合條件的病例按就診的順序排列,將患者分為三組,每組28例。2、實驗組服用“益腎通癃膠囊”6粒/次,每日2次,連續(xù)8周;西藥對照組服用“鹽酸坦索羅辛”0.2mg,每日1次,連續(xù)8周;中成藥對照組服用“癃閉舒膠囊”3粒/次,每日2次,連續(xù)8周。3、每個患者在觀察治療期間每2周復診一次,療程結(jié)束后一周內(nèi)復診調(diào)查患者:尿流率,IPSS評分,QOL評分,中醫(yī)證候評分,B超檢測前列腺大小及殘余尿量,并記錄所得數(shù)據(jù)。4、統(tǒng)計學處理:應用SPSS19.0軟件使用t檢驗,秩和檢驗等,比較三組治療效果,進行療效評定和結(jié)果分析。結(jié)果:實驗組治療有效率為89.28%,西藥對照組85.71%,中成藥對照組75%,三組有效率比較,實驗組與西藥對照組差異無統(tǒng)計學意義(P0.05),實驗組與中成藥對照組比較差異有統(tǒng)計學意義(P0.05)。結(jié)論:通過相關(guān)指標觀察,實驗組有效率明顯高于中成藥對照組;且實驗組在減輕患者的IPSS評分、中醫(yī)證候評分,QOL評分等方面均優(yōu)于西藥對照組和中成藥對照組,且有一定縮小前列腺體積作用。說明益腎通癃膠囊治療良性前列腺增生癥有較好療效。
[Abstract]:With the continuous development of national economy, China is gradually entering an aging society. As a common disease of elderly men, benign prostatic hyperplasia (benign prostatic hyperplasia BPH) is a common disease and multiple diseases of elderly men. It has a serious impact on the quality of life of elderly male patients. Despite the rapid development of medicine, its treatment methods and therapeutic effects are still not satisfactory. Traditional Chinese medicine not only has a broader train of thought, but also emphasizes individual differences and dialectical treatment, which has more obvious advantages than western medicine in clinical practice. My mentor Professor Chen Qihua, engaged in male science of traditional Chinese medicine for many years, after repeated clinical practice and exploration, summed up the treatment of benign prostatic hyperplasia from the kidney, self-made "Yishen Tonglong capsule" for the treatment of BPH. Good clinical results are obtained, which is worthy of further promotion and research. Objective: to verify and explore the clinical efficacy and possible mechanism of "Yishen Tonglong capsule" in the treatment of benign prostatic hyperplasia (kidney deficiency and blood stasis type), and to study a kind of proprietary Chinese medicine with good clinical effect. In order to provide valuable methods and drugs for the treatment of BPH with local traditional Chinese medicine. Methods: 84 patients with BPH, aged 50 to 70 years old, were enrolled in this study. IPSS score, TCM syndrome score and QOL score were recorded. The prostate size, residual urine volume and urine flow rate were measured by B-ultrasound. According to the order of treatment, the patients were divided into three groups, 28 cases in each group. 2. The experimental group was treated with "Yishen Tonglong capsule" 6 tablets twice a day for 8 weeks. The western medicine control group was treated with "Tansoloxin Hydrochloride" 0.2 mg once a day for 8 weeks. The Chinese patent medicine control group was treated with "Longshuanshu capsule" 3 tablets twice a day for 8 weeks. 3. Each patient was revisited every 2 weeks during the observation and treatment period, and the patients were investigated within one week after the end of the course of treatment: urine flow rate, IPSS score, QOL score, TCM syndrome score, B-ultrasound measured prostate size and residual urine volume, and recorded the data. 4, statistical processing: using SPSS19.0 software to use t test, rank sum test, etc., to compare the therapeutic effects of the three groups. The curative effect was evaluated and the results were analyzed. Results: the effective rate was 89.28% in the experimental group, 85.71% in the western medicine control group and 75% in the Chinese patent medicine control group. There was no significant difference between the experimental group and the western medicine control group (P 0.05). There was significant difference between the experimental group and the control group (P 0.05). Conclusion: through the observation of related indexes, the effective rate of the experimental group is significantly higher than that of the traditional Chinese patent medicine control group. The experimental group was superior to the western medicine control group and the proprietary Chinese medicine control group in reducing the IPSS score, TCM syndrome score and QOL score of the patients, and had the effect of reducing the prostate volume to a certain extent. It shows that Yishentong long capsule has a good curative effect on benign prostatic hyperplasia.
【學位授予單位】：湖南中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R277.5

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