输卵管炎性不孕症临床分型、用药规律分析及实验观察

发布时间：2018-01-03 23:36

本文关键词：输卵管炎性不孕症临床分型、用药规律分析及实验观察　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的观察临床输卵管炎性不孕患者的分型、用药规律及疗效;通过相关实验研究,分析膈下逐瘀汤加减方对气滞血瘀型输卵管炎性不孕大鼠模型的作用机理及效果。研究方法1、按照输卵管炎性不孕症诊断和排除标准,临床共纳入患者225例。统计分析患者的证型、用药规律及疗效。2、实验选择雌性大鼠作为研究对象,随机分四组:正常组、病证模型组、康妇炎组、膈下逐瘀汤组,采用复合刺激联合输卵管注菌的方法,制造符合中医证候特点的气滞血瘀型输卵管炎性不孕大鼠模型,分析用药后的相关指标变化。研究结果1、临床输卵管炎性不孕证型分别为:气滞血瘀型、湿热瘀阻型、肾虚血瘀型、寒凝瘀阻型和气虚血瘀型,各型比例分别为44.89%、29.33%、16.44%、5.78%、3.56%。2、方药使用上,共用药116味,药次3004次,涉及18个类型。3、经治疗后,气滞血瘀型、肾虚血瘀型、湿热瘀阻型、气虚血瘀型、寒凝瘀阻型患者的疗效总有效率依次为94.06%,91.89%,90.91%,87.50%,84.62%。4、在动物实验中,与病证模型组相比,中药组的症候积分有显著性差异(P0.01);中药组和康妇炎组的积分进行比较,差异有统计学意义(P0.05)。5、与模型组和康妇炎组比较,中药组血液黏度存在差异,且有统计学意义(P0.05)。6、与模型组比较,中药组的IFN-γ表达存在差异,且有统计学意义(P0.01);与康妇炎组比较,中药组的IFN-y存在差异,且有统计学意义(P0.05)。7、合笼后观察受孕情况,受孕率从高到低依次为:正常组、中药组、康妇炎组、病证模型组,分别为100%、50.0%、33.3%、16.7%。研究结论临床观察:1、在输卵管炎性不孕证型中,气滞血瘀型占44.89%,证明气滞血瘀型所占比例最多,膈下逐瘀汤加减方使用频率最高。2、方药使用上,活血化瘀类型药物频率最大、频次最多,为26.10%。3、通过对疗效有效率的统计,膈下逐瘀汤加减方有效率最高。实验研究:1.和模型组大鼠比较,膈下逐瘀汤加减方能改善气滞血瘀型输卵管炎性不孕大鼠的行为体征,有效降低血液黏度、IFN-γ的水平,提高受孕率。2.和康妇炎组比较,中药组的体征、血液黏度、IFN-γ表达存在差异,且有统计学意义,证明膈下逐瘀汤加减方对于气滞血瘀型输卵管炎性不孕的治疗效果优于康妇炎组。
[Abstract]:Objective to observe the classification, drug use and curative effect of salpingitis infertility. Through the relevant experimental studies, the article analyzed the mechanism and effect of Gexia Zhuyu decoction on the model of Qi-stagnation and blood-stasis type salpingitis infertility in rats. 1. According to the diagnosis and exclusion criteria of salpingitis infertility. A total of 225 patients were included in the clinical. Statistical analysis of the patients' syndrome types, drug use and efficacy. 2. Female rats were selected as the study object, randomly divided into four groups: normal group, disease syndrome model group, Kangfu group. Gexiazhuyu decoction group, using compound stimulation combined with fallopian tube injection of bacteria method, to create Qi-stagnation blood stasis type of salpingoinflammatory infertility rat model in accordance with the characteristics of TCM syndromes. Analysis of the changes of related indicators after medication. 1. Clinical tubal inflammatory infertility type are: Qi stagnation blood stasis type, damp-heat stasis type, kidney deficiency and blood stasis type, cold coagulation stasis type and Qi deficiency and blood stasis type. The proportions of each type were 44.89 and 29.33, respectively, and 16.445.785.785.56and 3.56. in the use of traditional Chinese medicine, 116 kinds of drugs were used, 3004 times. After treatment, the total effective rate of patients with Qi stagnation and blood stasis, kidney deficiency and blood stasis, dampness and heat stasis, qi deficiency and blood stasis, and cold coagulation stasis was 94.06 / 91.89%. In animal experiment, compared with the model group of disease and syndrome, the symptom integral of the traditional Chinese medicine group was significantly different from that of the model group (P 0.01). The scores of traditional Chinese medicine group and Kangfuyan group were compared, the difference was statistically significant (P 0.05). Compared with model group and Kangfuyan group, the blood viscosity of traditional Chinese medicine group was different. Compared with the model group, the expression of IFN- 纬 in the traditional Chinese medicine group was different, and the expression of IFN- 纬 in the traditional Chinese medicine group was significantly higher than that in the model group. Compared with Kangfuyan group, the IFN-y of TCM group was different, and there was statistical significance (P0.05. 7). The pregnant rate was observed from high to low in order of normal group and traditional Chinese medicine group. Kangfuyan group and disease syndrome model group were 100% 50.03 and 16.7g respectively. Conclusion Clinical observation 1 is in the type of salpingitis infertility. Qi stagnation and blood stasis type accounted for 44.89, which proved that Qi stagnation and blood stasis type accounted for the most proportion, Gexia Zhuyu decoction used frequency is the highest, the prescription used, the type of blood circulation and blood stasis type medicine frequency is the largest, the frequency is the most. Through the statistics of effective rate, the effective rate of Gexixuyu decoction was the highest. The experimental study was compared with that of the model group. Gexia Zhuyu decoction can improve the behavior and signs of inflammatory infertility rats with Qi-stagnation and blood-stasis type, effectively reduce the level of blood viscosity and IFN- 纬, and increase the pregnancy rate of .2.Compared with Kangfuyan group. The physical signs, blood viscosity and IFN- 纬 expression of TCM group were different, and there was statistical significance. It was proved that the treatment effect of Gexia Zhuyu decoction on oviduct inflammation infertility with qi stagnation and blood stasis type was better than that of Kangfuyan group.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

【参考文献】