温肾化瘀法治疗肾虚血瘀型子宫内膜异位性疾病的临床观察

发布时间：2018-01-16 23:05

本文关键词：温肾化瘀法治疗肾虚血瘀型子宫内膜异位性疾病的临床观察　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察以温肾化瘀为治法的导师临床经验方治疗肾虚血瘀型子宫内膜异位性疾病的临床疗效性及安全性,并初步探讨其作用机制,以期进一步为子宫内膜异位性疾病的治疗提供可行的思路、有效的方法及可靠的临床证据。方法:选取32例以痛经为主诉的肾虚血瘀型子宫内膜异位症和(或)子宫腺肌病患者作为临床研究对象,予导师经验方治疗3个月经周期。观察治疗前、治疗结束时患者的中医证候评分、痛经程度评分、VAS评分、血清CA125水平、B超等疗效性指标的变化,并通过监测患者安全性指标检测该治疗方法的安全性。治疗结束3个月后对临床治愈的受试者进行中医证候、疼痛程度的随访。结果:在治疗过程中有2例患者脱落,最终完成本课题研究的合格受试者共30例。30例肾虚血瘀型子宫内膜异位性疾病受试者经过3个月经周期的治疗后,痊愈5例,显效14例,有效8例,无效3例,总显愈率为63.34%,有效率90%,中医证候积分、痛经程度评分、VAS评分及血清CA125水平均较治疗前明显降低,对缩小异位囊肿方面有一定作用;统计分析发现痛经程度与疗效具有相关性,痛经程度越轻,疗效越显著,但年龄与疗效无明显相关性。检测了本次研究的30例患者的相关安全性指标,在整个治疗过程中受试者均未出现临床不良反应,各项安全性指标均在正常范围内,研究结果证实该治疗方法疗效确切并且安全无副作用。治疗结束后3个月对临床治愈的5名受试者进行了随访,均未发现有疼痛症状及相关伴随症状的复发,该研究结果表明本治疗方法疗效较稳定。结论:温肾化瘀法指导下的导师临床经验方能明显缓解子宫内膜异位性疾病患者的痛经症状,同时对改善患者肛门坠痛、非经期下腹部不适、形寒肢冷等伴随症状疗效确切,能有效降低血清CA125水平,且能在一定程度上缩减异位囊肿,无明显不良反应,疗效稳定,值得进一步研究及临床推广运用。
[Abstract]:Objective: to observe the clinical efficacy and safety of tutor's clinical experience prescription in treating endometriosis of kidney deficiency and blood stasis type with warming kidney and removing blood stasis, and to explore its mechanism. In order to further provide feasible ideas for the treatment of endometriosis. Methods: 32 cases of endometriosis and / or adenomyosis with dysmenorrhea as main complaint were selected. The Chinese medicine syndrome score, dysmenorrhea degree score and serum CA125 level were observed before and after treatment. B ultrasound and other therapeutic indicators, and by monitoring the safety indicators of patients to detect the safety of the treatment method. 3 months after the end of the treatment of clinical cured subjects for TCM syndromes. Results: during the course of treatment, 2 patients dropped off. A total of 30 cases of endometriosis with kidney deficiency and blood stasis were successfully completed. After 3 menstrual cycles, 5 cases were cured, 14 cases were effective, and 8 cases were effective. The total effective rate was 63.34 and the effective rate was 90. The scores of TCM syndromes, dysmenorrhea and serum CA125 were significantly lower than those before treatment. It plays a certain role in reducing ectopic cysts. Statistical analysis showed that the degree of dysmenorrhea was correlated with the curative effect. The milder the degree of dysmenorrhea, the more significant the curative effect, but the age had no significant correlation with the curative effect. In the whole course of treatment, the subjects did not appear clinical adverse reactions, the safety indicators were in the normal range. The results of the study confirmed that the treatment was effective and safe without side effects. 5 subjects who were clinically cured were followed up 3 months after the treatment. No recurrence of pain and associated symptoms was found. The results of this study show that the therapeutic effect of this method is more stable. Conclusion: the clinical experience of mentor guided by warming kidney and removing blood stasis can obviously relieve dysmenorrhea symptoms of patients with endometriosis. At the same time to improve the patients with anal pain, non-menstrual lower abdominal discomfort, cold cold, and other associated symptoms, can effectively reduce the level of serum CA125, and can reduce ectopic cysts to a certain extent. No obvious adverse reaction, stable curative effect, worthy of further study and clinical application.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

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