补肾调周法治疗高泌乳素血症的临床观察

发布时间：2018-04-30 12:55

本文选题：补肾调周法 + 高泌乳血症　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:观察运用补肾调周法治疗高泌乳素血症(Hyperprolactinemia,HPRL)的临床疗效,探讨其作用机理,为诊治HPRL提供值得推广的治疗方案和科学的理论依据。方法:选取符合纳入标准的肝郁肾虚型HPRL患者46例作为研究对象,给予补肾调周中药治疗3个月。观察治疗前后如月经周期延后、月经量少、溢乳、乳房胀痛、情绪抑郁或烦躁易怒、经行腹痛、胁肋胀满、腰膝酸软、咽干口燥、头晕耳鸣、五心烦热、夜尿频多、性欲减弱及舌苔脉象等中医症候的变化,基础血清性激素(血清泌乳素(PRL)、雌二醇(E2)、睾酮(T)、促黄体生成素(LH)、促卵泡刺激素(FSH))水平的变化以及基础体温(BBT)的变化。结果:①治疗效果:治愈5例,占10.87%;显效11例,占23.91%例;有效25例,占54.35%;无效5例,占10.87%;总有效率89.13%。②治疗后中医症候积分较治疗前降低,差异具有统计学意义(P0.01)。其中治疗后月经周期较治疗前显著规律(P0.01),月经量明显增多(P0.01),溢乳控制效果显著(P0.01),乳房胀痛、情绪抑郁或烦躁易怒、五心烦热、腰膝酸软、胁肋胀痛、头晕耳鸣、咽燥口干、舌苔脉象的改善显著(P0.01),经行腹痛、性欲减弱、夜尿频多明显改善(0.01P0.05)。③治疗后血清PRL低于治疗前,具有显著性差异(P0.01);治疗后血清E2高于治疗前,具有显著性差异(P0.01);LH、FSH、T治疗前后的变化并无统计学意义(P0.05)。④治疗前后基础体温的变化具有显著性差异(P0.01)。⑤5例治愈患者停药3月后复查PRL未见异常升高。⑥治疗期间仅4例发生轻度不良事件,安全性评价高。结论:补肾调周法能明显改善HPRL患者的临床症状,降低PRL,提高E2,改善BBT,复发率低,安全性高,具有重要的临床应用价值,值得推广。
[Abstract]:Objective: to observe the clinical effect of tonifying kidney and regulating week on hyperprolactinemiaHPRL (HyperprolactinemiaHPRL), to explore its mechanism, and to provide a scientific theoretical basis for the treatment of HPRL. Methods: 46 cases of HPRL with liver depression and kidney deficiency were selected as the study object and treated with tonifying kidney and regulating week Chinese medicine for 3 months. Observed before and after treatment, such as delayed menstrual cycle, less menstrual volume, galactorrhea, breast distension, depression or irritability, abdominal pain, full flank, sore waist and knee, dry pharynx, dizziness and tinnitus, five upset heat, frequent urination at night, Changes of sexual desire and tongue coating symptoms, changes of basic serum sex hormones (serum prolactin, estradiol, testosterone, luteinizing hormone, follicle-stimulating hormone FSHO) and basic body temperature (BBT). Results: 5 cases were cured (10.87%), 11 cases were markedly effective (23.91%), 25 cases were effective (54.35%), 5 cases were ineffective (10.87%), and the total effective rate 89.13.2 was lower than that before treatment (P 0.01). The menstrual cycle after treatment was more regular than that before treatment (P0.01A), the menstrual volume increased significantly (P0.01A), and the control effect of galactorrhea was significant (P0.01A), breast distended pain, emotional depression or irritability and irritability, five upset heat, sore waist and knee, flabby rib pain, dizziness tinnitus, dry pharynx and dry mouth, The improvement of pulse appearance of tongue coating was significant (P0.01A), abdominal pain and decreased libido. The frequency of nocturnal urination was significantly improved. The serum PRL after treatment was significantly lower than that before treatment (P 0.01), and the serum E 2 level was higher than that before treatment. There was no significant difference in basic body temperature before and after treatment with P0.01FSHT. There was a significant difference in basal body temperature before and after treatment. 55 cases of cured patients had no abnormal elevation of PRL after 3 months after drug withdrawal. Only 4 cases had mild adverse events. The safety evaluation is high. Conclusion: the method of tonifying the kidney and regulating the week can obviously improve the clinical symptoms, reduce the PRL, increase the E2 and improve the BBT. The recurrence rate is low and the safety is high. It has important clinical application value and is worth popularizing.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

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