消积活血调周法联合补佳乐治疗湿热瘀结型宫腔粘连的临床研究

发布时间：2018-03-09 00:35

本文选题：消积活血调周法　切入点：补佳乐　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对比分析治疗前后月经改善情况、中医证候积分、子宫内膜厚度及炎症细胞因子、纤维细胞生成因子的变化,来判定消积活血调周法联合补佳乐治疗湿热瘀结型宫腔粘连的临床疗效,并进一步阐述其疗效机制。方法:将符合研究标准的45例湿热瘀结型宫腔粘连患者随机分成治疗组、对照A组和对照B组各15例,均行宫腔镜下粘连分离术,术后治疗组以消积活血调调周法联合补佳乐治疗,对照A组予消积活血方联合补佳乐治疗,对照B组单用补佳乐治疗。以3个月经周期为一个疗程,观察一个疗程后三组患者月经及中医证候等临床症状的改善情况,子宫内膜厚度的变化及对炎症细胞因子、纤维细胞生成因子两项血清学指标的影响。结果:(1)治疗后三组的总有效率分别为93.33%、86.67%、60.00%,治疗组、对照A组均显著优于对照B组(P0.017),但治疗组和对照A组差异无统计学意义(P0.017)。(2)经治疗三组月经证候各项总有效率分别为:经期86.67%、80.00%、53.33%;经量 93.33%、93.33%、60.00%;色质 93.33%、86.67%、53.33%。治疗组在调节经期、改善经量、色质方面,均优于对照B组,差异具有统计学意义(P0.017)。治疗组对月经总体改善情况虽略优于对照A组,但无统计学意义(P0.017)。(3)经治疗后三组中医证候总有效率分别为93.33%、86.67%、60.00%,中医证候积分均较前降低,治疗组最优,对照A组次之,对照B组最差。差异具有统计学意义(P0.05)。(4)经治疗三组肿瘤坏死因子(TNF-α)水平均较前下降,组间比较治疗组、对照A组均显著优于对照B组(P0.05),但治疗组和对照A组差异无统计学意义(P0.05)。(5)治疗前后对比,三组转化生长因子(TGF-β)水平均较前下降,治疗组、对照A组在下调TGF-β方面虽无统计学差异(P0.05),但均优于对照B组(P0.05)。(6)经治疗三组子宫内膜厚度均较前增加,但差异无统计学意义(P0.05)。结论:消积活血调周法联合补佳乐能有效改善月经证候及临床症状、降低炎症反应、抑制纤维组织增生、帮助子宫内膜增生修复、调节全身内分泌等,是治疗湿热瘀结型宫腔粘连一种安全有效的方法。
[Abstract]:Objective: to compare and analyze the changes of menstrual improvement, TCM syndromes score, endometrial thickness, inflammatory cytokines and fibroblast factors before and after treatment. To determine the clinical effect of Xiaoji Huoxue Tiao Zhou method combined with Bujialao in treating intrauterine adhesions of dampness and heat stasis type, and to further explain its therapeutic mechanism. Methods: 45 cases of hygrothermal stasis type uterine adhesions were randomly divided into treatment group. 15 cases in control group A and 15 cases in control group B were treated with hysteroscopic adhesion separation. After operation, the treatment group was treated with Xiaoji Huoxue Tiao Zhou method combined with Bujialao, and control group A was treated with Xiaoji Huoxue prescription combined with Bujialao. Control group B was treated with Bujialao alone. Three menstrual cycles were used as a course of treatment. The improvement of clinical symptoms such as menstruation and TCM syndromes, the changes of endometrial thickness and inflammatory cytokines were observed in three groups after a course of treatment. Results the total effective rates of the three groups after the treatment were 93.33 and 86.670.The total effective rates of the three groups were 93.33 and 86.67, respectively. Control group A was significantly better than control group B (P 0.017), but there was no significant difference between treatment group and control group A (P 0.017).) the total effective rates of menstrual syndrome in treatment group were: menstrual period 86.67 + 80.005: 53.33; quantity 93.333360.00; color 93.333386.6753.33.The treatment group was able to adjust menstrual period, improve the menstrual volume, improve the menstrual volume, improve the menstrual symptoms, improve the menstrual syndromes, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual symptoms, improve the menstrual syndromes. In terms of color and quality, all of them were superior to the control group B, and the difference was statistically significant (P 0.017). The overall improvement of menstruation in the treatment group was slightly better than that in the control group A, But after treatment, the total effective rate of TCM syndromes in the three groups were 93.33 and 86.67 respectively. The scores of TCM syndromes were all lower than before, the treatment group was the best, the control group was the second. The level of TNF- 伪 in the treated group was lower than that in the previous group, and the levels of TNF- 伪 in the treatment group were significantly lower than those in the control group. The level of TGF- 尾 in group A was significantly higher than that in group B, but there was no significant difference between group A and group A before and after treatment. The level of TGF- 尾 in treatment group was lower than that in control group, and the level of TGF- 尾 in treatment group was significantly lower than that in control group, but there was no significant difference between group A and group A before and after treatment. Although there was no significant difference in down-regulation of TGF- 尾 in control group A, it was better than that of control group B in decreasing TGF- 尾. Conclusion: Xiaoji Huoxue Tiao Zhou method combined with Bujialao can effectively improve menstrual syndrome and clinical symptoms, reduce inflammatory reaction, inhibit fibrous hyperplasia, help endometrial hyperplasia repair, regulate the whole body endocrine, and so on. It is a safe and effective method for the treatment of dampness and heat stasis type intrauterine adhesion.
【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】：R711.74

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