补肾健脾化痰方治疗痰湿型PCOS的临床观察

发布时间：2018-06-12 13:58

本文选题：多囊卵巢综合征 + 痰湿型　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的旨在运用补肾健脾化痰方与达英-35加来曲唑对比治疗痰湿型PCOS,观察其临床疗效及相关指标,归纳总结经验为以后治疗该病作参考。方法选取在湖北省中医院的妇科门诊就诊的痰湿型PCOS的患者,均在育龄期的妇女,经筛选排除后纳入66例,经过患者知情同意,选用随机数字表法进行分组,在治疗过程中出现4例脱落病例,最后补肾健脾化痰方中药治疗组(n=35例),西药对照组(n=27例)。用药疗程6个月经周期,分别在治疗第6个周期及停药3个月观察两组治疗前后及停药后的体重指数(BMI)、腰臀比(WHR)、基础体温(BBT)、月经周期、卵巢多囊样改变的情况及子宫内膜的厚度、多毛及痤疮、性激素水平、妊娠、中医症状疗效积分、总体疗效等情况。结果1.两组患者在年龄、病程及初潮年龄、体重指数(BMI)、腰臀比(WHR)、基础体温(BBT)、月经周期、卵巢体积及卵泡发育、子宫内膜厚度、性激素水平、主要症状及体征这些方面均差异无统计学意义(P0.05),具有可比性。2.两组均能有效降低BMI,但治疗后组间比较差异无统计学意义;在停药3个月后,两组均没有BMI值回升的情况。两组治疗WHR有轻度降低,有一定的疗效,但是与治疗前比较均差异无统计学意义,停药3个月后也无明显变化。3.治疗后两组基础体温均有双相率升高恢复的情况,分别与治疗前比较明显升高,差异均有统计学意义,但组间比较差异无统计学意义;停药3个月后治疗组的双相率优于对照组,差异有统计学意义。4.治疗3个周期后两组月经周期改善例数均有一定的增加,对照组的改善程度优于治疗组;治疗6个周期后,两组疗效差异不大;在停药3个月后,治疗组月经规律人数变化小,对照组月经规律人数明显减少。5.治疗后两组的卵巢体积及卵泡数均有减小,两组子宫内膜厚度均有增厚,但均组间差异不大。停药3个月后,两组的卵巢体积均有小幅度的回升,差异无统计学意义;治疗组卵泡数增多不明显,维持优于对照组,差异有统计学意义。6.治疗后治疗组多毛及痤疮程度评分均有下降,对照组的痤疮评分在治疗前后有差异,但多毛程度的评分差异不大。治疗组改善痤疮的程度优于对照组。7.中药治疗组降低激素水平(LH值、T值、LH/FSH比值)的效果能达到西药效果,且停药3个月后维持激素水平(LH值、T值)的效果优于西药对照组。8.两组均可以有效地改善中医症状,较治疗前症候积分值均有明显下降,差异均具有统计学意义(P0.05);治疗后治疗组的效果优于对照组,差异无显著性(P0.05)。停药3个月后,治疗组的中医症状积分未见明显变化,与其治疗后比较差异无显著性(P0.05);对照组的中医症状积分有所回升,与其治疗后比较差异有统计学意义(P0.05)。停药3个月后,治疗组维持中医症状积分的效果优于对照组,差异有统计学意义(P0.05)。9.在停药3个月后,两组的总体治疗效果均可,中药治疗组能够达到与西药对照组相当的疗效,且略优于西药对照组。治疗组的不良反应(胃肠道反应)发生率低。结论补肾健脾化痰方中药治疗组和西药对照组均可以改善痰湿型多囊卵巢综合征症状,建立规律的月经周期,还能改善性激素水平(降低T值、LH值、LH/FSH比值),降低BMI、WHR,改善子宫内膜厚度及卵巢多囊样改变。在综合疗效方面,中药补肾健脾化痰方和西药治疗本病疗效相差不大,但是中药治疗组停药3个月后在维持正常月经周期和性激素水平方面较稳定,中药治疗组在治疗痤疮及停药3个月后卵泡数及BBT双相率效果优于对照组。中药治疗组无明显的毒副作用出现,中药补肾健脾化痰之法既病防变,作为PCOS中药调理周期防治结合的方法易被患者接受使用。
[Abstract]:Objective to use the prescription of invigorating the kidney, invigorating the phlegm and phlegm with -35 calazole to treat the phlegm wet PCOS, observe its clinical curative effect and related indexes, sum up the experience for the future treatment of the disease. Methods the patients with phlegm wet type PCOS in the gynecologic outpatient department of Hubei Provincial Traditional Chinese Medical Hospital were selected and excluded after screening and exclusion. In 66 cases, after informed consent of the patients, the patients were divided into groups by random digital table. In the course of the treatment, there were 4 cases of exfoliated cases, and finally the treatment group (n=35 cases) and the western medicine control group (n=27). The treatment course was 6 menstrual cycles, the sixth cycles of treatment and the 3 months of stopping medicine were observed before and after the treatment and stopping medicine. The post body mass index (BMI), the waist to hip ratio (WHR), the basal body temperature (BBT), the menstrual cycle, the polycystic change of the ovary and the thickness of the endometrium, the hairy and acne, the sex hormone level, the pregnancy, the TCM symptom curative effect integral, the overall effect, etc. results 1. two groups were in age, course and age of menarche, body mass index (BMI), waist to hip ratio (WHR), base The basal body temperature (BBT), menstrual cycle, ovarian volume and follicle development, endometrial thickness, sex hormone level, major symptoms and signs were not statistically significant (P0.05). The comparability of.2. two groups could effectively reduce BMI, but there was no statistical difference between the groups after treatment. The two groups had no BMI value after 3 months of drug withdrawal. There was a slight decrease in the treatment of WHR in the two groups, but there was no significant difference between the two groups, but there was no significant difference between the two groups before the treatment. After 3 months of withdrawal, there was no significant change in the recovery of the basal body temperature in the two groups after the treatment of.3., and the difference was significantly higher than that before the treatment, and the difference was statistically significant, but the difference was poor between the groups. After 3 months of drug withdrawal, the biphasic ratio of the treatment group was better than that of the control group. The difference was statistically significant in the 3 cycles of.4. treatment. The improvement of the two groups had a certain increase, the improvement of the control group was better than the treatment group; the two groups had no significant difference after the treatment of 6 cycles. After 3 months of drug withdrawal, the menstrual law of the treatment group was in the treatment group. The number of people was small, the number of ovarian follicles in the two groups of the two groups decreased significantly after the treatment of the control group. The thickness of the endometrium in the two groups was thickened, but there was little difference between the groups. After 3 months of stopping the drug, the ovarian volume of the two groups had a small increase, the difference was not statistically significant, and the number of follicles in the treatment group increased not significantly. The difference was statistically significant, the difference was statistically significant, the scores of hair and acne in the treatment group decreased after.6. treatment. The acne scores in the control group were different before and after treatment, but the difference in the degree of hairy was not significant. The improvement of acne in the treatment group was better than that of the control group.7. in the treatment group (LH, T, LH/FSH ratio). The effect can reach the effect of Western medicine, and after 3 months of withdrawal, the effect of maintaining hormone level (LH value, T value) is better than that in the group.8. two of the western medicine control group, which can effectively improve the symptoms of traditional Chinese medicine. Compared with the score of the symptoms before treatment, the difference is statistically significant (P0.05). The effect of the treatment group after treatment is better than that of the control group, and the difference is not significant. Sex (P0.05). After 3 months of drug withdrawal, the TCM symptom score of the treatment group had not changed significantly, and there was no significant difference between the treatment group and the treatment group (P0.05). The score of TCM symptoms in the control group was higher than that of the treatment group (P0.05). After 3 months of stopping the medicine, the curative effect of the treatment group was better than the control group, and the difference was better than the control group. The difference was statistically significant (P0.05).9. after 3 months of drug withdrawal, the overall treatment effect of the two groups can be achieved, the Chinese medicine treatment group can reach the same effect as the western medicine control group, and slightly better than the western medicine control group. The adverse reaction (gastrointestinal reaction) in the treatment group is low. Conclusion the treatment group of tonifying kidney, spleen and phlegm prescription and Western medicine control group are all To improve the symptoms of phlegm wet polycystic ovary syndrome, establish regular menstrual cycle, improve the level of sex hormone (T value, LH value, LH/FSH ratio), reduce BMI, WHR, improve the thickness of endometrium and ovarian polycystic change. The treatment group was more stable after 3 months of stopping the normal menstrual cycle and the level of sex hormone. The effect of the number of follicles and the BBT birate after 3 months of treatment of acne and stopping drugs in the Chinese medicine treatment group was better than that of the control group. There was no obvious toxic and side effects in the Chinese medicine treatment group. The method of combining treatment is easy to be used by the patient.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.75

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