右归丸联合雌—孕激素治疗肾阳虚型围绝经期功能失调性子宫出血的临床研究

发布时间：2018-08-03 10:30

【摘要】：目的：通过观察右归丸加减联合雌-孕激素序贯疗法治疗肾阳虚型围绝经期功能失调性子宫出血的临床效果,初步探讨中西医结合治疗围绝经期功血的有效性,为本病提供有效的临床治疗方法。方法：将68例经过筛选符合标准的患者随机分为治疗组与对照组。在月经第5天起或诊刮术后1周内,治疗组口服戊酸雌二醇,第11天加服地屈孕酮,自服药第1天起,同时口服右归丸随症加减治疗；对照组口服戊酸雌二醇,第11天加服地屈孕酮。21天为1个周期,3个周期为1疗程,连续观察1个疗程。观察两组患者近期止血疗效,治疗后月经主症、肾阳虚中医症候改善情况,贫血纠正及子宫内膜厚度改变情况,并随访半年复发情况。结果：治疗组与对照组相比,有较好的近期止血疗效,其差异有统计学意义(P0.05)。通过对两组患者月经改善情况,中医症状积分、中医症候疗效、血红蛋白测定、子宫内膜厚度测量结果比较,其差异均有显著性(P0.05)。治疗组的临床总疗效明显优于对照组,其差异有统计学意义(P0.05)。治疗组中治疗效果与病程长短有关,病程短治疗效果好,其差异有统计学意义(P0.05)。其疗效与疾病轻重程度无关,其差异不明显,无统计学意义。两组比较复发率有显著差异,其差异有统计学意义(P0.05),治疗组半年内复发率明显低于对照组。结论：右归丸联合雌-孕激素序贯疗法治疗肾阳虚型围绝经期功血患者,有较好的止血效果并可改善贫血状态,在调整月经周期、改善肾阳虚中医症候方面具有显著疗效,同时不增加子宫内膜病变的风险,其临床总有效率良好,临床复发率较低,值得临床进一步推广。
[Abstract]:Objective: to observe the clinical effect of the treatment of dysfunctional uterine bleeding in the peri-menopausal period of Kidney-Yang deficiency type by adding and subtracting Yougui Pill combined with estrogen and progesterone, and to explore the efficacy of integrated traditional Chinese and Western medicine in the treatment of peri-menopausal dysfunctional uterine bleeding. To provide effective clinical treatment for this disease. Methods: 68 patients were randomly divided into treatment group and control group. On the 5th day of menstruation or within 1 week after curettage, the treatment group was treated with estradiol valerate, plus diproprogesterone on the 11th day, and the control group was treated with estradiol valerate as well as with the symptoms from the first day of taking the medicine, and the control group was treated with estradiol valerate, and the control group was treated with estradiol valerate. On the 11th day, 1 cycle and 3 cycles were added with Diproprogesterone for 21 days, and one course of treatment was observed continuously. To observe the recent hemostatic effect of the two groups, the main menstrual symptoms after treatment, the improvement of traditional Chinese medicine syndrome of kidney-yang deficiency, anemia correction and endometrial thickness change, and follow up for half a year recurrence. Results: compared with the control group, the treatment group had better recent hemostatic effect, the difference was statistically significant (P0.05). Through the two groups of patients menstrual improvement, TCM symptom score, TCM symptom efficacy, hemoglobin measurement, endometrial thickness measurement results, there were significant differences (P0.05). The total clinical efficacy of the treatment group was significantly better than that of the control group, the difference was statistically significant (P0.05). In the treatment group, the therapeutic effect was related to the duration of the disease, the short course of treatment was good, the difference was statistically significant (P0.05). Its curative effect is not related to the severity of the disease, its difference is not obvious, there is no statistical significance. There was a significant difference in the recurrence rate between the two groups (P0.05). The recurrence rate in the treatment group was significantly lower than that in the control group within half a year. Conclusion: Yougui Pill combined with estrogen and progesterone Sequential Therapy has a good hemostatic effect and can improve anemia status in patients with kidney yang deficiency in perimenopausal period. It has remarkable curative effect in regulating menstrual cycle and improving TCM syndrome of kidney-yang deficiency. At the same time, the risk of endometrial lesions is not increased, the total clinical effective rate is good, the clinical recurrence rate is low, it is worthy of further clinical promotion.
【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】：2014
【分类号】：R711.52

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