补肾促排卵汤联合针刺治疗肾虚血瘀型未破裂卵泡黄素化综合征的临床研究

发布时间：2017-12-31 17:27

本文关键词：补肾促排卵汤联合针刺治疗肾虚血瘀型未破裂卵泡黄素化综合征的临床研究　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:观察联合运用夏桂成教授的补肾促排卵汤加减及针刺治疗肾虚血瘀型未破裂卵泡黄素化综合征(Luteinized Unrupture Follicle Syndrome,LUFS)的临床疗效,通过对比三组患者治疗前后外周血激素促黄体生成素(Luteotropic Hormone,LH)、雌二醇(Estradiol,E2)、孕酮(Progesterone,P)水平的差异及基础体温的变化情况,探讨补肾促排卵汤加减联合针刺是否在肾虚血瘀型LUFS的治疗中具有优势,提高妊娠率,进一步指导临床应用。方法:选择符合本课题纳入标准的肾虚血瘀型未破裂黄素化综合征患者90例,随机将其分为三组,西药组(HCG组)、中西药组(补肾促排卵方+HCG组)、针药组(针刺+补肾促排卵方+HCG组),所有患者各治疗三个月经周期。观察各组患者BBT类型及HPS评分,HCG日各组患者的E2、LH值以及排卵一周后的P值,并从排卵率、妊娠率等方面进行比较。结果:①中医临床症候积分:中西药组及针药组的治疗后平均积分对比治疗前均有所降低(P0.05),西药组的中医临床症候治疗后未获得明显的改善(P0.05)。且从治疗后下降的差值比较,针药组显著优于中西药组(P0.05)。②HPS评分:中西药组及针药组的治疗后平均积分对比治疗前均有所上升(P0.05),西药组的HPS评分治疗后未获得明显的改善(P0.05)。且从治疗后上升的差值比较,针药组上升更多(P0.05)。③激素水平:中西药组及针药组的治疗后E2水平对比治疗前均有所提高(P0.05),且针药组明显优于中西药组(P0.05)。西药组的E2水平治疗后未获得明显的提高(P0.05)。三组患者的LH、P水平治疗后均有不同程度的改善(P0.05),且改善程度针药组中西药组西药组(P0.05)。④排卵率、妊娠率:针药组的排卵率为59.21%,中西药组为46.91%,西药组为36.05%,同样针药组的妊娠率为63.33%,中西药组为36.67%,西药组为13.33%,三组比较有显著差异性(P0.05)。结论:针刺联合药物及补肾促排卵汤联合HCG的治疗方式,相比于单纯使用HCG治疗能明显提高患者的排卵率,妊娠率,改善患者的临床症状,且针药联合的治疗效果优于补肾促排卵汤联合HCG。研究结果表明运用针刺联合夏桂成教授的补肾促排卵汤加上HCG治疗肾虚血瘀型LUFS的效果相比传统单一的药物疗法具有一定的临床优势。
[Abstract]:Objective: to observe the treatment of unruptured follicular luteinization syndrome of kidney deficiency and blood stasis type by combined use of Professor Xia Guicheng's tonifying kidney and promoting ovulation decoction and acupuncture. Luteinized Unrupture Follicle Syndrome. The clinical effects of LUFS were compared before and after treatment with luteotropin luteotropin (LH). The difference of estradiol Estradiolus E _ (2) and progesterone (P) and the change of basal body temperature. To explore whether the combination of tonifying kidney promoting ovulation decoction and acupuncture has advantages in the treatment of kidney deficiency and blood stasis type LUFS and improve the pregnancy rate. Methods: 90 patients with unruptured luteinization syndrome of kidney deficiency and blood stasis syndrome were selected and randomly divided into three groups: Western medicine group (HCG group). Chinese and western medicine group (tonifying kidney and promoting ovulation prescription HCG group), acupuncture group (acupuncture kidney promoting ovulation prescription HCG group), all patients were treated for three menstrual cycles. BBT type and HPS score were observed in each group. On the day of HCG, the value of E2T LH and the P value after one week of ovulation, and the rate of ovulation. Results: the clinical symptom score of traditional Chinese medicine: the average score of TCM group and acupuncture group were decreased before treatment (P 0.05). The clinical symptoms of traditional Chinese medicine in the western medicine group were not significantly improved after treatment, and the difference value decreased after treatment. The average score of acupuncture and medicine group was significantly better than that of traditional Chinese medicine group and western medicine group. The average score of acupuncture and medicine group was higher than that of traditional Chinese medicine group and acupuncture medicine group before treatment (P 0.05). The HPS score of the western medicine group was not significantly improved after treatment, and the difference between the two groups was higher than that of the control group (P 0.05). The level of estradiol in the acupuncture and medicine group increased more than that in the western medicine group and the acupuncture and medicine group. The level of E _ 2 in the Chinese medicine group and the acupuncture medicine group after treatment was increased before treatment (P 0.05). The level of E2 in the western medicine group was not significantly improved after treatment. The LH of the three groups was significantly higher than that of the western medicine group. The P level was improved in different degree after treatment, and the ovulation rate was 59.21% in the acupuncture and medicine group, the western medicine group and the western medicine group. The pregnancy rate was 59.21% in the acupuncture and medicine group. The pregnancy rate was 63.33 in the Chinese medicine group, 36.67 in the western medicine group and 13.33% in the western medicine group. Conclusion: acupuncture combined with drugs and kidney promoting ovulation decoction combined with HCG can significantly improve the ovulation rate compared with the treatment of HCG alone. Pregnancy rate, improve the clinical symptoms of patients. The therapeutic effect of acupuncture combined with medicine was better than that of tonifying kidney promoting ovulation decoction combined with HCG.Results showed that acupuncture combined with Professor Xia Guicheng's Bushen promoting ovulation decoction plus HCG in the treatment of LUFS with kidney deficiency and blood stasis was more effective than that of traditional Chinese medicine. Single drug therapy has certain clinical advantages.
【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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