滋肾宁心方治疗肾阴亏虚、心肝火旺型月经过少的临床研究

发布时间：2018-01-01 15:29

  本文关键词：滋肾宁心方治疗肾阴亏虚、心肝火旺型月经过少的临床研究　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 滋肾宁心方 肾阴亏虚 心肝火旺 月经过少

【摘要】：目的：对滋肾宁心方治疗肾阴亏虚、心肝火旺型月经过少进行研究。通过观察患者月经量、中医症状、子宫内膜厚度、排卵直径及性激素等情况的改善,评价其治疗效果,探讨滋肾宁心汤改善月经量的可能作用机制,为临床应用提供依据,并通过与龟胶地黄汤的对比研究,探索宁心与阴长的关系,验证夏桂成教授“心(脑)-肾-子宫轴”学说。方法：选择2015年1月——2015年12月就诊于南京中医药大学附属医院江苏省中医院门诊60例月经过少患者,中医辨证属肾阴亏虚、心肝火旺型。将这些病例随机分为两组各30例,观察组采用自拟滋肾宁心方,对照组采用龟胶地黄汤。两组均于经后期第5天起服中药,第10天起隔日监测卵泡发育,待排卵后停服。观察各组治疗前一月与治疗后第一个月经周期的月经量、临床症状、排卵日子宫内膜厚度、卵泡发育情况及性激素素水平等改善情况,并比较组间疗效差异。结果：观察组总有效率93%,对照组总有效率80%,观察组优于对照组,差异具有统计学意义(P0.05)；两组均能明显改善月经量,但观察组优于对照组(P0.05)。两组组均能明显改善中医证候,但观察组优于对照组(P0.05)。两组均能显著增大卵泡直径,但观察组优于对照组(P0.05)；两组均能明显增厚排卵时子宫内膜厚度,但观察组优于对照组(P0.05)；两组均能明显升高E2水平,但观察组优于对照组(P0.05)；观察组可显著降低PRL水平,对照组无明显变化；观察组和对照组FSH、LH均无明显变化。结论：滋肾宁心方和龟胶地黄汤治疗肾阴亏虚、心肝火旺型月经过少患者,均可显著改善其月经量、中医证候,增大排卵期卵泡直径和排卵期子宫内膜厚度,升高早卵泡期E2水平,但滋肾宁心方明显优于龟胶地黄汤。滋肾宁心方可降低患者PRL水平,而龟胶地黄汤无此疗效。本研究一方面说明了经后期运用滋阴养血法在治疗肾阴亏虚、心肝火旺型月经过少中具有显著疗效；另一方面证明了宁心清肝在阴长中的作用,验证了夏老“心(脑)-肾-子宫轴”理论的正确性。
[Abstract]:Objective: to study the effect of Zishen Ningxin recipe on deficiency of kidney yin and excessive menstruation of heart, liver and fire. The improvement of menstrual volume, TCM symptoms, endometrial thickness, ovulation diameter and sex hormone were observed. To evaluate its therapeutic effect, to explore the possible mechanism of Zishen Ningxin decoction to improve menstrual volume, to provide the basis for clinical application, and to explore the relationship between Ningxin and Yin-long through comparative study with Guijiao Dihuang decoction. Verification of Professor Xia Guicheng's "Heart (brain)" Methods: from January 2015 to December 2015, 60 patients with menorrhagia were selected from the outpatient clinic of Jiangsu Provincial Hospital of traditional Chinese Medicine, affiliated Hospital of Nanjing University of traditional Chinese Medicine. TCM syndrome differentiation belongs to deficiency of kidney yin and flourishing of heart and liver fire. These cases were randomly divided into two groups (30 cases each) and the observation group was treated with Zishen Ningxin recipe. The control group was treated with Guijiao Dihuang decoction. The two groups were treated with traditional Chinese medicine on the 5th day after the end of the period and the follicular development was monitored every other day from the 10th day. The menstrual volume, clinical symptoms, endometrial thickness on the day of ovulation, follicle development and sex hormone level were observed before and after treatment. Results: the total effective rate of the observation group was 933.The total effective rate of the control group was 80%, and the observation group was superior to the control group (P 0.05). Both groups can obviously improve menstrual volume, but the observation group is better than the control group (P0.05). Both groups can obviously improve TCM syndrome. However, the observation group was superior to the control group (P 0.05). Both groups could significantly increase the follicle diameter, but the observation group was superior to the control group (P 0.05). The endometrial thickness of both groups was significantly thickened and ovulation, but the observation group was superior to the control group (P 0.05). The level of E2 was significantly increased in both groups, but the observation group was superior to the control group (P 0.05). The level of PRL was significantly decreased in the observation group, but not in the control group. Conclusion: Zishen Ningxin recipe and Guijiao Dihuang decoction can significantly improve the menstrual volume and TCM syndrome in the patients with deficiency of kidney yin and excessive menstruation of heart-liver-fire flourishing type. Increase follicle diameter and endometrial thickness in ovulation phase, increase E2 level in early follicular phase, but Zishen Ningxin prescription is better than Guijiao Dihuang decoction. Zishenning Xin decoction can reduce PRL level in patients. On the one hand, this study showed that the method of nourishing yin and nourishing blood was effective in the treatment of deficiency of kidney yin and excessive menstruation of heart, liver and fire. On the other hand, it proves the role of Ningxin Qinggan in Yin-long, and verifies the correctness of Xia Lao's theory of heart (brain, kidney and uterus axis).
【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】：2016
【分类号】：R271.111

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