补肾化痰法治疗多囊卵巢综合征的临床研究

发布时间：2018-01-06 19:34

本文关键词：补肾化痰法治疗多囊卵巢综合征的临床研究　出处：《广州中医药大学》2016年博士论文　论文类型：学位论文

【摘要】：目的：通过观察多囊卵巢综合征患者经六味地黄合苍附导痰汤和苍附导痰汤治疗后临床症状改善和半年内的妊娠情况,监测治疗前后基础体温(BBT)、体重指数(BMI)、多毛、痤疮、卵巢体积、性激素(FSH、LH、LH/FSH、E2、T)的变化,以探讨六味地黄合苍附导痰汤治疗多囊卵巢综合征的可能作用机制。方法：于台湾明华马光中医诊所就诊的多囊卵巢综合征患者中选择,收集诊断为肾虚痰阻证患者40例,随机分为2组。治疗组20例,予以六味地黄丸合苍附导痰汤加减口服；对照组20例,单纯予以苍附导痰汤加减口服。治疗6个月后,根据两组治疗前后中医证候评分、BBT、多毛、痤疮、BMI、性激素(FSH、LH、LH/FSH、E2、T)、B超检查卵巢体积及妊娠率情况来评估治疗效果。结果：1.治疗前治疗组(六味地黄合苍附导痰汤)、对照组苍附导痰汤两组间在年龄、病程、中医证候评分、BBT、多毛、痤疮、BMI、性激素(FSH、LH、LH/FSH、E2、T)、B超检查卵巢体积等方面无显著性差异,具有可比性(均P0.05)。2.治疗前后治疗组和对照组分别比较：两组治疗后中医证候评分、BBT、多毛、痤疮、BMI、性激素(FSH、LH、LH/FSH、E2、T)、B超检查卵巢体积及妊娠情况均得到改善(均P0.05)。3.治疗后治疗组和对照组组间比较：两组患者在改善中医证候评分、BBT、多毛、痤疮、BMI、性激素(FSH、LH, LH/FSH、E2、T)、B超检查卵巢体积及妊娠率情况方面有显著差异,治疗组优于对照组(均P0.05)。结论：本研究为六味地黄合苍附导痰汤治疗多囊卵巢综合征肾虚痰阻型的疗效和作用机理进行的临床研究。结果表明：六味地黄合苍附导痰汤治疗肾虚痰阻型多囊卵巢综合征的总有效率优于对照组苍附导痰汤,可明显改善患者的月经失调、头晕耳鸣、腰腿酸软、胸闷泛恶、神疲肢重等临床症状,降低体重指数,改善多毛F-G、痤疮评分,减小卵巢体积,改善基础体温,改善性激素水平,从而改善排卵及妊娠情况,从远期来讲,对于降低多囊卵巢综合征患者将来发展为子宫内膜癌、糖尿病、动脉粥样硬化症、缺血性心脏病等远期代谢并发症的危险性亦有重要意义,且无肝肾功能损害,治疗本病安全、有效,有广泛的应用前景。总之,六味地黄合苍附导痰汤治疗肾虚痰阻证多囊卵巢综合征无论从症状体征还是远期并发症都有显著疗效,从而为祖国医药治疗多囊卵巢综合征的作用机理提供更深层次的临床依据。
[Abstract]:Objective: to observe the improvement of clinical symptoms and pregnancy status of patients with polycystic ovary syndrome (PCOS) after treatment with Liuwei Dihuang Cangfu Dantan decoction and Cangfu Dantan decoction, and to monitor the basic body temperature (BBT) before and after treatment. Body mass index (BMI), hirsutism, acne, ovarian volume, sex hormone FSHLH, LH / FSHE2T). Objective: to explore the possible mechanism of Liuwei Dihuang and Cangfu Doutan decoction in the treatment of polycystic ovary syndrome (PCOS). Forty patients with deficiency of kidney and phlegm obstruction were randomly divided into two groups: the treatment group (n = 20) was treated with Liuwei Dihuang Pill and Cangfuguo phlegm decoction. In the control group, 20 cases were treated with Cangfu Dodao phlegm decoction. After 6 months of treatment, BBT, hirsutism, acne BMIand sex hormone FSH LH were assessed according to TCM syndromes before and after treatment in both groups. Results: 1. Before treatment, the treatment group (Liuwei Rehmannia and Cangguodan decoction) was evaluated by B-ultrasound examination of ovarian volume and pregnancy rate. In the control group, age, course of disease, TCM syndromes score (BBT), hirsutism, acne (BMIs), sex hormone FSHLHN (LH / FSHE2T) were observed between the two groups. B ultrasound examination of ovarian volume and other aspects of no significant difference, comparable (P0.05. 2. Treatment group and control group respectively before and after treatment: the two groups after treatment of traditional Chinese medicine syndromes score of BBT, hirsutism. Acne BMI. sex hormone FSHLH / FSHE2T). B ultrasound examination of ovarian volume and pregnancy were improved (P0.05. 3. Comparison between the treatment group and the control group: the two groups of patients in the improvement of traditional Chinese medicine syndrome score of BBT, hirsutism, acne. BMI, sex hormone FSHH, LH / FSHE2T, B ultrasound examination of ovarian volume and pregnancy rate were significantly different. The treatment group was superior to the control group (P0.05). Conclusion: this study is a clinical study on the therapeutic effect and mechanism of Liuwei Dihuang combined with Cangfu Dingtan decoction in the treatment of kidney deficiency and phlegm obstruction in polycystic ovary syndrome. The total effective rate of Liuwei Rehmannia combined with Cangfu Dingtan decoction in the treatment of kidney deficiency and phlegm obstruction type polycystic ovary syndrome was better than that of the control group. It can obviously improve the clinical symptoms, such as menstrual disorder, dizziness and tinnitus, weak waist and leg, severe chest tightness, tired limbs, etc., reduce body mass index, improve the score of hairy F-G, acne, and reduce the volume of ovary. Improve basic body temperature, improve sex hormone levels, thereby improving ovulation and pregnancy, in the long run, for the reduction of polycystic ovary syndrome patients with future development of endometrial cancer, diabetes, atherosclerosis. The risk of long-term metabolic complications such as ischemic heart disease is also of great significance, and no liver and kidney function damage, the treatment of this disease is safe, effective, has a wide range of application prospects. Liuwei Rehmannia combined with Cangfu Duan phlegm decoction in the treatment of kidney deficiency phlegm obstruction syndrome polycystic ovary syndrome in terms of symptoms and signs or long-term complications have a significant effect. It provides a deeper clinical basis for the therapeutic mechanism of polycystic ovary syndrome (PCOS) in traditional Chinese medicine.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R271.9

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