基于气精互化理论气精双补方治疗黄体功能不健型功血的临床研究

发布时间：2018-01-08 08:35

本文关键词：基于气精互化理论气精双补方治疗黄体功能不健型功血的临床研究　出处：《北京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的：本研究采用自身前后对照的研究方法,以46例黄体功能不健型功血患者作为研究对象,给予气精双补方治疗。观察治疗前后黄体功能不健型功血患者的临床症状改善情况,以及其对卵泡发育、基础体温、性激素等指标的影响,并探讨其可能的作用机理,丰富临床治疗方法,为黄体功能不健型功血的临床治疗提供参考,同时对导师学术思想及用药特点进行总结。研究方法：收集2014年12月至2015年12月北京中医药大学第三附属医院妇科门诊符合纳入标准的黄体功能不健型功血患者46例,年龄在18-40岁,同意参加本试验,并签署知情同意书者,填写研究观察表。采用自身前后对照的研究方法,以气精双补为法,给予导师经验方口服,具体处方为：党参15g、龟胶12g、黄芪40 g、当归10 g、白术15 g、熟地12 g、枸杞子30g、山萸肉12g、鹿角胶l0g、甘草12g。服药方法：取上药浓煎200m1,每日1剂,分2次,早晚温服,于月经第5天开始服药,连服2周,用药3个月经周期后评价疗效。疗程结束后,对比治疗前后患者中医症状积分、基础体温、血清内分泌激素水平、卵泡发育等指标的变化。建立Excel数据库,采用SPSS20.0统计软件进行数据处理,计量资料采用均数±标准差(X±S)表示,计数资料用构成比(%)表示。计量资料组间比较采用t检验(方差不齐采用秩和检验),计数资料采用X2检验,等级资料用秩和检验。P0.05时差异有统计学意义。研究结果：1.应用气精双补方治疗46例黄体功能不健型功血患者,在卵泡期给药,通过自身前后对照,结果显示痊愈8例(17.39%),显效20(43.49%),有效15例(32.6%),无效3例(6.52%),总有效率达93.48%。2.治疗前后中医症状积分比较,月经周期短、经期延长、腰膝酸软、四肢倦怠、畏寒肢冷等症状显著改善。3.治疗前后血清孕酮值的比较,治疗后黄体中期血清孕酮值较前提高,差异有统计学意义(P0.01)。4.治疗前后排卵前卵泡最大直径比较,卵泡直径较前明显增大,差异有统计学意义(P0.01)。5.治疗后基础体温HPS评分提高,高温相维持天数延长、高低温差较前改善,差异有统计学意义(P0.01)。研究结论：1.气精双补方治疗黄体功能不健型功血的临床疗效确切,能够改善患者的临床症状,促进卵泡发育,改善基础体温及提高黄体期血清孕激素水平。2.气精双补方间接证明气虚精亏是黄体功能不健型功血的病因病机之一,验证了“精”、“气”在卵泡、黄体发育中的作用及在卵泡期用药的合理性。3.气精双补方可能通过影响卵泡发育,促进颗粒细胞的不断增殖,从而促使黄体功能恢复正常。
[Abstract]:Objective: This study adopted the method of self-control, 46 patients with luteal phase type dub patients as the research object, give gas double fill treatment. Observed before and after treatment of hypoluteoidism clinical symptom type dub patients to improve the situation, and its effect on follicular development, basal body temperature, sex hormone influence etc. the index, and to explore its possible mechanism, rich clinical treatment methods, provide the reference for the clinical treatment of luteal phase type dub. The academic thought and treatment characteristics of mentors were summarized. Methods: collected from December 2014 to December 2015 in Beijing University of Chinese Medicine affiliated hospital gynecology clinic third met the inclusion criteria of 46 cases of hypoluteoidism type dub patients, at the age of 18-40, agreed to participate in the test, and signed the informed consent form, fill in the questionnaire by the self controlled study. The method to make up for double gas refining method, give the tutor experience of oral, specific prescription: dangshen 15g, 12g 40 g Huangqi, tortoise, angelica 10 g, 15 g 12 g Atractylodes, rehmannia, medlar 30g, Cornus 12g, antler glue L0g, licorice 12g. medication method: drug concentration fried 200m1, 1 daily, 2 times, sooner or later. On the fifth day of menstruation, taking the medicine, even for 2 weeks, evaluate the therapeutic effect of 3 menstrual cycles. After the end of treatment, compared before and after treatment in patients with symptoms of TCM, basal body temperature, hormone levels in serum, the change of follicular development. The establishment of index the Excel database, using SPSS20.0 statistical software for data processing, measurement data using the mean and standard deviation (X + S) said the count data with constituent ratio (%). Measurement data were compared by using t test (missingvariance Wilcoxon test was used), count data using X2 test, rank data using rank test.P0.05 The difference was statistically significant. Results: 1. application of gas fine tonifying Decoction "in Treating 46 cases of luteal phase type dub patients, administered during the follicular phase, through self control, results showed that 8 cases were cured (17.39%), 20 (43.49%), effective in 15 cases (32.6%), 3 cases were invalid (6.52%), the total effective rate of TCM symptom score before and after treatment of 93.48%.2., short menstrual cycle, menstruation, Yaoxisuanruan, lassitude, aversion to cold symptoms significantly improved serum progesterone value before and after.3. treatment, after the treatment of mid luteal serum progesterone value better than before, the difference was statistically significant (P0.01) before and after.4. treatment the largest preovulatory follicle diameter, follicle diameter significantly increased, the difference was statistically significant (P0.01) after.5. treatment, HPS score increase of basal body temperature, high temperature phase to maintain longer days, high and low temperature difference was better than before, the difference was statistically significant (P0.01). Conclusion: 1. kinds of essence tonifying Decoction in the treatment of luteal phase clinical effect of dysfunctional uterine bleeding is effective, can improve symptoms, promote follicular development, improve the basal body temperature and Tonifying Qi double indirect evidence that sperm loss is one of the pathogenesis of luteal phase serum progesterone level.2. type dub luteal phase to improve the precision of gas verify, "fine", "Qi" in the role of follicle, corpus luteum development and in the follicular phase of the rationality of drug use.3. gas double fill prescription may affect follicular development, promote the proliferation of granulosa cells, thus contributing to the luteal function returned to normal.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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