自拟滋肾清心汤治疗心肾失交型卵巢早衰的临床疗效观察

发布时间：2018-01-15 03:28

本文关键词：自拟滋肾清心汤治疗心肾失交型卵巢早衰的临床疗效观察　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:分析归纳卵巢早衰的中西医临床研究进展,观察自拟滋肾清心汤治疗心肾失交型卵巢早衰的临床疗效,结合课题结论指出中医药治疗本病的优势和趋势,为延缓卵巢早衰和恢复卵巢功能提供更多可能,同时促进自拟滋肾清心汤的临床推广和应用,达到提高卵巢早衰女性生活质量的目的。方法:本课题运用随机分组和设立对照的试验方法,将60例达到标准的卵巢早衰患者,1:1比例随机的分为治疗组和对照组。对照组予坤泰胶囊,治疗组予自拟滋肾清心汤。观察3个月后,详细记录两组临床症状及相关实验室指标变化,如:围绝经期不适表现、中医症候积分、血清FSH、LH、E2水平、妊娠率等。运用统计学方法分析两组治疗前后组间和组内的症状及指标变化,得出相应结论,进而评定药物的临床疗效。结果:(1)综合疗效:治疗后,治疗组中痊愈、显效、有效、无效病例数分别为1、8、18、3,总有效率为90.0%;对照组中分别为0、2、21、7,总有效率为76.7%。两组患者综合疗效经秩和检验分析,差异有统计学意义(P0.05),且治疗组优于对照组。(2)中医症候积分:治疗后,两组患者积分均有所降低,经t检验分析二者之间有显著差异(P0.05);两组治疗前后积分差值对比亦有统计学意义(P0.05),且治疗组积分改善大于对照组。(3)血清FSH、LH、E2水平:疗程结束后,两组患者性激素水平经统计学分析均有统计学意义(P0.05);两组治疗前后FSH、E2的差值对比有统计学意义,治疗组FSH、E2波动幅度大于对照组(P0.05);两组LH前后差值对比无统计学意义(P0.05)。(4)妊娠改善情况:治疗后,60例患者中,仅治疗组有1例早孕,因数据较少,无法进行统计学分析。结论:滋肾清心药物能有效改善患者的临床不适症状;可作用于下丘脑-垂体-卵巢生殖轴,不同程度的调节血中FSH、LH、E2的水平、改善和激活卵巢功能;自拟滋肾清心汤是治疗心肾失交型卵巢早衰的有效方剂;自拟滋肾清心汤疗效优于坤泰胶囊,说明中药煎剂效果最佳,其机理有待研究。
[Abstract]:Objective: to analyze and summarize the clinical research progress of traditional Chinese and western medicine on premature ovarian failure, to observe the clinical effect of Zishen Qingxin decoction in treating premature ovarian failure with heart and kidney loss, and to point out the advantages and trends of traditional Chinese medicine in the treatment of this disease. In order to delay premature ovarian failure and restore ovarian function to provide more possibilities, at the same time to promote the self-made kidney Qingxin decoction clinical promotion and application. Objective to improve the quality of life of women with premature ovarian failure. Methods: 60 cases of premature ovarian failure were divided into two groups randomly and controlled. The ratio of 1: 1 was randomly divided into the treatment group and the control group. The control group was given Kun Tai capsule and the treatment group was given the self-made Zishen Qingxin decoction. After 3 months observation, the clinical symptoms and the changes of the related laboratory indexes in the two groups were recorded in detail. Such as: peri-menopausal discomfort, TCM symptom score, serum FSHLHN E2 level, pregnancy rate and so on. Statistical analysis of the two groups before and after treatment and the changes of symptoms and indicators within the group. Results: after treatment, the patients in the treatment group were cured, effective, effective and ineffective. The total effective rate was 90.0. The total effective rate was 76.7in the control group. The comprehensive curative effect of the two groups was analyzed by rank sum test, the difference was statistically significant (P 0.05). And the treatment group is superior to the control group. (2) TCM symptom integral: after treatment, the scores of the two groups are all decreased, and there is a significant difference between the two groups by t test analysis (P 0.05). The difference between the two groups before and after treatment was statistically significant (P 0.05), and the improvement of the score in the treatment group was greater than that in the control group. 3) the level of serum FSHLHN E2: after the end of the course of treatment. The sex hormone levels in the two groups were statistically significant (P 0.05). The difference of FSHE _ 2 between the two groups before and after treatment was statistically significant. The amplitude of FSHE _ 2 in the treatment group was higher than that in the control group (P 0.05). There was no significant difference in the difference of LH between the two groups. There was no significant difference between the two groups (P0.05. 4) the improvement of pregnancy: in 60 patients after treatment, there was only one early pregnancy in the treatment group, because of less data. Conclusion: Nishen Qingxin medicine can effectively improve the clinical symptoms of patients; It can act on hypothalamus-pituitary-ovarian reproductive axis, regulate the level of FSHLHN E2 in blood, improve and activate ovarian function. Zishen Qingxin decoction is an effective prescription for premature ovarian failure with heart and kidney loss. The effect of Zishen Qingxin decoction is better than that of Kuntai capsule, which indicates that TCM decoction has the best effect and its mechanism needs to be studied.
【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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