膈下逐瘀汤应用于妇科疾病的现代文献研究及治疗CPID的临床疗效观察

发布时间：2018-01-15 08:16

本文关键词：膈下逐瘀汤应用于妇科疾病的现代文献研究及治疗CPID的临床疗效观察　出处：《黑龙江中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：1.文献研究：通过搜集近30年有关膈下逐瘀汤在妇科临床应用方面的文献,对其进行统计分析,进一步归纳总结出膈下逐瘀汤在妇科临床方面的应用规律,为临床工作提供参考,提高临床的疗效。2.临床观察：观察膈下逐瘀汤加减治疗慢性盆腔炎气滞血瘀证的临床疗效。方法：1.收集1985年1月至2015年10月在清华同方中国科技期刊数据库、万方数据库、维普数据库上发表的有关膈下逐瘀汤在妇科临床应用方面的文献。利用现代化统计工具对搜索到的文献加以处理,建立相关数据库,从多个角度进行处理分析,总结其运用范围、病因病机、适用证型、功效、常用的加减化裁以及配合的其它疗法等信息,将文献数据转换为数字信息,并对结果进行归纳分析。2.收集气滞血瘀型慢性盆腔炎患者50例,给予膈下逐瘀汤加减口服治疗,观察其治疗前后症状、局部体征的变化情况,超声监测盆腔包块的变化。结果：1.运用膈下逐瘀汤治疗妇科疾病的现代文献中,痛经出现的频率最高,占41.49%,其次为盆腔炎11.70%；常见的症状为腹痛,占87.09%；其涉及的病因病机以气滞血瘀、气血不畅最多见,分别占56.18%、22.47%；其加减涉及的功效以活血化瘀为最多占59.34%,行气止痛次之,为32.97%；在药味加减使用方面,膈下逐瘀汤加味的药物共有63种,分属15类,其中以活血化瘀药及补虚药最多,其次为清热药；与其合用以治妇科疾病的成方有当归芍药散和大柴胡汤；配合的外治疗法多样,以中药外敷和针刺为主。2.研究过程中剔除5例,脱落2例,剩余43例。治疗后综合疗效总有效率为81.40%,中医症状疗效总有效率为86.05%,局部体征疗效总有效率为72.09%；治疗前后中医症状积分比较差异显著(P0.01),治疗前后局部体征积分比较差异显著(P0.01),治疗后盆腔包块消散明显。结论：1.(1)现代妇科运用膈下逐瘀汤主要以疼痛性疾病和积聚为主,脉象多为弦脉、弦涩脉,多见舌紫黯、有瘀斑瘀点,苔薄白；(2)本方所主病因病机主要为气滞血瘀；功效主要为活血化瘀、行气止痛；(3)本方加味的药物主要为活血化瘀、补虚、清热、温里等类；主要配合的外治疗法为中药外敷和针刺。2.膈下逐瘀汤加减能够显著改善气滞血瘀型慢性盆腔炎患者的临床症状和局部体征,并能促进盆腔包块的吸收,是治疗气滞血瘀型慢性盆腔炎的有效方药。
[Abstract]:Objective: 1. literature study: through the collection of nearly 30 years of relevant literature infradiaphragmatic stasis soup clinical application in gynecology, carries on the statistical analysis, further summarizes the application of Gexia Zhuyu Decoction rules in gynecologic clinical aspects, provide a reference for clinical work, improve the clinical efficacy of.2. clinical curative effect observation of Gexia Zhuyu Decoction in the treatment of qi stagnation and blood stasis syndrome of chronic pelvic inflammatory disease. Methods: 1. from January 1985 to October 2015 in Tsinghua Tongfang Chinese journals database, Wanfang database, the published VIP database on the phrenic Zhuyu Decoction in the clinical application of gynecological aspects of literature. The use of modern statistical tools in search of the literature to deal with the establishment of the database, analyze from several angles, summarizes its application scope, etiology and pathogenesis, syndrome effect, application, commonly used to chmical process and fit the The therapy and other information, document data into digital information, and the results were analyzed in 50 cases of.2. collected qi stagnation and blood stasis type of chronic pelvic inflammatory disease, given gexiazhuyu Decoction oral treatment, observe the symptoms before and after treatment, changes of local signs, changes of pelvic mass measurement by ultrasonic monitoring. Results: 1. with the modern Zhuyu Decoction in the treatment of gynecological diseases under the diaphragm, dysmenorrhea occurred most frequently, accounting for 41.49%, followed by 11.70% pelvic inflammatory disease; common symptoms were abdominal pain, accounted for 87.09%; the etiology and pathogenesis of the qi stagnation and blood stasis, Qi and blood stagnation is most common, accounted for 56.18%, 22.47%; it involves addition and subtraction the effect of the blood circulation for up to 59.34%, xingqizhitong times, 32.97%; in terms of the use of addition and subtraction, Gexia Zhuyu Decoction drug total of 63 species, belonging to 15 categories, including blood stasis and tonifying drug most, followed by In combination with heat clearing drugs; prescription treatment of gynecological diseases and have Dangguishaoyaosan Dachaihutang; with external therapy with the external application of Chinese medicine and various acupuncture elimination in.2. during the study of 5 cases, 2 cases falling off, the remaining 43 cases. The comprehensive curative effect after treatment the total effective rate was 81.40%, the total curative effect of TCM symptoms efficiency of 86.05%, local signs of efficacy of the total effective rate was 72.09%; after treatment of TCM symptom score had significant difference (P0.01) before and after treatment, comparison of local signs integral significant difference (P0.01), after the treatment of pelvic mass dissipation obviously. Conclusion: 1. (1) by using modern gynecological gexiazhuyu Decoction mainly in pain disease and accumulation, pulse string pulse, unsmooth pulse string, see dark purple tongue, ecchymosis petechiae, moss thin white; (2) the main pathogenesis is Qi stagnation and blood stasis; the main effect of promoting blood circulation and removing blood stasis, Qi pain; (3) the main prescription drugs For blood stasis, tonifying deficiency, heat, temperature etc.; mainly with external therapy for external application of Chinese medicine and acupuncture.2. Gexia Zhuyu Decoction to the clinical symptoms and local signs of chronic pelvic inflammatory disease were significantly improved with qi stagnation and blood stasis, and can promote the absorption of the pelvic mass, effective prescription treatment Qi stagnation and blood stasis type of chronic pelvic inflammatory disease.

【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.1

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