补气活血法对卵巢巧克力囊肿术后复发干预的临床研究

发布时间：2018-01-19 13:17

本文关键词： 补气活血法 GnRHa 巧囊术后复发率临床疗效　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察补气活血法及其联合GnRHa(注射用醋酸亮丙瑞林微球)干预卵巢巧克力囊肿(简称为“巧囊”)术后复发的临床疗效,揭示中医药治疗该病的优势所在,弥补西医药在该领域的不足,同时证明中西医的协同作用和疗效叠加性,从而寻求一种更好的中西医结合治疗该病的方法。方法:选择2014年09月—2015年04月在广西中医药大学第一附属医院妇科门诊及病房就诊的符合卵巢巧克力囊肿术后诊断,并符合纳入标准的患者60人为受试者。按随机分组法分成3组,即A组(中药组)20例;B组(西药组)20例,C组(中药组+西药组)20例。3组患者均从术后第7天开始用药,1个月为1个疗程,共治疗3个疗程,停药后随访6个月。观察3组受试者的临床疗效、症状缓解情况及中医证候评分、妇科B超变化(包块大小),CA125检测(均指血清CA125),再应用统计学软件进行相关处理,得出结论。结果:(1)在改善患者症状方面取得了良效:其中中药组总数20例,痊愈1例,显效14例,有效2例,无效3例,总有效率为85%;西药组总数20例,痊愈0例,显效1例,有效15例,无效4例,总有效率为80%;中西医结合组总数20例,痊愈2例,显效14例,有效3例,无效1例,总有效率为95%。三组患者组间比较情况:三组患者两两之间比较均具有统计学差异(P0.05),根据总有效率可知,在改善患者症状方面,中西医结合组疗效最好,中药组次之,西药组疗效相对较差。(2)完成随访后进行试验结果总结:经B超提示为巧克力囊肿,并在B超引导下穿刺抽取囊液,根据对囊液性状分析证实为巧囊复发的中药组有3例,西药组有2例,中西医结合组0例;在中医证候评价方面,中药组无效数为3例,西药组无效数为4例,中西医结合组无效数为1例;术后各组患者的CA125均较术前下降,后复出现上升者,中药组有3例,西药组有2例,中西医结合组0例。故各组复发率分别为15%、10%、0%。由此证明,在防治巧克力囊肿术后复发方面,中西医结合组疗效最好,西药组次之,中药组疗效相对较差。(3)综上所述,在改善患者症状方面,中西医结合组疗效最好,中药组次之,西药组疗效相对较差。在防治巧克力囊肿复发方面,中西医结合组疗效最好,西药组次之,中药组疗效相对较差。可见中西医联合使用是治疗该病的最佳治疗方式,同时中药组在改善患者症状方面有着其特有的优势,是值得在临床应用和推广的。结论:研究表明:补气活血法通过益气补虚,活血化瘀的功效对改善患者下腹痛和痛经、性交痛等症状及降低术后复发率有较显著作用,其与GnRHa联合使用提高临床疗效的同时,更降低了GnRHa的临床副作用,充分体现了中西医结合的优势所在。
[Abstract]:Objective: to observe the clinical effect of invigorating qi and activating blood circulation method and combining with GnRHatreated microspheres to prevent the recurrence of chocolate cyst of ovary (abbreviated as "skillful cyst"). To reveal the advantages of traditional Chinese medicine in the treatment of the disease, to make up for the lack of western medicine in this field, and to prove the synergy of traditional Chinese and western medicine and the superposition of curative effect. So as to seek a better combination of traditional Chinese and Western medicine for the treatment of the disease. Methods:. From September 2014 to April 2015 in the first affiliated Hospital of Guangxi University of traditional Chinese Medicine gynecological outpatients and wards were selected in accordance with the diagnosis of chocolate cyst of ovary. 60 patients who met the inclusion criteria were randomly divided into three groups: group A (group A, n = 20); Group B (western medicine group, n = 20), group C (group C, n = 20) (group C, n = 20). All the patients in group B (n = 20) were treated with drugs from the 7th day after operation, one month as a course of treatment, and a total of three courses of treatment. The clinical efficacy, symptom relief, TCM syndrome score and gynecological B-ultrasound changes were observed in the three groups (mass size, CA125 (all referred to as serum CA125)). Then the statistical software was used to deal with the correlation, and the conclusion was drawn. Results: 20 cases of TCM group, 1 case of cure, 14 cases of remarkable effect and 2 cases of effective were obtained in improving the symptoms of the patients. 3 cases were ineffective, the total effective rate was 85%; There were 20 cases in western medicine group, 0 cases were cured, 1 case was remarkable effect, 15 cases were effective, 4 cases were ineffective, the total effective rate was 80%. There were 20 cases in the group of integrated traditional Chinese and western medicine, 2 cases were cured, 14 cases were effective, 3 cases were effective, and 1 case was ineffective. The total effective rate was 95. The comparison among the three groups of patients: there was statistical difference between the two groups. According to the total effective rate, we can know that it can improve the symptoms of the patients. Combination of traditional Chinese and Western medicine group the best curative effect, Chinese medicine group, Western medicine group relatively poor efficacy. 2) after the completion of follow-up results: B ultrasonic hint for chocolate cyst, and under the guidance of B-ultrasound puncture to extract sac fluid. According to the analysis of the cystic fluid, there were 3 cases in the Chinese medicine group, 2 cases in the western medicine group and 0 cases in the integrated Chinese and western medicine group. In the evaluation of TCM syndromes, the invalid number of TCM group was 3 cases, that of western medicine group was 4 cases, and that of integrated Chinese and western medicine group was 1 case. After the operation, the CA125 of the patients in each group was lower than that before operation, and then increased again. There were 3 cases in the Chinese medicine group, 2 cases in the western medicine group and 0 cases in the integrated Chinese and western medicine group. The recurrence rate of each group was 15% and 10% respectively. This proved that in the prevention and treatment of chocolate cyst recurrence, the combination of traditional Chinese and Western medicine group is the best, Western medicine group, the Chinese medicine group is relatively poor, in summary, in improving the symptoms of patients. In the prevention and treatment of chocolate cyst recurrence, the combination of traditional Chinese and western medicine group is the best, the western medicine group is the second. It can be seen that the combination of traditional Chinese and Western medicine is the best way to treat the disease, and the traditional Chinese medicine group has its unique advantages in improving the symptoms of patients. Conclusion: the method of invigorating qi and activating blood circulation can improve the pain of lower abdomen and dysmenorrhea through the effect of supplementing qi and tonifying deficiency and activating blood circulation and removing blood stasis. Sexual intercourse pain and other symptoms and reduce the recurrence rate has a significant effect, combined with the use of GnRHa to improve the clinical efficacy, but also reduce the clinical side effects of GnRHa. Fully reflect the advantages of integrated Chinese and western medicine.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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