补肾调周法治疗湿热瘀结型慢性盆腔炎的临床观察

发布时间：2018-02-04 12:24

本文关键词： 补肾调周法湿热瘀结型慢性盆腔炎临床观察　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过重点观察补肾调周法对慢性盆腔炎患者慢性盆腔痛及月经不调的改善情况,以评价补肾调周法治疗湿热瘀结型慢性盆腔炎的临床疗效,并探讨补肾调周法的作用机理,为临床治疗慢性盆腔炎提供依据。方法:所有观察病例均来自武汉市中医医院2014年3月-2015年3月妇科专家门诊就诊的诊断为慢性盆腔炎(湿热瘀结型)的患者,共观察60例,按就诊的先后顺序,随机分为治疗组30例和对照组30例。治疗组运用补肾调周法治疗,对照组采用中成药妇科千金片治疗。两组患者均以1个月经周期为1个观察周期,共连续观察3个月经周期。通过观察两组患者经过3个月经周期治疗后的综合疗效、局部体征疗效、中医证候疗效以及治疗后两组患者妇科B超改善情况,并随访治疗后3个月内的复发率,并通过统计学软件SPSS19.0进行数据分析,计量资料采用t检验,计数资料采用χ2检验,等级资料采用Ridit分析。结果:1.两组患者临床综合疗效的比较:治疗组痊愈8例,显效17例,有效3例,无效2例,总有效率93.3%;对照组痊愈4例,显效12例,有效6例,无效8例,总有效率73.3%;经统计学分析,P0.05,说明治疗组的综合疗效优于对照组。2.两组患者中医症状方面比较:治疗后两组中医症状方面均有改善,尤其在下腹疼痛、腰骶酸痛、月经异常、经期腹痛加重、带下异常、神疲乏力、大便异常症状方面,治疗组和对照组相比有显著性差异(P0.05),治疗组疗效优于对照组;在小便异常、舌脉异常等方面,治疗组与对照组无显著性差异(P0.05),但治疗组有效率高于对照组。3.两组患者局部体征方面的比较:治疗后两组患者局部体征均有改善,经统计学分析,在子宫活动受限压痛与骶韧带增粗触痛方面,治疗组和对照组相比有显著性差异(P0.05),说明治疗组疗效优于对照组;在附件增厚压痛方面,两组无显著性差异(P0.05),但治疗组有效率高于对照组。4.两组患者在治疗后B超检查提示盆腔积液或附件包块方面:治疗组复常率66.67%,对照组复常率35.00%,两组相比有统计学意义(P0.05),说明治疗组在治疗盆腔积液或附件包块方面疗效优于对照组。5.两组患者在治疗后三个月内的复发率比较:治疗组复发率为13.33%,对照组复发率为44.83%,两组相比有统计学意义(P0.05),治疗组的远期疗效明显优于对照组。结论:补肾调周法治疗湿热瘀结型慢性盆腔炎临床疗效较好。根据月经周期的不同时期肾阴阳气血变化的特点,采用补肾调周四期疗法,与不考虑月经周期生理特点在非经期采用妇科千金片治疗相比,补肾调周法兼顾清利化瘀,标本兼治,疗效更优,更能明显改善患者临床症状及体征,且能降低患者治疗后3个月内的复发率。
[Abstract]:Objective: to observe the improvement of chronic pelvic pain and irregular menstruation in patients with chronic pelvic inflammatory disease by the method of tonifying kidney and regulating week, and to evaluate the clinical effect of tonifying kidney and regulating week on chronic pelvic inflammatory disease of dampness and heat stasis. The mechanism of tonifying kidney and regulating week was discussed. Methods: all the observed cases were diagnosed as chronic pelvic inflammatory disease from March 2014 to March 2015 in Wuhan traditional Chinese Medicine Hospital. Type of dampness and heat stasis. A total of 60 cases were observed and randomly divided into treatment group (n = 30) and control group (n = 30). The control group was treated with traditional Chinese patent medicine gynecological Qianjin tablet. The two groups were treated with one menstrual cycle as one observation cycle. A total of 3 consecutive menstrual cycles. By observing the two groups of patients after three menstrual cycles after treatment of comprehensive efficacy, local signs, TCM syndromes and the treatment of two groups of patients after the improvement of gynecological B ultrasound. The recurrence rate within 3 months after treatment was followed up. The data were analyzed by statistical software SPSS19.0. T test was used for measurement data and 蠂 2 test was used for counting data. Grade data were analyzed by Ridit. Results comparison of clinical comprehensive efficacy between the two groups: 8 cases were cured, 17 cases were markedly effective, 3 cases were effective, 2 cases were ineffective, and the total effective rate was 93.3% in the treatment group. In the control group, 4 cases were cured, 12 cases were markedly effective, 6 cases were effective and 8 cases were ineffective. The total effective rate was 73.3%. By statistical analysis of P0.05, it shows that the comprehensive efficacy of the treatment group is better than the control group .2.The two groups of patients compared with the traditional Chinese medicine symptoms: after treatment, two groups of TCM symptoms have improved, especially in the lower abdominal pain. Lumbosacral soreness, abnormal menstruation, abdominal pain in menstrual period, abnormal under the belt, fatigue, abnormal stool symptoms, there was significant difference between the treatment group and the control group (P 0.05), the curative effect of the treatment group was better than that of the control group. There was no significant difference between the treatment group and the control group in urine abnormality and tongue pulse abnormality (P0.05). But the effective rate of the treatment group was higher than that of the control group .3.The comparison of local signs of the two groups: after treatment, the local signs of the two groups were improved, by statistical analysis. In terms of limited tenderness of uterine activity and thickening and tenderness of sacral ligament, there was significant difference between the treatment group and the control group (P 0.05), which indicated that the curative effect of the treatment group was better than that of the control group. There was no significant difference in attachment thickening tenderness between the two groups (P 0.05). But the effective rate in the treatment group was higher than that in the control group. 4. The B ultrasound examination showed that the pelvic effusion or adnexal mass in the treatment group was 66.67 in the treatment group and 35.00% in the control group. There was significant difference between the two groups (P0.05). The treatment group in the treatment of pelvic effusion or adnexal mass curative effect is better than the control group. 5. two groups of patients in the treatment of three months after the recurrence rate comparison: the treatment group recurrence rate is 13.33%. The recurrence rate of the control group was 44.83%, which was significantly higher than that of the control group (P 0.05). The long-term curative effect of the treatment group is obviously better than that of the control group. Conclusion: the therapy of tonifying the kidney and regulating the week is better in the treatment of chronic pelvic inflammatory disease of dampness and heat stasis type. According to the characteristics of the changes of kidney yin and yang qi and blood in different periods of menstrual cycle. Using tonifying kidney and regulating Thursday period therapy, compared with non-menstrual cycle physiological characteristics in the treatment of gynecological Qianjin tablet, tonifying kidney and regulating week to take into account Qingli Huayu, both symptoms and symptoms, the curative effect is better. It can significantly improve the clinical symptoms and signs, and reduce the recurrence rate within 3 months after treatment.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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