自拟止血方治疗肝肾阴虚型围绝经期功血的临床观察

发布时间：2018-02-25 20:26

本文关键词： 自拟止血方肝肾阴虚围绝经期功血临床观察　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:围绝经期功血是困扰围绝经期妇女的一种多发疾患,患者由于长期反复出血常常伴有贫血,严重影响围绝经期妇女的健康及正常生活。虽然西医在治疗本病方面具有止血疗效好、实验室检查丰富的优势,但是不可避免的是激素类药物带来的副作用以及手术治疗的不便,使中医在治疗本病时显示出了显著的优势。本研究采用随机对照的临床研究方法针对临床上常见的肝肾阴虚型围绝经期功血,采用口服自拟止血方加减治疗。观察临床各项症状的改善情况及药物的安全性。结果表明自拟止血方加减可以有效、安全的治疗肝肾阴虚型功血,为临床推广提供依据。方法:1.收集资料:将符合中西医诊断标准的60例患者,随机分为治疗组30例,对照组30例。2.治疗方法:治疗组:出血期口服自拟止血方(女贞子、麦冬、白芍、太子参、墨旱莲、茜草、甘草、益母草、续断、补骨脂、五味子、三七、生地、熟地、仙鹤草。)每日1剂,水煎,早晚分服,血止期:自拟止血方减茜草、仙鹤草,加党参、白术、枸杞子、何首乌,连续服用至下个出血周期开始,于出血周期第4日开始继续服用自拟止血方,服药方法同前,连续服用3个出血周期,中药统一由我院中药房煎药室机器煎煮。对照组:口服妇康片(上海信谊康捷药业有限公司,国药准字H31021769,0.625mg*100s/瓶)首次剂量为5mg,每8小时1次,血止后每隔3日递减1/3的药量,直到每日2.5mg的维持剂量,自血止日算起,共服20日停药,等撤退性出血,自出血开始第5日开始第2个周期的治疗,治疗3个周期。观察患者治疗前后症状改善情况及中医证候积分变化,观察服药开始到服药后血止所需的时间,治疗前及治疗后血红蛋白含量,治疗前及治疗后的血清性激素水平,治疗停止后随访3个月了解患者的复发情况,以及服药过程中的不良反应。结果:1.两组止血疗效比较,治疗组及对照组总有效率分别为80%、86.67%,经检验两组止血疗效差异无显著意义(P0.05)。2.两组治疗前后证候疗效比较,治疗组及对照组总有效率分别为93.33%、70%,经统计学检验两组治疗前后证候疗效有显著差异(P0.05),治疗组证候疗效优于对照组。3.两组治疗前后症状积分比较,经检验分析治疗组与对照组治疗前积分比较无显著差异(P0.05),具有可比性;治疗组治疗后积分较治疗前降低,差异有显著性(P0.01);对照组治疗后积分较治疗前降低,差异有显著性(P0.01);治疗组与对照组治疗后症状积分组间比较有显著性差异(P=0.0010.01)。4.治疗前治疗后血清FSH、LH、E2比较,经检验分析治疗组治疗前后FSH水平无显著变化(P0.05);治疗组治疗前后LH水平无明显变化(P0.05);治疗组治疗后E2较治疗前升高,差异有显著性(P0.01);对照组治疗前后FSH水平无显著变化(P0.05);对照组治疗前后LH水平无显著变化(P0.05);对照组治疗前后E2无明显变化(P0.05)。5.两组血红蛋白治疗前及治疗后变化,经检验分析治疗前治疗组血红蛋白含量与对照比较无显著差异(P0.05)。治疗后治疗组与对照组血红蛋白含量比较有显著差异(P0.05)。治疗组治疗前后血红蛋白含量比较有显著差异(P0.05)。对照组治疗前后血红蛋白含量比较有显著差异(P0.05)。6.两组治疗后随访3个月后复发率的比较,治疗组复发率为6.7%,对照组复发率为33.3%,经分析两组复发率比较有显著差异(P0.05),治疗组复发率明显低于对照组。结论自拟止血方在治疗肝肾阴虚型围绝经期功血疾病是有显著的疗效,与对照组相比较,不仅可以止血,改善患者的临床症状,调节患者的内分泌,增加患者的血红蛋白含量,且在副作用方面较西药小,值得临床推广。
[Abstract]:Objective: perimenopausal dysfunctional uterine bleeding in perimenopausal women was plagued by a multiple diseases, patients with long-term repeated hemorrhage often accompanied by anemia, seriously affected the normal life and health of perimenopausal women. Although western medicine in the treatment of this disease has good hemostatic effect, laboratory examination of the advantages of the rich but inevitably is the side effect of steroid the drug and the inconvenience of surgical treatment, the Chinese medicine in the treatment of this disease shows significant advantages. This study adopts randomized controlled clinical research methods for common clinical liver deficiency of kidney yin, using oral hemostatic decoction treatment. To observe the safety and improve the clinical symptoms the results show that the self hemostatic decoction can effectively treat liver and kidney yin deficiency type safe blood, to provide the basis for clinical application. Methods: 1. collect data: 60 cases with traditional Chinese medicine and Western medicine diagnostic criteria were randomly divided into treatment group 30 cases, 30 cases in the control group.2. treatment: the treatment group: oral hemorrhage with hemostatic recipe (Ligustrum lucidum, ophiopogon root, Radix Paeoniae Alba, Radix Pseudostellariae, Eclipta, madder, licorice, motherwort, teasel root, Schisandra chinensis, Fructus Psoraleae, 37 students. 1). Moreover, agrimony agent, water decoction daily, morning and evening service points, blood check period: with hemostatic reduction with madder, agrimony, Codonopsis, Atractylodes, medlar, Radix Polygoni Multiflori, taking to the next cycle began to hemorrhage, bleeding period beginning fourth days to continue taking the medication with hemostatic, with continuous. Take 3 blood cycle, unified medicine by traditional Chinese medicine decocting room real machine decoction. The control group: oral Norlutin (Shanghai Xinyi Jie Kang Pharmaceutical Co. Ltd., Zhunzi H31021769,0.625mg*100s/ bottle) the first dose is 5mg, every 8 hours for 1 times every 3 days after the cessation of blood, decreasing the dose of 1/3 2.5mg, until the daily maintenance dose, blood check date, serving a total of 20 days of withdrawal, such as withdrawal bleeding, bleeding from the beginning to fifth at the beginning of the second treatment cycles, 3 cycles of treatment. Patients were observed before and after treatment the improvement of symptoms and TCM syndrome score changes, observation of medication required to start after taking the blood stopping time, hemoglobin content before and after treatment, serum sex hormone levels before and after treatment, after treatment were followed up for 3 months to understand the recurrence of patients with adverse reactions, and the process of medicine. Results: 1. compared with two groups of hemostatic efficacy, the treatment group and control group total the efficiency was 80%, 86.67%, the difference in efficacy test of two group was no significant (P0.05) compared the syndromes of.2. before and after treatment in the two groups, the treatment group and the control group total effective rate was 93.33%, 70%, the statistical test of the two groups before and after treatment of syndrome curative effect significantly The difference (P0.05), the treatment group than the control group before and after the syndromes of.3. treatment in the two groups symptoms integral comparison, by analysis of treatment group and control group before treatment showed no significant difference (P0.05), comparable; the treatment group scores after treatment than before treatment decreased, the difference was significant (P0.01); the control group scores after treatment than before treatment decreased, there was significant difference (P0.01); there were significant differences between treatment group and control group after treatment symptom scores between the groups (P=0.0010.01.4.) before treatment and after treatment of serum FSH, LH, E2, the results showed no significant changes before and after treatment, the level of FSH (P0.05); no significant changes in LH level of treatment group before and after treatment (P0.05); the treatment group after treatment than before treatment E2 increased significantly (P0.01); no significant changes in FSH level of control group before and after the treatment (P0.05); no significant changes in LH level of control group before and after the treatment of (P0.05); As the group before and after treatment there was no significant change in E2 (P0.05).5. changes in two groups of hemoglobin before and after treatment, by analysis of pre treatment group and control the content of HB showed no significant difference (P0.05). After treatment, the treatment group and the control group there was a significant difference between the content of hemoglobin (P0.05). The treatment group before and after treatment, hemoglobin content there was a significant difference (P0.05). The control group before and after treatment, the hemoglobin content had significant difference (P0.05) between the two groups after treatment were followed up for.6. 3 months after recurrence, the recurrence rate of treatment group was 6.7%, the recurrence rate of control group was 33.3%, by the analysis of the recurrence rate of the two groups had significant difference (P0.05). The recurrence rate of treatment group was significantly lower than the control group. Conclusion with hemostatic prescription in the treatment of liver and kidney yin deficiency perimenopausal dysfunctional uterine bleeding disease is a significant effect, compared with the control group, not only can improve the clinical symptoms of patients with bleeding It regulates the endocrine of the patient, increases the hemoglobin content of the patient, and is smaller in side effects than western medicine. It is worth promoting in clinical practice.

【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】：R271.116

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