子午流注纳甲法治疗多囊卵巢综合征排卵障碍的临床研究

发布时间：2018-03-02 12:04

  本文选题：子午流注纳甲法　切入点：针灸　出处：《云南中医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究采用临床小样本随机对照研究,运用子午流注纳甲法配合普通针刺对多囊卵巢综合征(PCOS)排卵障碍的患者进行治疗,并设普通针刺组对照进行观察比较,客观评价子午流注纳甲法治疗PCOS患者排卵障碍的临床疗效,初步探索子午流注纳甲法治疗PCOS排卵障碍的机理。方法:按照纳入标准选择病例,采用随机数字表法把60例患者随机分为治疗组和对照组,每组各30例。治疗组采用子午流注纳甲法开穴配合普通针刺治疗,对照组采用普通针刺治疗,治疗3个疗程后观察两组的疗效,进行统计学分析并做出疗效评价。结果:(1)治疗后,治疗组总有效率86.7%,对照组总有效率为70%,两组患者总疗效比较,差异有统计学意义(P0.05),结果显示:两种方法治疗PCOS均有效,治疗组总体疗效优于对照组。(2)两组治疗前后中医症状总积分比较,差异有统计学意义(P0.01)。治疗后两组间进行比较,差异有统计学意义(P0.01)。结果表明:两组治疗方法都能改善中医症状,治疗组在改善中医症状方面较对照组明显。(3)治疗后,两组LH、T、LH/FSH均有下降,E2均有升高,治疗前后差异有统计学意义(P0.05)。两组间比较,治疗组中LH、T、LH/FSH三项数值下降的幅度较对照组明显(P0.05),E2两组间比较则无明显统计学意义(P0.05)。FSH治疗前后及组间对照均没有统计学意义(P0.05)。结果表明:两种治疗方法对LH、T、LH/FSH有降低作用,对E2有升高作用,治疗组对LH、T、LH/FSH的改善较对照组明显。(4)治疗后,两组空腹血糖、空腹胰岛素水平、胰岛素抵抗指数、体重指数较治疗前均有下降,差异有统计学意义(P0.05)。两组治疗后组间比较,差异有统计学意义(P0.05)。结果表明:两种治疗方法对空腹血糖、空腹胰岛素水平、胰岛素抵抗指数、体重指数均有改善作用,治疗组疗效较对照组明显。(5)治疗后,两组子宫内膜厚度及最大卵泡直径均有改善,治疗前后差异有统计学意义(P0.05)。两组治疗后进行疗效比较,差异有统计学意义(P0.05)。结果表明:两种治疗方法对子宫内膜厚度及最大卵泡直径均有改善作用,治疗组疗效较对照组明显。(6)治疗组总的观察周期为117个,排卵周期为87个,排卵率为72.4%;对照组总的观察周期为112个,排卵周期为68个,排卵率为64.8%。比较两组排卵率,差异有统计学意义(P0.05)。统计结果表明:两种治疗方法均能改善患者排卵情况,治疗组排卵率高于对照组。(7)治疗组中有16例患者备孕,经治疗后妊娠6例,未妊娠10例,妊娠率37.5%;对照组中备孕患者有15例,治疗后妊娠3例,未妊娠12例,妊娠率17.6%。比较两组妊娠率,差异虽没有统计学意义(P0.05),但治疗组妊娠率有高于对照组的趋势。结论:本研究表明两组所采用的治疗方法均能改善PCOS患者临床症状、体征及生化指标。两组患者治疗前后血清性激素、空腹血糖、空腹胰岛素、妇科B超检查的比较,显示在改善性激素、胰岛素抵抗指数、体重指数、子宫内膜厚度、卵泡发育及排卵方面,治疗组优于对照组。提示子午流注纳甲法治疗PCOS排卵障碍疗效较好,临床上值得深入研究。本课题子午流注纳甲法治疗PCOS排卵障碍的机理可能是通过子午流注纳甲法开穴,通过针刺值日经敏感穴,顺应人体的自然节律,调节“下丘脑-垂体-卵巢-子宫”轴生理功能,引起下丘脑对内分泌的良性调节,改善卵巢功能,从而促进卵泡的生长发育,诱发排卵。
[Abstract]:Objective: the clinical randomized controlled study was used in this study, the use of Ziwuliuzhu Najia method with ordinary acupuncture on polycystic ovary syndrome (PCOS) ovulation disorder patients were treated with common acupuncture group were observed and compared, objective evaluation of clinical efficacy of Ziwuliuzhu Najia method in the treatment of ovulation disorders in PCOS patients, preliminary exploration the mechanism of Ziwuliuzhu Najia method of ovulation PCOS. Methods: according to the criteria for selected cases, randomly 60 patients were randomly divided into treatment group and control group, 30 cases in each group. The treatment group used acupuncture Ziwuliuzhu Najia method with ordinary acupuncture treatment, the control group with normal acupuncture treatment to observe the curative effect of the two groups, after 3 courses of treatment, statistical analysis and evaluate the curative effect. Results: (1) after treatment, the total effective rate of treatment group 86.7%, control group total effective rate was 70%, two groups of patients The total curative effect comparison, the difference was statistically significant (P0.05). The results show that two methods are effective in the treatment of PCOS. The overall efficacy of the treatment group than control group. (2) the TCM symptoms total score before and after treatment in the two groups, the difference was statistically significant (P0.01). After treatment between the two groups were compared with statistical significance the difference (P0.01). The results showed that the two groups of treatment can improve the TCM symptoms, the treatment group than the control group significantly in symptoms. (3) after treatment, two groups of LH, T, LH/FSH were decreased, E2 increased before and after treatment, there was statistically significant difference between the two groups (P0.05). In the treatment group, LH, T, LH/FSH decreased three numerical magnitude significantly compared with the control group (P0.05), E2 of the two groups had no statistical significance (P0.05) before and after.FSH treatment and the control group had no statistical significance (P0.05). The results showed that: two kinds of treatment methods of LH, T. LH/FSH down Low, rise the function of E2, the treatment group of LH, T, LH/FSH were better than the control group. (4) after treatment, two groups of fasting blood glucose, fasting insulin, insulin resistance index, body mass index were decreased compared with before treatment, the difference was statistically significant (P0.05). The two groups after treatment comparison, the difference was statistically significant (P0.05). The results showed that: two kinds of treatment methods on the fasting blood glucose, fasting insulin, insulin resistance index, body mass index were improved, the curative effect of the treatment group than the control group obviously. (5) after treatment, two groups of endometrial thickness and the diameter of the largest follicle were improved significantly significant differences before and after the treatment (P0.05). The therapeutic effects were compared after the treatment in the two groups, the difference was statistically significant (P0.05). The results show that the two methods both have effect on improving the endometrial thickness and the diameter of the largest follicle, the efficacy of the treatment group than the control group obviously .(6)娌荤枟缁勬，

本文编号：1556443