补肾调周化瘀法干预卵巢巧克力囊肿术后复发的临床观察

发布时间：2018-03-09 16:48

本文选题：补肾调周化瘀　切入点：巧克力囊肿　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：本课题通过运用补肾调周化瘀法对卵巢子宫内膜异位(Ovarian endometriosis cyst,OEC)患者腹腔镜保守手术术后预防复发的干预治疗,并与抑那通治疗对照,观察两组患者术后的复发率、痛经及妊娠的情况,探讨补肾调周化瘀法用于巧克力囊肿患者术后辅助治疗的可行性,找寻能够巩固手术治疗效果,降低术后的复发率,并且副作用较小的治疗方法。方法：收集2014年10月至2015年6月江苏省中医院门诊及住院部符合纳入标准的巧囊腹腔镜术后的患者45例,分为治疗组30例、对照组15例。治疗组予补肾调周化瘀法,服用中医治疗,对照组予抑那通皮下注射,3个月为一个疗程。观察两组病例治疗前、治疗3个月后、停药3个月后、停药6个月后痛经的程度、临床症状、复发率、妊娠率、CA125水平以及血液流变学指标的变化,将两组数据用统计学方法进行处理、分析。结果：临床疗效：治疗组与对照组的复发率分别为16.7%、13.3%,无明显的差异(P0.05)；两组患者治疗后痛经症状均有非常明显的改善(P0.01),但组间比较无明显差异(P0.05)；两组患者痛经、盆腔痛、性交痛、肛门坠痛的临床症状改善无明显的差异(P0.05)。治疗组与对照组治疗后血清CA125及血液流变学指标均显著降低(P0.01),但组间比较无明显差异(P0.05)。安全性观察：治疗组在治疗过程中无明显不良反应及毒副作用,对照组患者用药后出现肝功能损害的概率为20%(3/15),出现阴道干燥、阴道不规则出血等副反应发生概率合计为46.7%(7/15)。结论：补肾调周化瘀法能够有效的预防巧克力囊肿患者术后的复发,具有缓解患者痛经等临床症状,提高妊娠率等多重效应,能明显降低患者的血清CA125水平,降低血液粘稠度,未发现明显不良反应及毒副作用。
[Abstract]:Objective: to observe the recurrence rate of patients with ovarian endometriosis after laparoscopic conservative surgery by using the method of tonifying the kidney and regulating the weeks and removing blood stasis, and to observe the recurrence rate of the two groups. To explore the feasibility of tonifying kidney and regulating Zhou and removing blood stasis in postoperative adjuvant treatment in patients with chocolate cyst in order to consolidate the effect of operation and reduce the recurrence rate. Methods: from October 2014 to June 2015, 45 cases of out-patient and inpatient department of Jiangsu Provincial Hospital of traditional Chinese Medicine (TCM) were collected and divided into treatment group (n = 30). In the control group, 15 cases were treated with tonifying kidney, regulating the week and removing blood stasis. The control group was given subcutaneous injection of Yonatong, and the control group was given subcutaneous injection for 3 months as a course of treatment. Before treatment, 3 months after treatment, 3 months after stopping the treatment, the patients in the two groups were treated. The changes of the degree of dysmenorrhea, clinical symptoms, recurrence rate, pregnancy rate, CA125 level and hemorheology index were analyzed by statistical method. Results: clinical efficacy: the recurrence rate of the treatment group and the control group were 16.7g / 13.3, respectively, and there was no significant difference between the two groups (P0.05), the symptoms of dysmenorrhea in the two groups were significantly improved (P0.01D), but there was no significant difference between the two groups (P0.05A), the patients in the two groups had dysmenorrhea, pelvic pain, pelvic pain, and no significant difference between the two groups in the treatment of dysmenorrhea and pelvic pain. Intercourse pain, There was no significant difference in the improvement of clinical symptoms of anus drop pain. The serum CA125 and hemorheological indexes of the treatment group and the control group were significantly decreased after treatment, but there was no significant difference between the two groups. Safety observation: the treatment group in the treatment process. There were no obvious adverse reactions and side effects. In the control group, the probability of liver function damage was 20 / 15, and the probability of vaginal dryness and irregular vaginal bleeding was 46.7 / 15. Conclusion: the method of tonifying kidney and regulating Zhou and removing blood stasis can effectively prevent the recurrence of chocolate cyst patients after operation. It can alleviate clinical symptoms such as dysmenorrhea and increase pregnancy rate. It can significantly reduce serum CA125 level and blood viscosity without obvious adverse reactions and side effects.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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