舒盆汤治疗湿热瘀阻型慢性盆腔痛的临床观察

发布时间：2018-03-16 12:05

本文选题：慢性盆腔痛　切入点：舒盆汤　出处：《广西中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本课题采用舒盆汤保留灌肠的方法治疗湿热瘀阻型慢性盆腔痛,通过统计分析,比较治疗前、治疗后及停药后1月盆腔疼痛VAS评分、中医证候积分,观察患者盆腔疼痛程度及临床症状改善情况,科学评价其临床疗效,并探讨其作用机制,为慢性盆腔痛患者提供更为有效的医疗举措,造福于众多患者,推进中医药在临床的推广及应用。方法:本课题选取符合纳入标准的65例慢性盆腔痛患者,中医辨证为湿热瘀阻型,将其随机分为治疗组与对照组,治疗组33例,对照组32例。治疗过程中,因各种因素共有4例病例中途中止治疗,治疗组2例,对照组2例,实际治疗组完成31例研究病例,对照组完成30例研究病例。治疗组给予舒盆汤保留灌肠治疗,对照组用红藤汤保留灌肠治疗,两组均在月经干净后3天开始灌肠,每日1次,经前1周至经期停用,10天为1个疗程,连用3个疗程。观察治疗后及停药后1月,比较两组病例的盆腔疼痛VAS评分及中医证候的变化。于治疗前后行血、尿、粪常规、肝肾功能及心电图等检查以作安全性评价,观察并及时记录不良反应。用SPSS17.0统计软件分析数据。所有病例均来源于广西中医药大学附属瑞康医院(国家三级甲等医院)妇科门诊。结果:1两组患者在年龄、病程、生育情况、盆腔疼痛VAS评分和中医证候积分差异无统计学意义(P0.05),具有可比性。2舒盆汤保留灌肠治疗组总有效率达96.77%,红藤汤保留灌肠对照组总有效率达93.33%,两组总有效率相当,但疗效分级比较差异有统计学意义(P0.05)。3两组治疗后盆腔疼痛VAS评分均较治疗前下降,组内自身前后比较,差异有统计学意义(P0.05);两组组内分别进行治疗后与停药后1月的盆腔疼痛VAS评分比较,差异无统计学意义(P0.05);两组组间分别进行治疗后、停药后1月的盆腔疼痛VAS评分比较,差异有统计学意义(P0.05)。4两组治疗后中医证候积分均较治疗前下降,组内自身前后比较,差异有统计学意义(P0.05);两组组内分别进行治疗后与停药后1月的盆中医证候积分比较,差异无统计学意义(P0.05);两组组间分别进行治疗后、停药后1月的中医证候积分比较,差异有统计学意义(P0.05)。两组患者在临床治疗中及治疗后均未出现明显不良反应,血、尿、粪便常规、肝肾功能及心电图等安全性指标检查结果显示均未见异常。结论:1舒盆汤保留灌肠能减轻湿热瘀阻型慢性盆腔痛患者的盆腔疼痛程度,降低中医证候积分,改善临床症状,提高生活质量,是治疗慢性盆腔痛的有效方法之一。2中药保留灌肠局部给药浓度高,能提高药物的生物利用率,无明显毒副作用,且操作简便,患者易于坚持,疗效显著,值得临床推广。
[Abstract]:Objective: to treat chronic pelvic pain of dampness and heat stasis type by reserving enema with Shupan decoction. Through statistical analysis, the VAS score and TCM syndromes score of pelvic pain were compared before, after treatment and after drug withdrawal on January. To observe the degree of pelvic pain and the improvement of clinical symptoms, to evaluate the clinical efficacy scientifically, and to explore the mechanism of its action, to provide more effective medical measures for patients with chronic pelvic pain, and to benefit many patients. Methods: 65 patients with chronic pelvic pain were selected and divided into treatment group (n = 33) and control group (n = 33). In the course of treatment, there were 4 cases who stopped treatment, 2 cases in the treatment group, 2 cases in the control group, 31 cases in the actual treatment group. The treatment group was treated with Shupan decoction and the control group was treated with Hongteng decoction. The two groups began enema 3 days after menstruation, once a day. During the first week to menstrual period, 10 days were used as a course of treatment, followed by 3 courses of treatment. The VAS score of pelvic pain and the changes of TCM syndromes were compared between the two groups after treatment and on January. Routine blood, urine and feces were performed before and after treatment. Liver and kidney function and electrocardiogram were examined for safety evaluation. Adverse reactions were observed and recorded in time. Data were analyzed by SPSS17.0 software. All cases were from gynecological outpatient department of Ruikang Hospital (National Grade 3A Hospital) affiliated to Guangxi University of traditional Chinese Medicine. Results two groups of patients were in age and course of disease. There was no significant difference in the VAS score of pelvic pain and the score of TCM syndromes. There was no significant difference between the two groups. 2 the total effective rate of Shupan decoction retention enema treatment group was 96.77777.The total effective rate of Hongteng decoction retention enema control group was 93.33. The total effective rate of the two groups was similar. However, there was significant difference in the grade of curative effect between the two groups. The VAS scores of pelvic pain in the two groups were lower than those before and after treatment, and there was a significant difference between the two groups before and after the treatment. There was no significant difference in the VAS scores of pelvic pain between the two groups after treatment and January after drug withdrawal. The VAS scores of pelvic pain were compared between the two groups after treatment and January after withdrawal. The difference was statistically significant (P 0.05). 4 after treatment, the scores of TCM syndromes in the two groups were all decreased compared with those before and after treatment, and the differences were statistically significant before and after treatment in the two groups. There was no significant difference between the two groups after treatment, the difference was statistically significant between the two groups on January after the treatment, the difference was statistically significant (P 0.05). There were no significant adverse reactions, blood and urine in the two groups during and after the treatment. The results of routine stool examination, liver and kidney function and electrocardiogram showed that there was no abnormality. Conclusion the retention enema of 1% Shupan decoction can alleviate the degree of pelvic pain and reduce the integral of TCM syndrome in the patients with damp-heat stasis type chronic pelvic pain. Improving clinical symptoms and quality of life is one of the effective methods for the treatment of chronic pelvic pain. 2. The traditional Chinese medicine retention enema has high local administration concentration, can improve the bioavailability of drugs, has no obvious side effects, and is easy to operate, and the patients are easy to adhere to. The curative effect is remarkable and worth popularizing clinically.
【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】：2017
【分类号】：R271.9

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