针药结合治疗肾虚血瘀型排卵障碍性不孕促排效应的临床研究

发布时间：2018-03-16 20:21

本文选题：排卵障碍　切入点：肾虚血瘀型　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察针刺结合补肾活血汤与单纯内服补肾活血汤对排卵障碍性不孕症促排效应及妊娠结局的影响,为针灸治疗肾虚血瘀型排卵障碍性不孕症寻求更有效的方法。方法:将40例中医辨证为肾虚血瘀型的排卵障碍性患者按照随机对照的方法分为针药组(20例)和中药组(20例),针药组采用针刺结合内服补肾活血汤治疗,在月经周期第7天取关元、大赫、气穴、太溪、太冲、三阴交、足三里、合谷,隔日针刺1次,总计(13±2)次,并每日内服补肾活血汤,直至下次月经来潮;中药组不予针刺治疗,于月经周期第7天开始每日内服补肾活血汤治疗,直至下次月经来潮。共治疗3个月经周期。治疗后分析比较针药组和中药组的最大卵泡直径、排卵率、子宫内膜情况、妊娠率、中医症状积分及总体疗效方面的差异,同时比较两组治疗前后的最大卵泡直径、子宫内膜情况、中医症状积分方面的差异。结果:(1)针药组采用针刺结合内服补肾活血汤与中药组单纯内服补肾活血汤治疗后排卵率、子宫内膜情况、妊娠率、中医症状积分均较治疗前改善(P0.05);(2)针药组排卵率为68.3%,中药组排卵率为46.7%,两组对比差异有统计学意义(P0.05),针药组的排卵率优于中药组;(3)在第一个月经周期,两组最大卵泡直径比较无统计学差异(P0.05),在第二、三个月经周期,两组对比有统计学差异(P0.05),针药组的最大卵泡直径优于中药组;(4)子宫内膜情况与中医症状积分,两组比较有统计学差异(P0.05),针药组的疗效均优于中药组;(5)针药组妊娠率为40%,中医组妊娠率为10%,两组对比差异有统计意义(P0.05),针药组的妊娠率优于中药组;(6)针药组治疗后的总有效率为85%,中药组治疗后的总有效率为60%,两组疗效对比差异有统计学意义(P0.05),针药组的总体疗效高于中药组。结论:针刺结合补肾活血汤能有效、促进卵泡发育、提高排卵率、改善子宫内膜情况、进而提高肾虚血瘀型排卵障碍性不孕症患者的临床妊娠率。
[Abstract]:Objective: To observe the effect of acupuncture combined with Bushen Huoxue Decoction and simple oral Bushen Huoxue Decoction promoting effect effect and pregnancy outcome of anovulatory infertility, to seek more effective methods for acupuncture treatment of kidney deficiency and blood stasis of anovulatory infertility. Methods: 40 cases of patients with anovulatory syndrome of kidney deficiency and blood stasis type according to random control method the divided into acupuncture group (20 cases) and Chinese medicine group (20 cases), acupuncture group treated by acupuncture combined with oral Bushen Huoxue Decoction, Guanyuan, on the seventh day of menstrual cycle amnesty, cavitation, Taixi, Taichong, Sanyinjiao, foot three, Hegu acupuncture every other day for 1 times, a total of 13 (+ 2), and daily oral Bushen Huoxue Decoction, until the next menstrual cramps; traditional Chinese medicine group was given acupuncture treatment, daily oral Bushen Huoxue Decoction in treating menstrual cycle for seventh days, until the next menstrual cramps. The treatment lasted 3 months. After treatment by cycle analysis and comparison of needle The diameter of the largest follicle, medicine group and Chinese medicine group the ovulation rate, pregnancy rate, endometrium, differences in TCM symptom score and overall efficacy, and compared between the two groups before and after treatment the maximum follicular diameter, endometrial, differences in TCM symptom score. Results: (1) the acupuncture group received acupuncture combined with oral administration Bushen Huoxue Decoction and Chinese medicine group oral Bushen Huoxue Decoction in treating ovulation rate, pregnancy rate, endometrium, TCM symptom scores were better than those before treatment (P0.05); (2) the acupuncture group ovulation rate was 68.3%, the Chinese medicine group ovulation rate was 46.7%, the difference was statistically significant between the two groups (P0.05). The ovulation rate of acupuncture group is superior to the TCM group; (3) in the first menstrual cycle, the two groups had no significant difference in the diameter of the largest follicle (P0.05), in second, third of the menstrual cycle, compared the two groups had statistical difference (P0.05), acupuncture group the largest follicle diameter. In the traditional Chinese medicine group; (4) the endometrium and TCM symptom score, a significant difference between two groups (P0.05), the curative effect of acupuncture combined with medicine group were better than that of the traditional Chinese medicine group; (5) acupuncture group and TCM group the pregnancy rate was 40%, the pregnancy rate was 10%. There was statistical difference between the two groups (P0.05). The pregnancy rate of acupuncture group is superior to the TCM group; (6) the needle medicine group after treatment, the total efficiency of 85%, Chinese medicine group after treatment, the total effective rate was 60%, there was statistically significant difference in two groups (P0.05), the overall effect of acupuncture group was higher than that of the traditional Chinese medicine group. Conclusion: acupuncture combined with Bushen Huoxue Decoction can effectively promote the follicular development, ovulation rate, improve, improve the endometrial condition, thus improve the clinical blood stasis in patients with anovulatory infertility and pregnancy rate.

【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】：2016
【分类号】：R271.14

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