黄李平教授诊治月经病学术思想及临床研究

发布时间：2018-03-19 15:40

本文选题：黄李平教授　切入点：学术思想　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:黄李平教授是第五批全国名老中医,擅长于中医妇科疾病的治疗,对月经病的治疗具有丰富的临床经验和独特的见解,对中医后学者有非常大的帮助和指导意义。本课题拟通过收集整理黄李平教授治疗月经病的病案,归纳总结出黄李平教授诊治月经病的常用方剂、常用药物等,从中提炼出其治疗月经病的学术思想,并采用自身治疗前后对照方法,对黄李平教授的经验方"理平调经汤"治疗肝郁型月经先后无定期进行初步的临床研究,以评价其有效性及安全性,为黄李平教授治疗月经病的学术理论及经验方提供科学依据,以期为黄李平教授治疗月经病的学术思想及经验方的临床应用提供依据,同时为进一步更深入的学术理论研究提供依据。方法:首先,通过跟师临床实践,归纳、整理病案资料,系统总结出黄李平教授治疗月经病的学术思想及经验方;其次,采用非随机自身前后对照法,对"理平调经汤治疗肝郁型月经先后无定期"进行临床研究。选择2015年1月至2016年1月广西医科大学第一附属医院中医妇科门诊符合肝郁型月经先后无定期,经各项检查排除器质性病变(子宫肌瘤、子宫腺肌病、垂体肿瘤等)患者80例。予理平调经汤水煎剂(方药:柴胡10g,当归15g,白芍15g,郁金10g,泽兰15g,苍术10g,冤丝子30g,甘草6g)辨证加味:月经期加益母草、香附;月经后期加枸杞子、熟地或生地;月经间期加怀牛膝、枳壳;月经前期加肉苁蓉、淫羊藿。每日1剂,分2次水煎服。复诊时随证加减,连续用药3个月经周期;停药后随访3个月经周期。采用月经情况及中医证候评分表对理平调经汤治疗月经先后无定期进行临床观察,采用SPSS16.0建立数据库并进行统计学分析。研究结果:1.黄李平教授诊治月经病注重病证结合,因时制宜,突出中医整体辨证思路,崇尚经方;提出治经必治血,肝脾肾同治以肝为主,认为女子以血为用,以肝为先天,肝郁血虚是影响女子月经不调的关键病机;主张月经病从肝论治,治疗当以疏肝解郁,养血柔肝为主。2.临床研究结果:(1)本研究符合纳入标准患者80例。其中,完整接受治疗和随访患者共69例,脱落病例11例(因不能坚持服药退出者9例,妊娠退出者2例)。(2)69例受试者,痊愈18例,显效25例,有效14例,无效12例,总有效率为82.61%。(3)理平调经汤治疗前后月经情况积分比较,P0.05,差异有统计学意义;(4)治疗前后中医证候比较:经行腹痛,胸胁、乳房胀痛,嗳气食少,情志抑郁或烦躁易怒,善太息,治疗前后比较P0.05,差异有统计学意义;脉弦症状,治疗前后比较P0.05,差异无统计学意义。结论:1.理平调经汤治疗肝郁型月经先后无定期疗效显著,能够明显改善患者月经情况(月经周期、经量、经(质)色)及中医证候(肝郁证症候)。2.理平调经汤治疗肝郁型月经先后无定期有效且安全,这一初步的临床研究结果,为黄李平教授从肝论治月经病的学术思想及经验方的临床应用提供依据,同时为进一步更深入的研究提供依据。3.黄李平教授治疗月经病从肝论治的学术思想独特,经验方安全有效,可以应用于临床,并且具有更深入研究的价值。
[Abstract]:Objective: Professor Huang Liping is the fifth batch of the old Chinese medicine, treatment of gynecological diseases is good at traditional Chinese medicine, has rich clinical experience and unique insights into the treatment of menstrual disorders, there is a very big help and guidance for Chinese scholars. After this project intends to organize Huang professor Li Ping treatment of menstrual disorders by collecting medical records, summary summarize the prescriptions of Professor Huang Liping on the treatment of menstrual disorders, commonly used drugs, to refine the academic thought from the treatment of menstrual disorders, and self control method was used before and after the treatment, the experience of Professor Li Ping's flat by Huang Decoction "in the treatment of liver stagnation menstruation has no regular clinical study was performed to evaluate the preliminary. Effectiveness and safety, and provide scientific basis for academic theory and experience of Professor Huang Liping in the treatment of menstrual disorders, in order to clinical academic thoughts and experience of Professor Huang Liping in the treatment of menstrual disorders. Provide the basis for further application, and provide the basis for further academic research. Methods: first, with the division of clinical practice, induction, consolidation of medical records, the system summed up the academic thought and experience of Professor Huang Liping in the treatment of menstrual disorders; secondly, using non random self control method, has no regular clinical "study on the" Ping Tiaojing Decoction in the treatment of liver stagnation menstruation. The First Affiliated Hospital of Guangxi Medical University in January 2016 January 2015 to the gynecology clinic with liver stagnation has no regular menstruation, after the examination to exclude organic disease (uterine leiomyoma, adenomyosis, pituitary tumor) in 80 patients. To the management level of the decoction (decoction Bupleurum 10g, angelica 15g, Radix Paeoniae Alba 15g, Radix Curcumae 10g, Eupatorium 15g, Atractylodes 10g, Cuscuta 30g, licorice 6g) with syndrome differentiation: menstrual period and Herba Leonuri, Rhizoma Cyperi; menstruation plus medlar, or raw Rehmannia Menstrual interval; and Achyranthes, Fructus aurantii; premenstrual and Cistanche epimedium, 1. 2 times daily, Shuijianbi. Visit with syndrome, continuous medication for 3 menstrual cycles; follow-up after discontinuation of 3 menstrual cycles. The menstruation and the TCM syndrome score of clinical observation the level of decoction has no regular menstruation, using SPSS16.0 to establish a database and analyzed statistically. Results: 1. with Professor Huang Liping on the treatment of menstrual disease disease injection time, highlighting the whole Chinese dialectical thinking, advocating classics and classical prescription; put forward will cure the blood, spleen and kidney Tongzhi mainly in liver, that women with blood for use, the liver is the congenital deficiency is the key pathogenesis of stagnation of liver qi, affect female irregular menstruation; advocate on the treatment of menstrual disease from the liver, treatment with liver qi stagnation, nourishing blood and liver.2. clinical research results: (1) this study met the inclusion criteria of 80 patients. A total of 69 cases, treatment and follow-up of patients undergoing complete, off 11 cases (2 cases for medication adherence exit 9 cases, pregnancy quittters). (2) of 69 subjects, 18 cases were cured, 25 cases markedly effective, 14 cases effective, 12 cases ineffective, the total effective rate was 82.61%. (3) Li Ping Tiaojing decoction, menstruation score after treatment of P0.05, the difference was statistically significant; (4) comparison of TCM syndromes before and after treatment: the abdominal pain, chest, breast pain, belching less food, emotional depression or irritability, deep sigh, before and after treatment with P0.05, the difference was statistically significant; pulse string of symptoms before and after treatment with P0.05, the difference was not statistically significant. Conclusion: 1. flat Tiaojing Decoction in the treatment of liver stagnation has no regular menstruation curative effect, can significantly improve patients' menstruation (menstrual cycle, the amount of the (quality) color) and TCM syndrome (liver stagnation syndrome).2. flat Tiaojing Decoction the treatment of liver type has no fixed period Effective and safe, the preliminary clinical results, provide the basis for clinical application of Professor Huang Liping s academic thought and experience of treating the menstrual disease from the liver, while further research provides the basis for the.3. of Professor Huang Liping in treating menstrual disease from the liver to the unique academic thought, the experience can be safe and effective. In clinical application, and has a more in-depth study.

【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】：R249;R271.11

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