针药结合治疗阴虚湿热型围绝经期尿道综合征的临床观察

发布时间：2018-03-22 17:55

本文选题：围绝经期　切入点：尿道综合征　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过滋阴通淋汤配合针刺治疗围绝经期尿道综合征的临床观察,评价针药结合治疗围绝经期尿道综合征的确切疗效和安全性,探求围绝经期尿道综合征更为科学的治疗方案。方法:选取符合围绝经期尿道综合征纳入标准患者95例,按随机数字表法随机分为中药组32例,针刺组32例和针药结合组31例。中药组给予导师临床经验方滋阴通淋汤口服治疗;针刺组针刺中极穴、委中穴、肝俞穴、肾俞穴治疗;针药结合组采用针刺结合中药自拟方口服治疗;治疗时间均为3个月。观察治疗前后中医证候积分、国际下尿路症状评分、血清雌二醇、卵泡刺激素、黄体生成素,并对此进行分析,观察三组疗效。结果:1、国际下尿路症状评分疗效比较:中药组总有效率83.87%,针刺组总有效率76.67%,针药结合组总有效率93.55%。三组疗效比较,中药组和针刺组疗效无明显差异(P0.017),而针药结合组疗效明显优于中药组和针刺组(P0.017)。2、中医症状积分疗效比较:中药组总有效率77.42%,针刺组总有效率73.33%,针药结合组总有效率90.32%。三组疗效比较,中药组和针刺组疗效无明显差异(P0.017),针药结合组疗效明显优于中药组和针刺组(P0.017)。3、国际下尿路症状评分比较:三组治疗后国际下尿路症状评分较治疗前均下降,差异有显著统计学意义(P0.01);治疗后国际下尿路症状评分组间比较,中药组和针刺组在改善国际下尿路症状方面无明显差异(P0.05),针药结合组在改善国际下尿路症状方面优于中药组及针刺组(P0.05)。4、中医症状积分比较:三组治疗后中医症状积分较治疗前均下降,差异有显著统计学意义(P0.01);治疗后中医症状积分组间比较,中药组和针刺组在改善中医症状方面无明显差异(P0.05),针药结合组在改善中医症状方面优于中药组及针刺组(P0.05)。5、激素水平改善情况比较:卵泡刺激素水平比较:三组治疗后卵泡刺激素水平较疗前均下降,中药组、针刺组治疗前后比较无明显差异(P0.05),针药结合组治疗前后比较差异有统计学意义(P0.05);治疗后组间比较,中药组与针刺组无明显差异(P0.05),针药结合组优于中药组、针刺组(P0.05)。血清雌二醇水平比较:三组治疗后血清雌二醇水平较疗前均上升,中药组、针刺组治疗前后比较无明显差异(P0.05),针药结合组治疗前后比较差异有统计学意义(P0.05);治疗后组间比较,中药组与针刺组无明显差异(P0.05),针药结合组优于中药组、针刺组(P0.05)。黄体生成素水平比较:三组治疗前后比较均无明显差异(P0.05);治疗后组间比较,三组间无明显差异(P0.05)。结论:中药组、针刺组、针药结合组治疗围绝经期尿道综合征皆有疗效。其中针药结合组治疗围绝经期尿道综合征疗效显著,且明显优于中药组及针刺组,临床疗效确切,安全性好,是治疗围绝经期尿道综合征的较好方法之一。
[Abstract]:Objective: through Ziyin Tonglin Decoction Combined with clinical observation of menopausal urethral syndrome treated with acupuncture, acupuncture combined with evaluation of the treatment of perimenopausal urethral the exact efficacy and safety of perimenopausal syndrome, explore the urethral syndrome more scientific treatment. Methods: with menopause urethral syndrome encircled the inclusion criteria of 95 cases of patients. Randomly divided into treatment group of 32 cases, 32 cases in the acupuncture group and acupuncture group of 31 cases. The TCM group was given mentor clinical experience Ziyin Tonglin Decoction oral treatment; Acupuncture Acupuncture in acupoints Weizhong, Ganshu acupuncture point, Shenshu acupoint therapy; acupuncture combined with medicine group were treated with acupuncture combination of Chinese herbal medicine decoction oral treatment; the treatment time was 3 months. Before and after treatment of TCM syndrome integral, the lower urinary tract symptom score, serum estradiol, follicle stimulating hormone, luteinizing hormone, and conduct analysis, observation of three groups Effect. Results: 1, international comparison of lower urinary tract symptom score: the treatment group curative effect the total efficiency of 83.87%, total effective rate in the acupuncture group 76.67%, acupuncture medicine group total efficiency 93.55%. comparison of the three groups had no significant difference, the Chinese medicine group and acupuncture group (P0.017), and the curative effect of combined acupuncture and medicine group curative effect is obviously superior to traditional Chinese medicine group and acupuncture group (P0.017.2), TCM symptom efficacy: Chinese medicine group total effective rate was 77.42%, total effective rate in the acupuncture group 73.33%, acupuncture medicine group total efficiency 90.32%. comparison of the three groups had no significant difference, the Chinese medicine group and acupuncture group (P0.017), the curative effect of combined acupuncture and medicine group was better than the traditional Chinese medicine group and the acupuncture group (P0.017.3), the international comparison of lower urinary tract symptoms score: three groups after treatment the lower urinary tract symptoms score before treatment were decreased, the difference was statistically significant (P0.01); after treatment the lower urinary tract symptoms score between the two groups, Chinese medicine group and acupuncture group in change No significant difference between the good international lower urinary tract symptoms (P0.05), to improve the international lower urinary tract symptoms is better than that of the traditional Chinese medicine group and acupuncture group, acupuncture combined with medicine group (P0.05.4), comparison of TCM symptom score: three groups after treatment of TCM symptom score before treatment were decreased, there was significant difference in statistical significance (P0.01); after the treatment of TCM symptom scores between the two groups, Chinese medicine group and acupuncture group in improving TCM symptoms had no significant difference (P0.05), acupuncture combined with medicine group in improving TCM symptoms than the traditional Chinese medicine group and acupuncture group (P0.05.5), compare the hormone level to improve the situation: FSH level comparison: three groups after treatment FSH levels were decreased compared with before treatment, traditional Chinese medicine group, acupuncture group before and after treatment had no significant difference (P0.05), acupuncture medicine group before and after treatment, the difference was statistically significant (P0.05); the treatment group compared with traditional Chinese medicine group and the acupuncture group had no significant difference (P0 .05), acupuncture medicine group is better than the traditional Chinese medicine group, acupuncture group (P0.05). The serum estradiol level: serum estradiol levels were increased compared with before treatment, after treatment of the three groups of Chinese medicine group, acupuncture group before and after treatment had no significant difference (P0.05), acupuncture medicine group before and after treatment, the difference was statistically significant (P0.05); comparison between groups after treatment, Chinese medicine group and the acupuncture group had no significant difference (P0.05), acupuncture medicine group is better than the traditional Chinese medicine group, acupuncture group (P0.05). Comparison of luteinizing hormone levels: the three groups before and after treatment showed no significant difference (P0.05); comparison between groups after treatment, no significant difference between the three groups (P0.05). Conclusion: the traditional Chinese medicine group, acupuncture group, peri menopausal urethral syndrome has the curative effect of combined acupuncture and medicine treatment. Acupuncture combined with medicine group treatment of perimenopausal urethral syndrome is effective, and is superior to the traditional Chinese medicine group and acupuncture group, clinical curative effect, good safety, is the treatment of perimenopause One of the better methods of urethral syndrome.

【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

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