益气滋阴法治疗气阴两虚型经期延长病的作用及机制研究

发布时间：2018-03-26 09:10

本文选题：经期延长　切入点：异常子宫出血　出处：《北京中医药大学》2017年硕士论文

【摘要】：研究目的:经期延长病是妇科常见内分泌疾病,现代医学对于经期延长病无明确定义,且研究数据甚少;治疗方面激素用药及手术治疗患者接受率低,复发率高。本试验通过分析对比不同发病原因引起经期延长的两组患者,服用益气滋阴经验方前后受试者行经时间、性激素六项、中医证候积分变化,以及远期复发率回访,一方面为了提高经期延长患者生活质量,另一方面旨在探讨益气滋阴经验方治疗气阴两虚型经期延长病的作用及机制,总结导师治疗经期延长的临床经验,丰富临床对于经期延长的诊断及治疗思路,为经期延长的研究提供临床数据。研究方法:收集2015年9月至2016年8月来自我院妇科门诊,符合气阴两虚型经期延长病,具有正常月经周期,自愿加入本试验并签署知情同意书的患者36例,根据临床病因分为AUB.O(排卵障碍)组及AUB.E(子宫内膜局部异常)组,同时给予益气滋阴经验方治疗,从月经第5天开始服药,连续服用10天。以3个月经周期为1个疗程,治疗1个疗程。观察患者行经时间、性激素六项、中医症状量表的改变情况,停药3个月经周期后进行远期复发率电话回访。对收集到的临床数据用Excel进行录入、整合,建立数据,并用SPSS23统计软件进行数据分析。研究结果:①益气滋阴法可明显缩短AUB.O组患者的行经天数,AUB.O组中66.7%的患者治疗后月经经期恢复正常天数,对比AUB.E组中25.0%恢复正常行经天数的患者P＜0.05,有统计学意义;②益气滋阴法可提高两组患者血清孕酮水平,两组患者治疗前后P＜0.05,差异有统计学意义;③益气滋阴法对于全身气阴两虚症状有显著改善,治疗前后对比P＜0.05,但对于治疗脱发无明显效果P＞0.05,且两组间对比统计学差异P＞0.05;④在整个治疗周期中,尚未有患者发生不良事件;⑤3个月后,在恢复正常的17例患者中仅有1例患者复发。研究结论:①益气滋阴经验方可能通过调节下丘脑-垂体-卵巢轴,促进卵泡发育,增强黄体功能,从而增加血清孕酮水平,缩短由AUB.O引起的经期延长行经时间;②益气滋阴方间接验证了气阴两虚是经期延长病的常见证型之一,印证了"气、精"理论对于经期延长及全身气阴两虚症状治疗的可行性;③本试验验证了在卵泡期用药,可促进卵泡发育从而增强黄体功能的合理性。
[Abstract]:Objective: menstrual prolongation disease is a common endocrine disease in gynecology. There is no clear definition of menstrual prolongation disease in modern medicine. By analyzing and comparing the two groups of patients with prolonged menstrual period caused by different causes, the subjects' menstrual time, sex hormones, TCM syndromes and long term recurrence rate before and after taking Yiqi Ziyin experience prescription were analyzed and compared. On the one hand, in order to improve the quality of life of the patients with prolonged menstrual period, on the other hand, the purpose of the study was to explore the effect and mechanism of invigorating qi and nourishing yin experience prescription in the treatment of prolonged menstrual period disease of Qi and Yin deficiency, and summarize the clinical experience of tutor in treating prolonged menstr@@. To enrich the clinical diagnosis and treatment of menstrual prolongation, and to provide clinical data for the study of menstrual prolongation. Methods: from September 2015 to August 2016, gynecological outpatients of our hospital were collected, which were consistent with the prolonged menstrual period disease of deficiency of Qi and Yin. Thirty-six patients with normal menstrual cycle who volunteered to join the trial and sign informed consent were divided into two groups according to their clinical etiology: AUB.O group and AUB.E group, and were treated with Yiqi Ziyin experience prescription. Take medicine from the 5th day of menstruation, take it continuously for 10 days. Take 3 menstrual cycles as a course of treatment and treat for 1 course. Observe the patient's menstrual time, six items of sex hormone, the change of TCM symptom scale, After three menstrual cycles, the long term recurrence rate was returned by telephone. The collected clinical data were input, integrated and established with Excel. The statistical software of SPSS23 was used to analyze the data. The results showed that the menstrual period of 66.7% of the patients in the AUB.O group was significantly shorter than that in the AUB.O group, and the menstrual period returned to normal days in 66.7% of the patients in the AUB.O group. In AUB.E group, 25.0% of the patients returned to normal menstrual days (P < 0.05). There was a significant difference in serum progesterone level between the two groups with the method of tonifying qi and nourishing yin. Before and after treatment, there was a significant difference between the two groups (P < 0.05), and the difference was statistically significant (P < 0.05). The contrast before and after treatment was P < 0.05, but there was no significant effect on alopecia (P > 0.05), and there were no adverse events in the whole treatment cycle between the two groups (P > 0.05). Among the 17 patients who returned to normal, only one patient recurred. Conclusion the prescription may promote follicular development and enhance luteal function by regulating hypothalamus-pituitary-ovary axis, thus increasing serum progesterone level. Shortening the menstrual period and prolonging the menstrual period caused by AUB.O indirectly validates that deficiency of Qi and Yin is one of the common syndromes of prolonged menstrual period disease, which confirms "Qi, Qi, Qi and Qi," The feasibility of "essence" theory for prolonging menstrual period and treating the symptoms of deficiency of qi and yin in the whole body. 3. This experiment verifies the reasonableness of using drugs in follicular phase to promote follicular development and enhance luteal function.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.111

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