更年汤配合心理疏导治疗围绝经期综合征肾虚肝郁证的临床观察

发布时间：2018-03-28 06:25

本文选题：中医　切入点：围绝经期综合征　出处：《湖南中医药大学》2016年硕士论文

【摘要】：[目的]观察更年汤配合心理疏导治疗围绝经期综合征肾虚肝郁证的临床疗效,为临床应用提供依据。[资料和方法]本研究在湖南中医药大学第一附属医院门诊展开。病例采集时间:2014年6月1日-2015年3月1日,纳入60例符合观察条件的围绝经期综合征肾虚肝郁证的患者。使用随机、阳性药物平行对照设计方法,受试者随机分为治疗者和对照组各30例。治疗前,两组患者的年龄、病程比较无明显差异。治疗组予以更年汤配合心理疏导,对照组予以坤泰胶囊配合心理疏导,共服用3个月经周期为完成本疗程。详细观察治疗组和对照组治疗前后的症状体征、中医证候积分、中医疗效积分,女性内分泌激素的改变并进行对比,密切观察患者用药过程中有无不良反应。[结果]治疗组临床痊愈4例,显效6例,有效16例,无效4例,总有效率86.6%;对照组临床痊愈2例,显效3例,有效15例,无效10例,总有效率66.7%,两组间疗效比较差异有统计学意义(P0.05)。两组病例、年龄相似,具有可比性;本方治疗后患者症状积分较治疗前下降,说明本方具有良好的治疗效果,对改善患者主证潮热汗出、次症急躁易怒、腰膝酸软、头晕耳鸣、失眠多梦的临床症状方面疗效显著,具有统计学意义(P0.05);病情轻重对疗效有关系,有统计学意义(P0.05);病程长短对疗效无影响,无统计学意义(P0.05);两组病例治疗前后FSH、LH、E2的比较,经统计学分析,无显著差异(P0.05),表面治疗组和对照组两组药物在治疗围绝经期综合征患者时,对FSH、LH、E2无显著影响。[结论]1.更年配合心理疏导疗法是治疗围绝经期综合征肾虚肝郁证的有效方法,能够改善临床症状,提高患者生活治疗。2.此次更年汤配合心理疏导疗法在治疗前和治疗后中医临床症状总积分、改良Kupperman量表评分及各项临床症状评分比较差异具有显著统计学意义。3.更年汤在治疗患者过程中未发现有任何不良反应和毒副作用,说明本方的实用价值,值得在临床中推广。
[Abstract]:[objective] to observe the clinical effect of Gannian decoction combined with psychological guidance in the treatment of kidney deficiency and liver depression syndrome in perimenopausal syndrome. This study was carried out in the outpatient clinic of the first affiliated Hospital of Hunan University of traditional Chinese Medicine. Case collection time: June 1, 2014-March 1, 2015, Sixty cases of peri-menopausal syndrome with kidney deficiency and liver depression were included. The subjects were randomly divided into two groups: 30 patients and 30 patients in the control group. There was no significant difference in the course of disease. The treatment group was given Gannian decoction with psychological guidance, and the control group was given Kuntai capsule with psychological guidance. Three menstrual cycles were taken to complete the course. The changes of symptoms and signs, TCM syndromes integral, TCM curative effect score, female endocrine hormones were observed and compared before and after treatment in the treatment group and the control group. [results] in the treatment group, 4 cases were cured, 6 cases were effective, 16 cases were effective, 4 cases were ineffective, and the total effective rate was 86.6 cases, while in the control group, 2 cases were cured, 3 cases were effective, 15 cases were effective, 10 cases were ineffective. The total effective rate was 66.7%, and the difference between the two groups was statistically significant (P 0.05). The patients in the two groups were of similar age and comparable. The symptom score of the patients after the treatment was lower than that of the patients before treatment, which indicated that it had a good therapeutic effect. It has a significant effect on improving the clinical symptoms of patients with main syndrome, such as hot tidal sweating, irritability and irritability, sore waist and soft knees, dizziness and tinnitus, insomnia and many dreams, and has statistical significance (P 0.05), and the severity of the disease is related to the curative effect. The course of disease had no effect on the curative effect, there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment. There was no significant difference between the two groups in the treatment of peri-menopausal syndrome. [conclusion] 1.Gannian combined with psychological dredging therapy is an effective method for the treatment of kidney deficiency and liver-depression syndrome in perimenopausal syndrome, and there is no significant difference between the two groups in the treatment of peri-menopausal syndrome patients with peri-menopausal syndrome. Can improve clinical symptoms, improve patients' life treatment .2.The total score of clinical symptoms of traditional Chinese medicine before and after treatment can be improved by Gannian decoction combined with psychological dredging therapy. There were significant differences in the scores of modified Kupperman scale and clinical symptoms. 3. Gannian decoction did not find any side effects and side effects in the course of treatment, which indicated the practical value of the prescription and was worth popularizing in clinic.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.116

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