补肾活血汤治疗人流术后肾虚血瘀型月经过少的临床研究

发布时间：2018-05-05 17:14

本文选题：人流术后 + 月经过少　；参考：《福建中医药大学》2016年硕士论文

【摘要】：目的：分析补肾活血汤对改善患者临床症状,增加经量、行经时间、子宫内膜厚度,改善子宫螺旋动脉血流方面的作用；客观评价补肾活血汤治疗人流术后肾虚血瘀型月经过少的临床疗效。方法：收集符合纳入标准的人流术后肾虚血瘀型月经过少的患者共60例,随机分为采用补肾活血汤治疗的治疗组；戊酸雌二醇、黄体酮胶囊序贯治疗的对照组,每组各30例。观察比较治疗前后两组患者经量、行经时间、子宫内膜厚度、子宫螺旋动脉血流参数、中医证候积分的差异；比较两组中医证候疗效及综合疗效的差异。结果：1.经量的比较：两组治疗前后月经失血图积分比较,差异有统计学意义(P0.05)；治疗后两组月经失血图积分组间比较,差异有统计学意义(P0.05),说明两组治疗后均可增加经量,治疗组优于对照组。2.行经时间的比较：两组行经时间治疗前后比较,差异有统计学意义(P0.05)；治疗后两组行经时间组间比较,差异有统计学意义(P0.05),说明两组治疗后均可延长行经时间,治疗组优于对照组。3.子宫内膜厚度的比较：两组治疗前后子宫内膜厚度比较,差异有统计学意义(P0.05)；治疗后两组子宫内膜厚度组间比较,差异无统计学意义(P0.05),说明两组治疗后均可增加患者子宫内膜厚度,作用无差异。4.子宫螺旋动脉血流参数的比较：两组治疗前后子宫螺旋动脉S/D、阻力指数、搏动指数比较,差异均有统计学意义(P0.05)；治疗后两组子宫螺旋动脉S/D、阻力指数、搏动指数组间比较,差异均有统计学意义(P0.05),说明治疗后两组的子宫螺旋动脉血流均得到改善,治疗组优于对照组。5.中医证候积分的比较：两组治疗前后中医证候积分比较,差异有统计学意义(P0.05)；治疗后两组中医证候积分组间比较,差异有统计学意义(P0.05),说明两组治疗后均可改善患者临床症状,治疗组优于对照组。6.中医证候疗效的比较：治疗组中医证候总有效率为96.67%；对照组中医证候总有效率为83.33%。两组中医证候疗效比较,差异有统计学意义(P0.05)。说明治疗组中医证候疗效优于对照组。7.综合疗效比较：治疗组综合疗效总有效率为96.7%,对照组综合疗效总有效率为83.33%,两组综合疗效比较,差异有统计学意义(P0.05)。说明治疗组综合疗效优于对照组。结论：运用补肾活血汤治疗人流术后肾虚血瘀型月经过少,在增加子宫内膜厚度方面与对照组(戊酸雌二醇+黄体酮胶囊)治疗疗效相当；但在改善临床症状、增加经量、延长经期、改善子宫螺旋动脉血流方面,优于对照组(戊酸雌二醇+黄体酮胶囊)治疗；显示了中医药治疗本病的优越性,为中医辨证治疗本病提供客观依据。
[Abstract]:Objective: to analyze the effect of Bushen Huoxue decoction on improving clinical symptoms, increasing menstrual volume, menstrual time, endometrial thickness and improving the blood flow of uterine spiral artery. Objective to evaluate the clinical efficacy of Bushen Huoxue decoction (BUST) in the treatment of deficiency of kidney and blood stasis type of menstruation. Methods: a total of 60 patients with insufficient menstruation of kidney deficiency and blood stasis type were collected and randomly divided into treatment group treated with Bushen Huoxue decoction and control group treated with estradiol valerate and progesterone capsules. To observe and compare the difference between the two groups before and after treatment in terms of menstrual volume, menstrual time, endometrial thickness, uterine spiral artery blood flow parameters, TCM syndromes integral, and compare the curative effect and comprehensive curative effect of TCM syndromes between the two groups. The result is 1: 1. Comparison of the two groups before and after treatment, the difference was statistically significant (P 0.05); after treatment, the difference was statistically significant (P 0.05), indicating that both groups could increase the menstrual volume after treatment. The treatment group was superior to the control group. Comparison of menstrual time: there was a significant difference between the two groups before and after treatment, and the difference between the two groups after treatment was statistically significant (P 0.05), indicating that the menstrual time of the two groups could be prolonged after treatment. The treatment group was superior to the control group. Comparison of endometrial thickness: there was significant difference in endometrial thickness between the two groups before and after treatment (P 0.05). The difference was not statistically significant (P 0.05), indicating that both groups could increase the endometrial thickness after treatment. Comparison of blood flow parameters of uterine spiral artery: there were statistically significant differences in uterine spiral artery S / D, resistance index and pulsatile index between the two groups before and after treatment, and there were significant differences between the two groups before and after treatment (P < 0.05); after treatment, there was a comparison between the two groups of uterine spiral artery S / D, resistance index and pulsatile index. The difference was statistically significant (P 0.05), indicating that the uterine spiral artery blood flow of the two groups were improved after treatment, and the treatment group was better than the control group. 5. Comparison of TCM syndromes integral: the difference between the two groups before and after treatment was statistically significant (P 0.05); after treatment, the difference was statistically significant between the two groups, indicating that the two groups could improve the clinical symptoms of the patients after treatment. The treatment group was superior to the control group. Comparison of TCM syndrome efficacy: the total effective rate of TCM syndrome in the treatment group was 96.677.The total effective rate of TCM syndrome in the control group was 83.33. The difference between the two groups was statistically significant (P 0.05). It shows that the therapeutic effect of TCM syndrome in the treatment group is better than that in the control group. Comprehensive curative effect comparison: the total effective rate of comprehensive curative effect in the treatment group was 96.77.The total effective rate in the control group was 83.33.The difference between the two groups was statistically significant (P 0.05). The comprehensive curative effect of the treatment group was better than that of the control group. Conclusion: the application of Bushen Huoxue decoction in the treatment of excessive menstruation due to deficiency of kidney and blood stasis after abortion is comparable to that of control group (estradiol valerate progesterone capsule) in increasing the thickness of endometrium, but it can improve the clinical symptoms and increase the amount of menstruation. Prolonging menstrual period and improving uterine spiral artery blood flow were superior to control group (estradiol valerate progesterone capsule), which showed the superiority of traditional Chinese medicine in treating this disease and provided objective basis for TCM syndrome differentiation treatment.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.111

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