痛经方治疗原发性痛经临床疗效及对前列环素、血栓素的影响

发布时间：2018-05-12 10:47

本文选题：痛经方 + 原发性痛经　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:通过观察痛经方治疗脾肾两虚型原发性痛经的痛经改善情况、症状积分变化情况等来探讨其临床疗效;通过检测血栓素(TXB2)和前列环素(6-Keto-PGF1α)含量,探讨痛经方治疗原发性痛经的疗效机制。方法:收集2016年1月至2017年1月在江苏省中医院妇科门诊就诊的脾肾两虚型原发性痛经患者60例,随机分为治疗组和对照组各30例。治疗组:经期前两天至经期结束痛经方汤剂,200ml,口服,1剂/日,早晚分服;非经期健脾补肾汤剂,200ml,口服,1剂/日,早晚分服。对照组:经期前两天至经期结束服用痛经宝颗粒剂,1袋/次,2次/日,温开水冲服;非经期治疗同上。3个月经周期为一个疗程,观察1个疗程。观察治疗前后两组患者痛经改善情况、症状积分变化及血浆TXB2和6-keto-PGF1α含量,采用SPSS21.0软件,进行数据处理,统计分析结果。结果:1.痛经疗效:治疗组痊愈13例,显效10例,有效5例,无效2例,总有效率为93.3%;对照组痊愈5例,显效7例,有效11例,无效7例,总有效率为76.7%,治疗组疗效优于对照组(PO.O5)。2.中医证候疗效:治疗组痊愈10例,显效12例,有效6例,无效2例,总有效率为93.3%;对照组痊愈4例,显效7例,有效11例,无效8例,总有效率为73.3%,治疗组优于对照组(P0.05)。3.各个症状改善情况:治疗组优于对照组P0.05,其中在改善月经量、色质,畏寒肢冷、腰膝酸软方面治疗组显著优于对照组。4.综合疗效:治疗组痊愈3例,显效10例,有效15例,无效2例,总有效率为93.3%;对照组痊愈2例,显效6例,有效10例,无效12例,总有效率为60.0%,治疗组优于对照组(P0.05)。5.TXB2值比较:治疗组治疗后明显低于治疗前(P0.05);对照组治疗前后无明显变化(PO.O5);两组组间比较治疗组TXB2值降低明显优于对照组(P0.05)6.6-keto-PGF1α值比较:治疗组治疗后高于治疗前(P0.05);对照组治疗前后无明显变化(P0.05);两组组间比较治疗组6-keto-PGF1α值升高优于对照组(P0.05)。7.TXB2/6-keto-PGF1α值比较:治疗组明显低于对照组(P0.05)。8.安全性指标:通过观察血常规、肝肾功能(ALT、AST、BUN、Scr)、心电图两组均未发现有异常。结论:痛经方治疗原发性痛经的临床疗效确切,不仅能缓解痛经症状,还能明显改善全身症状,综合临床疗效达93.3%,且安全无毒副作用;痛经方的疗效机制可能与升高血浆6-keto-PGF1α的水平,降低TXB2的水平及TXB2/6-keto-PGF1α的比值,改善胞宫微血管舒缩状态有关。
[Abstract]:Objective: to investigate the clinical efficacy of Tongjing recipe in the treatment of primary dysmenorrhea with deficiency of spleen and kidney, and to detect the contents of TXB2 and 6-Keto-PGF 1 伪. To explore the therapeutic mechanism of Tongjing prescription in treating primary dysmenorrhea. Methods: from January 2016 to January 2017, 60 patients with primary dysmenorrhea with deficiency of spleen and kidney were randomly divided into treatment group (n = 30) and control group (n = 30). Treatment group: two days before the menstrual period to the end of menstrual period Tongjing decoction 200 ml, oral 1 dose / day, morning and evening, divided; non-menstrual period tonifying kidney decoction 200 ml, orally take 1 dose / day, morning and evening. Control group: 2 days before the menstrual period to the end of menstrual period taking Tongjingbao granule 1 bag / twice a day, warm boiled water, unmenstrual period treatment is equal. 3 menstrual cycle as a course of treatment, observe a course of treatment. The improvement of dysmenorrhea, the change of symptom score and the contents of TXB2 and 6-keto-PGF1 伪 in plasma were observed before and after treatment. The data were processed by SPSS21.0 software, and the results were analyzed statistically. The result is 1: 1. The curative effect of dysmenorrhea: in the treatment group, 13 cases were cured, 10 cases were effective, 5 cases were effective, 2 cases were ineffective, the total effective rate was 93.33.In the control group, 5 cases were cured, 7 cases were effective, 11 cases were effective, 7 cases were ineffective, and the total effective rate was 76.70.The curative effect of the treatment group was better than that of the control group (P < 0.05). The curative effect of TCM syndromes: in the treatment group, 10 cases were cured, 12 cases were effective, 6 cases were effective, 2 cases were ineffective, the total effective rate was 93.3.The treatment group was superior to the control group (P 0.05g 路3), while the control group was cured in 4 cases, markedly effective in 7 cases, effective in 11 cases, ineffective in 8 cases, and the total effective rate was 73.3%. The improvement of symptoms: the treatment group was better than the control group (P0.05), especially in improving menstrual volume, color, cold limbs, waist and knee sore and soft, the treatment group was significantly better than the control group. 4. In the treatment group, 3 cases were cured, 10 cases were effective, 15 cases were effective, 2 cases were ineffective, and the total effective rate was 93.33.In the control group, 2 cases were cured, 6 cases were effective, 10 cases were effective, 12 cases were ineffective. The total effective rate was 60. 0. The treatment group was superior to the control group (P 0. 05). 5. TXB2: after treatment, the treatment group was significantly lower than that before and after treatment (P 0. 05); the control group had no significant change before and after treatment; the TXB2 value of the treatment group was significantly lower than that of the control group (P 0. 05 and P 0. 05 keto-PGF 1 伪) before and after treatment. After treatment, the 6-keto-PGF1 伪 in the treatment group was higher than that in the control group (P 0.05), and no significant change was found in the control group before and after treatment, and the increase of 6-keto-PGF1 伪 in the treatment group was better than that in the control group (P 0.05) .7.TXB _ 2 / 6-keto-PGF _ 1 伪: the treatment group was significantly lower than the control group (P 0.05). Safety index: according to blood routine examination, liver and kidney function were not abnormal in both groups. Conclusion: Tongjing prescription is effective in treating primary dysmenorrhea. It can not only relieve dysmenorrhea symptoms, but also improve systemic symptoms. The therapeutic mechanism of Tongjing recipe may be related to increasing the level of plasma 6-keto-PGF1 伪, decreasing the level of TXB2 and the ratio of TXB2/6-keto-PGF1 伪, and improving the state of vasomotor and contraction of microvessels in the uterus.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.113

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