温针灸为主治疗肾阳虚型排卵障碍的临床疗效观察

发布时间：2018-05-31 18:50

本文选题：温针灸 + 耳穴埋籽　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：以温针灸为主治疗肾阳虚型排卵障碍,探讨温针灸为主的综合疗法对排卵障碍的作用机制,为以温针灸为主的综合疗法治疗排卵障碍提供更有力的指导。方法：本临床观察中的60例排卵障碍的患者均来自于南京中医药大学第一附属医院江苏省中医院生殖医学科及针灸康复科的门诊患者,按照患者就诊先后顺序纳入后进行编号,随机分为两组：温针灸为主即温针灸加耳穴埋籽联合中药组(治疗组)和中药组(对照组),每组各30例,疗程为3个周期(该周期为患者的月经周期)。通过对月经情况中医临床症状积分、基础体温、B超监测卵泡这三项指标,对比两组治疗前后各项指标的变化以及综合疗效的评价,并进行统计学分析。结果：①综合疗效的对比：治疗组总有效率90.0%；对照组总有效率76.7%。两组对比(P0.05),差异没有统计学意义,说明两组疗效相当。②卵泡排出率的变化：两组患者所有促排周期中治疗组排卵率达52.38%,对照组排卵率36.05%,两组比较P0.05,治疗组更能促进卵泡排出。③妊娠情况比较：治疗组妊娠4例,对照组妊娠2例,P值0.05,差异没有统计学意义,说明两组疗效相当。④优势卵泡发育情况的比较：两组内治疗前后比较(P0.05),两组均能促进卵泡发育。治疗后两组间临床积分比较(P0.05),差异具有统计学意义,治疗组在促进卵泡发育方面组明显好于对照组。⑤基础体温变化的比较：两组治疗前后比较(P0.05),差异具有统计学意义,治疗组与对照组都改善患者基础体温。治疗后两组间比较(P0.05),差异没有统计学意义,说明两组疗效相当。⑥月经情况中医临床症状积分变化的比较：两组内治疗前后比较(P0.05),两组均能改善患者月经情况。治疗后两组间临床积分比较(P0.05),差异具有统计学意义,治疗组在改善月经情况方面组明显好于对照组。结论：两组治疗方法在排卵障碍疾病上均得到了较为肯定的疗效,都能改善患者月经情况,提高患者基础体温的双相率,促使卵泡生长、发育、成熟,使卵泡顺利排出。其中,治疗组(温针灸加耳穴埋籽联合中药组)虽然在综合疗效上与对照组没有显著差异,但在促使卵泡生长发育,提高卵泡排出率,改善患者月经临床症状方面,其疗效较单纯中药组有一定的优势。该方法体现了温针灸加耳穴埋籽联合中药的综合疗法的特色,疗效上得到肯定,避免了西药的副作用及并发症,特别是在调节自身机体功能方面有独特的优势,可以在今后多应用到临床上。
[Abstract]:Objective: to treat ovulation disorder of kidney-yang deficiency type by warming acupuncture and moxibustion, to explore the mechanism of warming acupuncture and moxibustion combined therapy on ovulation disorder, and to provide more effective guidance for the treatment of ovulation disorder with warming acupuncture and moxibustion. Methods: the 60 patients with ovulation disorder in this clinical observation were all from the outpatients of Department of Reproductive Medicine and Department of Acupuncture and Rehabilitation of Jiangsu Provincial Hospital of traditional Chinese Medicine, first affiliated Hospital of Nanjing University of traditional Chinese Medicine. They were randomly divided into two groups: warming acupuncture and moxibustion plus ear point embedding seed combined with Chinese medicine group (treatment group) and traditional Chinese medicine group (control group, 30 cases in each group). The course of treatment was 3 cycles (this period was the menstrual cycle of patients). The clinical symptoms of menstruation, basic body temperature and B ultrasound monitoring follicle were compared between the two groups before and after treatment and comprehensive evaluation of curative effect, and statistical analysis was carried out. Results: the total effective rate was 90.0 in the treatment group and 76. 7 in the control group. The difference between the two groups was not statistically significant. The results showed that the rate of ovulation in treatment group and control group were 52.38 and 36.05, respectively. Compared with P0.05, the ovulation rate of treatment group was better than that of control group (P0.05). In the treatment group, 4 cases were pregnant, There was no significant difference in P value of 2 cases in the control group (P 0.05), which indicated that the effect of the two groups was equivalent to the comparison of the development of dominant follicles in the two groups: compared before and after treatment in the two groups, both groups could promote follicle development. After treatment, the clinical scores of the two groups were significantly higher than that of the control group in promoting follicle development (P 0.05), and the difference between the two groups before and after treatment was statistically significant, compared with that of the control group (P 0.05). Both the treatment group and the control group improved the basic body temperature. There was no significant difference between the two groups after treatment, indicating that the curative effect of the two groups was equivalent to that of traditional Chinese medicine (TCM) clinical symptom integral change: the comparison between the two groups before and after treatment could improve the menstrual status of the patients. The difference between the two groups was statistically significant. The treatment group was better than the control group in improving menstruation. Conclusion: both of the two treatments can improve menstruation, increase the biphasic rate of basic body temperature, promote follicle growth, development, maturation and smooth discharge of follicles. Among them, the treatment group (warm acupuncture and moxibustion plus ear point seed burying combined with Chinese medicine group) has no significant difference from the control group in the comprehensive curative effect, but in promoting follicular growth and development, increasing follicular excretion rate, and improving the clinical symptoms of menstruation of the patients, The curative effect is better than the traditional Chinese medicine group. This method embodies the characteristics of the combined therapy of warming acupuncture and acupuncture plus embedding seeds at auricular points combined with traditional Chinese medicine. The curative effect is confirmed, and the side effects and complications of western medicine are avoided, especially the unique advantages in regulating the function of the body. It can be applied to clinic in the future.
【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】：2016
【分类号】：R246.3

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