仙河更年颗粒治疗肾阳虚型绝经综合征临床研究

发布时间：2018-06-02 08:56

本文选题：仙河更年颗粒 + 肾阳虚　；参考：《山西中医学院》2016年硕士论文

【摘要】：目的:本研究旨在观察仙河更年颗粒治疗肾阳虚型绝经综合征的临床疗效及治疗前后性激素水平的变化,并对结果进行统计分析,为其临床应用提供客观依据。方法:依据随机双盲对照原则,选取符合绝经综合征(MPS)西医诊断标准及肾阳虚型证候诊断标准的患者60例,设仙河更年颗粒治疗组30例和右归饮颗粒对照组30例,每组连续给药4周。以Kuperman评分表与肾阳虚证候积分表作为疗效评价指标,观察两组患者治疗前后的疾病症状、证候评分,来研究自拟仙河更年颗粒治疗肾阳虚型绝经前后诸证的临床疗效及证候改善情况、治疗前后血E2、FSH、LH水平的改变情况。结果:1.疾病疗效:根据治疗前后Kupperman评分表总积分,仙河更年颗粒治疗组总有效率90.00%,右归饮颗粒对照组总有效率80.00%,两组比较总有效率有统计学差异(P㩳O.O5),仙河更年颗粒临床疗效的优于右归饮颗粒。2.中医证候疗效:根据治疗前后证候评分表,治疗组总有效率93.33%,对照组总有效率为83.33%。两组比较总有效率有统计学差异(P㩳O.O5),故在中医证候改善方面,仙河更年颗粒的疗效优于右归饮颗粒。3.仙河更年颗粒治疗MPS前后改良Kupperman积分比较:Kupperman积分均有明显下降(P㩳0.01),且治疗组优于对照组,差异有统计学意义(P㩳O.O5),说明在改善临床症状方面,仙河更年颗粒的疗效优于右归饮颗粒。4.仙河更年颗粒治疗MPS前后中医证候积分比较:治疗后中医证候积分均有下降(P㩳0.05),且治疗组优于对照组,差异有统计学意义(P㩳O.O5),说明在改善绝经综合征患者的中医症状方面,仙河更年颗粒的疗效优于右归饮颗粒。5.仙河更年颗粒治疗MPS前后疾病主要症状疗效:依据治疗前后改良Kuperman评分表主要症状积分差,两组组间进行对比,在改善潮热汗出、失眠、易激动症状有统计学差(P0.05),而对感觉异常、泌尿系症状、性交痛症状无明显差异(P0.05),提示仙河更年颗粒在改善潮热汗出、失眠、易激动症状疗效优于右归饮颗粒,在感觉异常、泌尿系症状、性交痛症状仙河更年颗粒与右归饮颗粒疗效相当。6.仙河更年颗粒治疗MPS前后主要证候症状疗效:依据治疗前后肾阳虚证候积分表中主要症状积分差异,两组组间进行对比,在改善形寒肢冷、关节冷痛方面有统计学差异(P0.05),而对精神萎靡、小便清长、夜尿频数症状无明显差异(P0.05),提示仙河更年颗粒在改善形寒肢冷、关节冷痛方面疗效优于右归饮颗粒,在精神萎靡、小便清长、夜尿频数方面仙河更年颗粒与右归饮颗粒疗效相当。7.仙河更年颗粒治疗MPS前后对性激素水平影响:两组的血清雌二醇(E2)均较治疗前略有升高,卵泡刺激素(FSH)、黄体生成素(LH)略有下降,但统计学分析P0.05,说明不存在显著性差异,提示两组药物对E2、FSH、LH影响不大。结论:仙河更年颗粒治疗肾阳虚型绝经综合征临床疗效优越,明显改善证候症状情况,且均优于传统方右归饮颗粒;尤其对在潮热汗出、失眠、易激动疾病症状及对形寒肢冷、关节冷痛证候症状改善明显,且服用安全可靠,无明显不良反应。但对E2、FSH、LH影响不大。
[Abstract]:Objective: the purpose of this study was to observe the clinical effect and the changes of sex hormone levels before and after the treatment of kidney yang deficiency syndrome in Xianhe, and to provide an objective basis for its clinical application. Methods: according to the principle of randomized double blind control, the diagnostic criteria of Western medicine and kidney Yang in accordance with MPS were selected. 60 patients with virtual syndrome diagnostic criteria were set up in 30 cases in Xianhe more annual particle treatment group and 30 cases of right Gui Yin granule control group, each group was given 4 weeks. The Kuperman score table and the kidney yang deficiency syndrome score table were used as the evaluation index of the curative effect. The symptoms of the two groups before and after treatment and the syndrome score were observed to study the self-made Xianhe more annual granule treatment. The clinical curative effect and syndrome improvement of the syndrome of kidney yang deficiency and menopause, the changes of E2, FSH and LH levels before and after treatment. Results: 1. the curative effect: according to the total integral of the Kupperman score table before and after the treatment, the total effective rate of the Xianhe granule group treatment group was 90%, the total effective rate of the right Decoction granule control group was 80%, and the total effective rate of the two groups was more effective. There were statistical differences (P? O.O5), the clinical curative effect of Xianhe's more annual granule was better than that of right Gui Yin granule. According to the syndrome score table before and after treatment, the total effective rate of the treatment group was 93.33%, the total effective rate of the control group was 83.33%. two, the total effective rate was statistically different (P? O.O5), so in the improvement of TCM syndromes, Xianhe was more granular. The curative effect was better than that of right Gui Yin granule.3. Xianhe PG in the treatment of MPS before and after the treatment of MPS (P? 0.01), and the treatment group was better than the control group, the difference was statistically significant (P? O.O5), indicating that in improving the clinical symptoms, the curative effect was better than that of the right GUI granule.4. Xianhe more annual granules. Comparison of TCM syndrome scores before and after treatment MPS: after treatment, TCM syndrome scores were decreased (P? 0.05), and the treatment group was better than the control group, the difference was statistically significant (P? O.O5), indicating that in improving the symptoms of Chinese medicine of menopause syndrome, the therapeutic effect of Xianhe granule was better than that of right Gui Yin granule,.5. Xianhe more annual granule in the treatment of MPS disease. Main symptom curative effect: according to the improved Kuperman score table before and after treatment, the main symptom score was poor, the two groups were compared, in the improvement of hot and hot sweat, insomnia, and the symptoms of easy excitement were statistically poor (P0.05), but there was no significant difference (P0.05) for the abnormal sensation, urinary system symptoms and sexual pain symptoms (P0.05), suggesting that the more annual granules in Xianhe are improving the hot hot sweat, sweating and insomnia. The effect of the irritability symptom was better than that of the right Gui Yin granule, the curative effect of Xianhe more annual granule and the right Gui Yin granule in the feeling abnormality, the urinary system symptom and the pain symptom in Xianhe was equivalent to the main symptom symptom before and after the treatment of MPS. According to the difference of the main symptom scores in the kidney yang deficiency syndrome score table before and after the treatment, the comparison between the two groups was compared. There were statistically significant differences in cold limb cold and joint cold pain (P0.05), but there was no significant difference in mental malaise, long bowel movement, and nocturnal frequency (P0.05), suggesting that Xianhe's more annual granule is better than right Gui Yin granule in improving cold limb cold and joint cold pain. It is in the spirit of dispirited, urinating and the frequency of nocturnal urine in Xianhe more annual particles and right The effect of Gui Yin granule was equivalent to the effect of.7. Xianhe's more annual Granule on the level of sex hormone before and after MPS: the serum estradiol (E2) in the two groups was slightly higher than that before the treatment, and the follicle stimulating hormone (FSH) and luteinizing hormone (LH) decreased slightly, but the statistical analysis of P0.05 showed no significant difference, suggesting that the effects of the two groups on E2, FSH and LH were not significant. The treatment of kidney yang deficiency syndrome by Xianhe granule is superior in clinical effect, obviously improving symptoms of syndrome, and superior to the traditional right Decoction granules, especially for the symptoms of hot tide sweat, insomnia, easily excited disease and cold and pain syndrome of the shape cold limbs, and it is safe and reliable, but there is no obvious adverse reaction. But to E2 FSH, LH has little effect.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.116

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