吴克明教授平衡肾阴肾阳法治疗早期（围绝经期）PMS的用药经验与疗效观察

发布时间：2018-06-02 11:57

本文选题：围绝经期综合征 + 围绝经期　；参考：《成都中医药大学》2016年硕士论文

【摘要】：目的：探讨导师平衡肾阴肾阳法治疗早期(围绝经期)围绝经期综合征的用药经验并观察其临床疗效,以期为中医药早期防治围绝经期综合征提供客观依据。方法：收集符合纳入标准的围绝经期综合征患者88例,给予平衡肾阴肾阳的中药口服3个疗程。分别于治疗前后监测血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平,记录改良Kupperman评分及中医证候评分。采用自身前后对照的方法,判定疗效,分析年龄、病程及病情与疗效的相关性。结果：(1)观察的88例患者中,根据改良Kupperman疗效判定标准,临床治愈28例(31.82%),显效54例(61.36%),有效6例(6.82%),无效0例,愈显率达93.18%；根据中医证候疗效判定标准,临床痊愈31例(35.23%),显效56例(63.63%),进步1例(1.14%),无效0例,愈显率达98.86%。(2)治疗前后患者改良Kupperman积分、中医证候积分经统计分析P0.05,差异有统计学意义,表明平衡肾阴肾阳法可以显著改善患者的临床症状,减轻患者不适。(3)治疗前后患者血清FSH、LH及E2水平经统计分析P0.05,差异均有统计学意义,表明平衡肾脏阴阳法可以降低血清FSH、LH水平,提高血清E2水平。(4)患者年龄、病程、病情及用药剂型与疗效之间无相关性(P0.05)。(5)通过分析患者治疗前后盆腔瘕瘕情况,发现平衡肾脏阴阳法并未增加盆腔ve瘕的相关风险。疗程结束后对所有患者进行血常规、凝血常规、肝肾功能检查,皆未见异常。观察期间所有患者皆未出现与药物相关的不良反应,表明平衡肾脏阴阳法临床运用安全。结论：综上,平衡肾阴肾阳法治疗围绝经期PMS,可以显著改善患者的临床症状及血清相关性激素水平,并且不增加盆腔ve瘕的相关风险,也未出现与药物相关的不良反应,表明平衡肾阴肾阳法临床运用安全、有效。
[Abstract]:Objective: to explore the experience and clinical effect of tutor's method of balancing kidney yin and kidney yang in the treatment of peri-menopausal syndrome in order to provide an objective basis for early prevention and treatment of peri-menopausal syndrome by traditional Chinese medicine. Methods: 88 patients with perimenopausal syndrome who met the inclusion criteria were given three courses of oral administration of traditional Chinese medicine to balance kidney yin and kidney yang. The levels of serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2) were monitored before and after treatment, and the modified Kupperman score and TCM syndrome score were recorded. Self-control method was used to determine the curative effect and to analyze the correlation between age, course of disease and the curative effect. Results among 88 patients observed, 28 cases were cured according to modified Kupperman criteria, 54 cases were significantly effective, 6 cases were effective, 6.82 cases were ineffective, 0 cases were ineffective, and the effective rate was 93.18%, according to traditional Chinese medicine syndromes, 28 cases were cured and 31. 822%, 54 cases were effective, 6 cases were effective, 0 cases were ineffective, and the rate of recovery was 93.18%. There were 31 cases of clinical cure, 56 cases with remarkable effect and 63.63%, 1 case with improvement of 1.14%, 0 cases with no effect, and the effective rate reached 98.86%.) before and after treatment, the improved Kupperman integral was improved, and the score of TCM syndromes was statistically analyzed (P 0.05), the difference was statistically significant. The results showed that the method of balancing kidney yin and kidney yang could significantly improve the clinical symptoms and relieve the discomfort of the patients before and after treatment. The serum levels of FSHN LH and E2 were statistically significant by statistical analysis (P0.05). The results showed that the method of balancing kidney yin and yang could decrease the serum FSHN LH level and increase the serum E 2 level. There was no correlation between the age, course of disease, state of illness, dosage form and curative effect.) by analyzing the pelvic mass of the patients before and after treatment, there was no correlation between the patients' age, disease course, dosage form and curative effect. It was found that the method of balancing kidney yin and yang did not increase the risk of pelvic mass. After the course of treatment, all patients were examined with blood routine, coagulation, liver and kidney function. No adverse drug-related reactions were found in all patients during the observation period, indicating that the method of balancing kidney yin and yang was safe in clinical practice. Conclusion: in conclusion, the treatment of peri-menopausal PMSs with balanced kidney yin and kidney yang method can significantly improve the clinical symptoms and serum levels of sex hormones, and does not increase the risk of pelvic mass, and there are no adverse drug related reactions. It shows that the method of balancing kidney yin and kidney yang is safe and effective.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R271.116

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