金水相生配穴法治疗肾阴虚型更年期综合征的临床研究

发布时间：2018-06-18 13:35

本文选题：金水相生 + 更年期综合症　；参考：《广州中医药大学》2017年硕士论文

【摘要】：背景:更年期综合征(Climacteric syndrome,CMS)又称围绝经期综合征,是女性从中年逐渐进入老年期的明显标志,也是妇女生理机能衰退的标志,CMS是由于体内性激素水平的波动或减少导致的一系列症状,主要表现为躯体化症状及情志障碍,如月经功能失调、潮热、心慌心悸、焦躁不安、记忆力降低、少眠、喜怒无常等等,严重影响到广大更年期妇女的生活质量,并可增加心血管、骨质疏松等多种并发症的风险,给社会增加了较大的负担与压力。目的:本研究主要观察金水相生配穴法与普通配穴法治疗肾阴虚型更年期妇女的综合临床疗效,主要通过简单随机对照原则,将60例患者分为两组,治疗组取穴如下:主穴(肾俞、肝俞、气海、三阴交、神门、内关、太冲)加上金水相生配穴(鱼际、太渊、太溪、复溜),对照组取穴如下:主穴(同治疗组)加上常规配穴(阴谷、照海),以观察两组患者的治疗效果。研究中采用国际公认的Kupperman Index评分量表(简称KI指数)及中医症候评分来记录两组患者的治疗效果,观察金水相生配穴法对比普通配穴方法在治疗肾阴虚型围绝经期系列症状方面是否更具有优越性,以便为临床上治疗本病探索更加高效的治疗方法。研究方法:本次实验运用简单随机对照的原则,根据研究目的和受试对象的各个标准,将符合标准的受试对象随机分配为金水相生配穴法组与普通配穴法组各30例,共60例,每周针刺3次,隔天1次,8周为1疗程,经治疗一疗程后分别记录中西医评分量表,采用SPSS19.0软件包统计分析收集数据。研究结果:1、治疗前后KI指数疗效评价:经过一疗程的治疗,两组患者的KI指数相比治疗之前都有明显下降,对比两组治疗之后结果,P值0.05,两组治疗方法均存在明显的统计学差异,结合二者的治疗前后KI指数差值,说明治疗组疗效较对照组好。2、综合临床疗效比较:KI指数经过尼莫地平法计算后得出一下结果,治疗组30例,经过8周治疗后,痊愈2例(6.7%),显效21例(70%),有效6例(20%),无效1例(3.33%),总有效率为96.67%。对照组30例患者,经过8周治疗之后,痊愈 0 例(0.00%),显效 21 例(70%),有效 7 例(23.330%),无效 2 例(6.67%),总有效率93.33%。治疗组总有效率大于对照组,但经Ridit分析后得出P0.05,无明显的统计学差异。3、中医症候疗效评价:经一疗程治疗,治疗组和对照组各中医症状积分较前都有所下降,将两组经治疗之后评分各自行组内配对秩和检验后得出:除治疗组阴部干涩症状P大于0.05,余各症状p值均小于0.05,故两组治疗均有效;将两组间各症状行两独立样本秩和检验后得出烘热汗出、少寐多梦、阴部干涩三个症状的P值小于0.05,差异有统计学意义,据治疗前后差值可得出结论:治疗组在改善烘热汗出、少寐多梦方面优于对照组,而在改善阴部干涩方面不如对照组;而腰膝酸痛或足跟痛、头晕、五心烦热、心悸、急躁易怒、口干、皮肤瘙痒p值均大于0.05,差异无统计学意义。故金水相生配穴法治疗肾阴虚型更年期综合症,在烘热汗出、少寐多梦方面明显优于对照组。结论:金水相生配穴法与普通配穴方法在治疗肾阴虚型CMS方面皆存在明显疗效,但在降低KI指数及中医症候的烘热汗出、少寐多梦两方面,金水相生配穴法均明显优于普通配穴法,故金水相生配穴法治疗肾阴虚型围绝经期综合症,尤其是在烘热汗出、少寐多梦明显的患者更具优越性,值得在临床上进一步推广应用。
[Abstract]:Background: Climacteric syndrome (CMS), also known as perimenopausal syndrome, is a marked sign of women's gradual entry into the aged from middle age. It is also a sign of the decline of the physiological function of women. CMS is a series of symptoms caused by the fluctuation or reduction of sex hormone levels in the body, mainly manifested in somatization symptoms and emotional disorders, such as Menstrual dysfunction, hot flashes, palpitation, restlessness, memory reduction, less sleep, and moody, etc., seriously affect the quality of life of the women in the menopause, and increase the risk of many complications such as cardiovascular and osteoporosis, and increase the burden and pressure on the society. Objective: This study mainly observed the combination of golden water and water. The comprehensive clinical effect of the method and the common acupoint method in the treatment of menopause women of kidney yin deficiency type, mainly through the simple random control principle, divided 60 patients into two groups. The treatment group took the following points as following: the main point (Shenshu, Gan Shu, Qi Hai, Sanyinjiao, Shenmen, Neiguan, Taijin) plus golden water matching acupoints (thenar, Taiyuan, Taiyuan, Fu slip), and the control group taking acupoints as follows: The treatment effect of the two groups of patients was observed in the main points (the same treatment group) with the conventional acupoints (Yin Valley and the sea) to observe the therapeutic effect of the two groups. In the study, the therapeutic effect of the two groups of patients was recorded by the internationally recognized Kupperman (abbreviation) scale (abbreviated KI index) and TCM syndrome score, and the golden water phase matching point method was compared with the common acupoint method in the treatment of kidney yin deficiency type circumference. Whether the menopause series of symptoms are more superior in order to explore more efficient treatment methods for the clinical treatment of the disease. There were 30 cases in each group, 60 cases were treated with acupuncture 3 times a week, 1 times a day and 8 weeks as 1 courses. After a course of treatment, the score of Chinese and Western medicine was recorded, and the data were collected by SPSS19.0 software package. The results were 1. After a course of treatment, the KI index of the two groups was compared with the treatment before treatment. Significantly decreased, compared the results of two groups after treatment, P value 0.05, two groups of treatment methods have obvious statistical differences, combined with the KI index difference before and after the treatment of two, indicating that the treatment group is better than the control group.2, comprehensive clinical efficacy comparison: KI index after nimodipine calculation, the result, 30 cases in the treatment group, after 8 weeks of treatment. After that, 2 cases (6.7%), 21 cases (70%), 6 cases (20%) and 1 cases (3.33%) were effective. The total effective rate was 30 patients in 96.67%. control group. After 8 weeks of treatment, 0 cases (0%) were cured, effective 21 cases (0%), invalid cases, total effective efficiency of 93.33%. treatment group were more effective than the control group, but after Ridit analysis, the total effective rate was higher than that of the control group, but after Ridit analysis, the total effective rate was higher than that of the control group. P0.05, there was no significant difference in statistics.3, traditional Chinese medicine syndrome effect evaluation: after a course of treatment, the treatment group and the control group all the symptoms of TCM symptoms were lower than before, the two groups after the treatment scores of each group in the paired rank and test after the treatment group, except for the treatment group of the perineum dry and astringent symptoms P more than 0.05, the remaining symptoms of the p value are less than 0.05, so two Group treatment was effective, the two groups of the symptoms of two independent samples of the rank sum test to get hot sweat out, less sleep dream, the P value of the perineum dry three symptoms less than 0.05, the difference is statistically significant, according to the difference before and after treatment can be concluded that the treatment group is better than the control group in improving the baking sweat, less dream and more dream, and in improving the perineum dry. It is not as good as the control group; while the waist and knee pain or heel pain, dizziness, five heart trouble heat, palpitation, irritability, dry mouth, and skin pruritus p value are more than 0.05, the difference is not statistically significant. Therefore, the golden water matching point method is obviously superior to the control group in the treatment of kidney yin deficiency type menopause syndrome. In the treatment of kidney yin deficiency type CMS, there is a significant effect in the treatment of kidney yin deficiency type, but in the two aspects of reducing the KI index and the hot sweat out of the syndrome of traditional Chinese medicine and less dream, the golden water phase matching acupoint method is obviously superior to the common acupoint method. Therefore, the golden water phase matching acupoint method is used to treat the kidney yin deficiency syndrome, especially in the hot sweat and less dream. Obvious patients have more advantages, which is worthy of further application in clinic.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.3

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