补肾疏肝方治疗肝郁肾虚证高催乳素血症患者的临床研究

发布时间：2018-07-03 05:56

本文选题：补肾疏肝方 + 高催乳素血症　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:通过观察补肾疏肝方治疗肝郁肾虚证高催乳素血症(Hyperprolactinemia,HPRL)患者的临床疗效,并探讨其机制,为该病的临床诊治提供一些思路和方法。方法:本研究选取来自我院妇科门诊就诊的符合入组标准的高催乳素血症患者,采取随机对照试验方法,分为中药组24例,西药组24例。治疗组予口服中药组方补肾疏肝方治疗,西药组予口服溴隐亭治疗。两组患者治疗3个月后判定疗效,并通过统计学方法处理后进行对比分析和总结。观察治疗前后血清泌乳素(PRL)与中医证候改善情况,观察停药三个月内复发率。结果:1.综合疗效比较:中药组对治疗肝郁肾虚证高催乳素血症患者的总有效率为83.33%,西药组为87.49%,差异无统计学意义(P0.05)。2.中医临床症状比较:两组患者治疗后中医症状总积分均有明显下降,组间比较差异有统计学意义(P0.05)。两组治疗后,在改善月经稀发或闭经、溢乳、经行小腹胀痛、性欲减退、胁肋胀痛上,组间比较差别无统计学意义(P0.05);两组在改善腰膝酸软方面,组间比较有统计学差异(P0.05),中药组优于西药组;中药组在改善月经量少、情绪抑郁或心烦易怒、乳房胀痛方面,显著优于西药组(P0.01)。3.治疗前后PRL水平方面比较:两组患者治疗后PRL水平均降低,有统计学的差异(P0.05),组间比较西药组PRL水平对比中药组下降幅度较大(P0.05)。4.停药后随访期复发情况:两组PRL恢复正常范围的患者停药后在随访期3个月内PRL异常升高人数,中药组3人,西药组8人,差异有统计学意义(P0.05),复发率中药组为16.67%,西药组为44.45%。5.不良反应比较:两组患者用药治疗期间,不良反应发生率中药组为12.50%,西药组为41.67%,两组不良反应比较有统计学意义(P0.05)。结论:研究结果表明,补肾疏肝方及溴隐亭对肝郁肾虚证高催乳素血症患者出现的中医症状均有着良好的临床治疗效果,在改善月经量少、情绪抑郁或心烦易怒、腰膝酸软、乳房胀痛不适方面,补肾疏肝方较溴隐亭有优势。溴隐亭治疗HPRL虽然疗效确切,但服药后存在恶心、头晕、便秘等不良反应,且停药后血清PRL水平易反弹。疏肝补肾方临床上降低PRL水平缓和,停药后不易复发,且服药后不良反应发生率小,安全性方面较使用溴隐亭更佳,体现了中药方剂治疗本病的优势。
[Abstract]:Objective: to observe the clinical effect of Bushen Shugan recipe in treating hyperprolactinemiaemia (HPRL) patients with liver stagnation and kidney deficiency syndrome, and to explore its mechanism, and to provide some ideas and methods for the clinical diagnosis and treatment of the disease. Methods: patients with hyperprolactinemia who were admitted to gynecological outpatient clinic in our hospital were randomly divided into Chinese medicine group (n = 24) and western medicine group (n = 24). The treatment group was treated with Bushen Shugan prescription and the western medicine group with bromocriptine. Two groups of patients after 3 months of treatment to determine the efficacy, and statistical treatment after comparative analysis and summary. To observe the improvement of serum prolactin (PRL) and TCM syndromes before and after treatment, and to observe the recurrence rate within 3 months. The result is 1: 1. Comprehensive efficacy comparison: the total effective rate of traditional Chinese medicine group in treating hyperprolactinemia patients with liver stagnation and kidney deficiency syndrome was 83.33 and that of western medicine group was 87.49.The difference was not statistically significant (P0.05). 2. Comparison of clinical symptoms of traditional Chinese medicine: the total scores of TCM symptoms in the two groups were significantly decreased after treatment, and the difference between the two groups was statistically significant (P0.05). After treatment, there was no significant difference between the two groups in the improvement of menorrhagia or amenorrhea, galactorrhea, abdominal distending pain, decreased libido and hypochondria pain between the two groups (P0.05). There was significant difference between the groups (P0.05), the Chinese medicine group was better than the western medicine group; the traditional Chinese medicine group in improving menstrual volume, emotional depression or irritability, breast pain, significantly better than the western medicine group (P0.01) .3. Comparison of PRL levels before and after treatment: the PRL level of the two groups decreased after treatment, there was a statistical difference (P0.05), the PRL level of the Western medicine group decreased significantly compared with the traditional Chinese medicine group (P0.05). 4. The recurrence of PRL in the two groups was significantly higher than that in the traditional Chinese medicine group (3 cases) and the western medicine group (8 cases) (P0.05). The recurrence rate was 16.67 in the Chinese medicine group and 44.45.5in the western medicine group. Comparison of adverse reactions: the incidence of adverse reactions was 12.50 in the traditional Chinese medicine group and 41.67 in the western medicine group. There was statistical significance between the two groups (P0.05). Conclusion: the results show that both Bushen Shugan recipe and Bromocriptine have good therapeutic effect on the symptoms of hyperprolactinemia of liver depression and kidney deficiency syndrome, which can improve menstrual volume less, emotional depression or irritability, weakness of waist and knee. Breast pain discomfort, kidney-soothing side than bromocriptine has an advantage. Bromocriptine was effective in treating HPRL, but there were adverse reactions such as nausea, dizziness, constipation and so on. Shugan Bushen prescription can reduce the level of PRL in clinic, but it is not easy to recur after withdrawal, and the incidence of adverse reactions after taking medicine is small, and the safety is better than that of bromocriptine, which reflects the advantage of traditional Chinese medicine prescription in the treatment of this disease.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

【参考文献】