补肾疏肝方治疗肾虚肝郁型卵巢早衰的临床研究

发布时间：2018-07-17 19:22

【摘要】：目的：通过研究,观察补肾疏肝方治疗肾虚肝郁型卵巢早衰的临床疗效,分析本研究方法对卵巢早衰患者的月经情况、中医证候、血性激素、神经递质的影响,探讨补肾填精、疏肝解郁法对肾虚肝郁型POF治疗的临床疗效,并初探其作用机制以及预防疾病的重要性。方法：选取卵巢早衰患者(通过辨证为肾虚肝郁型)40例,随机分成两组,每组20例,各服药两个疗程。第一疗程：治疗组—补肾疏肝方结合雌孕激素序贯疗法、对照组—坤泰胶囊结合雌孕激素序贯疗法,治疗3个周期；第二疗程：治疗组—补肾疏肝方、对照组—坤泰胶囊,治疗3个周期。结束治疗后,比较研究两组患者的月经及相关伴随症状的改善状况,观察FSH、LH、E2、5-羟色胺(5-HT)的变化。结果：(1)治疗后,两组的总有效率各为90%及70%,组间比较差异显著(P0.05)(2)经治后治疗组经量、经期、色质总有效率分别达90.00%、85.00%、90.00%,和对照组的70%、60%、60%相比,差异有统计学意义(P0.05)。而在改善周期上,两组的有效率分别为90.00%、65.00%,之间的差别不显著(P0.05)。(3)经治后,在中医证候总有效率上,两组各达95%、65%,而治疗组总积分下降更明显,两组间进行比较差异有统计学意义(P0.05)。(4)疗后两组E2水平较前升高、FSH和LH水平降低,差异显著(P0.05),组间比较差异有统计学意义(P0.05)。(5)治疗后,两个组均见5-HT水平上升,差异显著(P0.05),组间比较差异在统计学上有意义(P0.05)。(6)治疗后,两组均见子宫内膜厚度较前增加,但组间比较无差异(P0.05)。结论：应用补肾疏肝方联合雌孕激素序贯疗法治疗卵巢早衰(辨证为肾虚肝郁型)的患者,可以较好地改善月经情况和相关中医证候,升高患者的E2、5-HT,降低促性腺激素,改善患者的卵巢功能及抑郁状态,和应用坤泰胶囊联合雌孕序贯治疗相比,疗效更加明显,且不良反应小,安全度高,可选择为一种有效的治疗方式。
[Abstract]:Objective: to observe the clinical effect of Bushen Shugan recipe on premature ovarian failure with kidney deficiency and liver depression, and to analyze the effects of this research method on menstruation, TCM syndromes, blood sex hormones and neurotransmitters in patients with premature ovarian failure. The clinical efficacy of the method of soothing the liver and relieving the depression in the treatment of POF with kidney deficiency and liver depression is discussed. The mechanism of the treatment and the importance of preventing diseases are also discussed. Methods: 40 cases of premature ovarian failure were randomly divided into two groups, 20 cases in each group. The first course of treatment: the treatment group-Bushen Shugan recipe combined with estrogen and progesterone sequential therapy, the control group-Kun Tai capsule combined with estrogen and progesterone sequential therapy for 3 cycles; the second course of treatment: treatment group-Bushen Shugan recipe, control group-Kuntai capsule, Treatment 3 cycles. At the end of treatment, the improvement of menstruation and associated symptoms were compared between the two groups, and the changes of 5-HT in FSHLHN E2 serotonin (5-HT) were observed. Results: (1) after treatment, the total effective rates of the two groups were 90% and 70%, respectively. There were significant differences between the two groups (P0.05). (2) the total effective rates of the treatment group were 90.0085.00% and 90% respectively after treatment (P0.05). The difference was statistically significant (P0.05). However, in the improvement cycle, the effective rate of the two groups was 90.000 and 65.00, respectively. The difference between the two groups was not significant (P0.05). (3). After treatment, the total effective rate of TCM syndromes in the two groups reached 95% and 65% respectively, while the total score of the treatment group decreased more obviously. The difference between the two groups was statistically significant (P0.05). (4). After treatment, the E2 level of the two groups was significantly lower than that of the former (P0.05). The difference between the two groups was statistically significant (P0.05). (5), the level of 5-HT increased in both groups after treatment. The difference was significant (P0.05), the difference between the two groups was statistically significant (P0.05). (6), the endometrial thickness of the two groups was increased, but there was no difference between the two groups (P0.05). Conclusion: the application of Bushen Shugan recipe combined with estrogen and progesterone sequential therapy in the treatment of premature ovarian failure (syndrome differentiation as kidney deficiency and liver depression) can improve menstruation and related TCM syndromes, increase E25-HTand decrease gonadotropin. To improve the ovarian function and depression of the patients, compared with the application of Kuntai capsule combined with female pregnancy sequential treatment, the curative effect is more obvious, the adverse reaction is small, the degree of safety is high, so it can be an effective treatment method.
【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】：R271.9

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