滋肾宁心汤治疗应用GnRH-a患者类绝经期症状的临床疗效观察

发布时间：2018-08-05 11:59

【摘要】：目的：观察滋肾宁心汤治疗应用GnRH-a后出现类绝经期症状且中医辨证属于肾阴虚证的子宫内膜异位症术后患者的中医临床症状疗效、绝经症状严重程度、各项症状的发生率及不良反应等。探讨滋肾宁心汤治疗应用GnRH-a致类绝经期症状的子宫内膜异位症术后患者的临床疗效,为子宫内膜异位症术后应用GnRH-a后出现类绝经期症状的治疗提供临床研究依据。方法：本研究选取病例均来自2014年01月01日至2016年05月31日于南京中医药大学附属中西医结合医院行腹腔镜手术且病理确诊为子宫内膜异位症,术后应用促性腺激素释放激素激动剂(GnRH-a)治疗时出现类绝经期症状的且中医辨证属肾阴虚证的患者100例(对照组35例,坤泰组32例,中药组33例),随机分为3组,排除脱落病例,最终完成每组各30例。所有患者均于术后月经周期第1天给予GnRH-a注射(戈舍瑞林3.6mg皮下注射),每28天注射1次,共4次。对照组仅予GnRH-a注射,坤泰组、中药组分别于第二次给予GnRH-a同时加用坤泰胶囊、中药方滋肾宁心汤,每四周为一个疗程,共三个疗程；比较三组患者在应用坤泰胶囊或滋肾宁心汤治疗前后中医临床症状疗效评价、绝经症状评分及不良反应。结果：1.三组患者治疗后第12周相比,坤泰组及中药组均较同组治疗前临床症状及体征积分明显下降,差异有统计学意义(p0.05),而对照组与治疗前比较差异无统计学意义(p0.05)。治疗后第12周三组Kupermann评分均较同组治疗前升高,且按对照组、坤泰组、中药组的顺序依次呈下降趋势,且差异具有的统计学意义(p0.05)。2.对照组在治疗期间出现了一系列的类绝经期症状,坤泰组及中药组相应症状出现的例数均有所减少,且中药组与坤泰组相比其类绝经期症状的严重程度明显较轻。结论：滋肾宁心汤在临床上可有效缓解子宫内膜异位症术后患者应用促性腺激素释放激素激动剂(GnRH-a)治疗所引起的类绝经期症状,且疗效优于坤泰胶囊。
[Abstract]:Objective: to observe the effect of Zishen Ningxin decoction on the clinical symptoms and the severity of menopausal symptoms in patients with endometriosis with syndrome differentiation of kidney yin deficiency after GnRH-a. Incidence of symptoms and adverse reactions. To explore the clinical effect of Zishen Ningxin decoction in treating endometriosis patients with menopausal symptoms caused by GnRH-a, and to provide clinical research basis for the treatment of menopausal symptoms after GnRH-a. Methods: all cases were selected from January 01, 2014 to May 31, 2016 in Nanjing University of traditional Chinese Medicine affiliated to the hospital of integrated traditional Chinese and western medicine laparoscopic surgery and pathological diagnosis of endometriosis, After operation, 100 patients (35 cases in control group, 32 cases in Kuntai group and 33 cases in Chinese herbal medicine group) who had postmenopausal symptoms of gonadotropin releasing hormone agonist (GnRH-a) were randomly divided into 3 groups, excluding shedding cases. 30 cases in each group were finished. All patients were given GnRH-a injection (3.6mg subcutaneous injection) on the first day of menstrual cycle after operation, once every 28 days, a total of 4 times. The control group was only given GnRH-a injection, the Kun Tai group and the traditional Chinese medicine group were given GnRH-a plus Kun Tai capsule for the second time. The traditional Chinese medicine prescription Zishen Ningxin decoction was a course of treatment every four weeks for a total of three courses. To compare the curative effect evaluation, menopausal symptom score and adverse reaction of TCM before and after the treatment with Kun Tai capsule or Zishen Ningxin decoction. The result is 1: 1. At the 12th week after treatment, the scores of clinical symptoms and signs in Kuntai group and traditional Chinese medicine group were significantly lower than those in the same group (p0.05), but there was no significant difference between control group and pre-treatment group (p0.05). The Kupermann scores in the 12th Wednesday group were higher than those in the same group before treatment, and the order of control group, Kuntai group and Chinese medicine group showed a decreasing trend, and the difference was statistically significant (p0. 05). 2. In the control group, a series of menopausal symptoms appeared during the treatment period, and the corresponding symptoms in the Kun Tai group and the traditional Chinese medicine group were decreased, and the severity of the menopausal symptoms in the Chinese medicine group was significantly less than that in the Kuntai group. Conclusion: Zishen Ningxin decoction can effectively relieve the menopausal symptoms caused by gonadotropin releasing hormone agonist (GnRH-a) in patients with endometriosis after operation, and the curative effect is better than Kuntai capsule.
【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】：R271.116

【参考文献】