补脾胃泻阴火升阳汤加减治疗围绝经期综合征疗效观察

发布时间：2018-08-24 12:47

【摘要】：目的:通过观察补脾胃泻阴火升阳汤治疗围绝经期综合征的临床治疗效果,探讨脾胃论治在治疗该病的特点和思路,从而为临床上利用中医健脾益气法为主对治疗围绝经期综合征提供可靠的依据。方法:选取2015年3月1日-2015年7月30日晋城煤业集团中医科门诊约120例围绝经期综合征患者,随机分成治疗组和对照组。其中,治疗组(中药组)60例,以补脾胃泻阴火升阳汤为主作为治疗手段;对照组(西药组)60例,以西药HRT作为治疗手段。使用实验室的检验设备分别检测两组患者用药前以及用药6个月后血中的卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E2)的含量,然后用改良Kupperman评分法评价两组患者用药前及用药后临床症状的改善情况,数据经过记录后录入Excel表格中,应用SPSS17.0软件包对数据进行统计分析,计数资料采用χ~2检验,计量资料用(?)±S表示,两种独立样本均采用t检验。结果:中药组和西药组的患者在用药前及用药6个月后分别通过实验室检测血中卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E2)三种激素的含量,然后进行比较,发现在两组患者用药前FSH、LH、E2的激素含量水平是相当的,两者之间没有明显的差距,没有统计学差异(P0.05);而在坚持用药6个月以后则两组患者的FSH、LH、E2的激素含量未出现差距,没有统计学差异(P0.05);但两组患者的FSH、LH、E2的激素含量在治疗前后均出现明显差异(P0.05);说明有统计学意义,这就说明中药组和西药组在改变激素水平的治疗中均具有显著疗效,但不能说明哪一组的治疗更显著。中药组及西药组两组患者在用药前及用药6个月后进行改良Kupperman评分,两组患者在用药前所有患者的评分均超过14分,两组患者之间无显著差异,在治疗6个月之后出现差距,中药组有32(53%)个病人的评分仍超过14分,而西药组则有35(58%)个的病人评分超过14分,两组间存在差异。在两组症状评分比较中,两组治疗前比较P0.05,无差异,西药组治疗前后对比P0.05,无统计学差异,中药组治疗前后对比,P0.01,有明显差异,中药组治疗后和西药组治疗后比较,P0.05,有差异。说明两组患者在临床症状的改善情况方面中药组的治疗较西药组治疗是具有明显优势的。根据改良Kupperman疗效评价标准,临床总疗效结果显示,中药组总有效率为90%;西药组总有效率为72%。在安全性检测中,两组患者用药过程中均未诉特殊不适,血、尿、便常规,肝、肾系列,心电图检查均未见明显异常。说明两组患者在临床症状的改善情况方面中药组的疗效较西药组疗效是具有明显优势的。结论:“补脾胃泻阴火升阳汤”在治疗围绝经期综合征患者时,能够明显减轻和改善患者的一些症状,并且在原定的疗程后痊愈率高于西药组,精神症状改善效果也优于西药组,它可以提高了血中E2的水平,降低了血中FSH、LH的水平,还可以有效的调节免疫功能,而且没有明显的毒副作用及不良反应。本研究应用先进的检测方法,选择采用改良Kupperman评分法评价两组患者用药前及用药6个月之后两组围绝经期综合征患者症状的改善情况,客观说明了该药的在治疗本病中取得的疗效,而且还进行了详细的机理探讨,为中医健脾益气法为主治疗围绝经期综合征患者提供了有力的依据。
[Abstract]:Objective: To observe the clinical effect of Bupiwei Xieyin Huo Shengyang Decoction in treating perimenopausal syndrome, and to explore the characteristics and thinking of the treatment of perimenopausal syndrome by spleen and stomach theory, so as to provide reliable basis for clinical treatment of perimenopausal syndrome mainly by the method of invigorating spleen and supplementing qi. About 120 cases of perimenopausal syndrome were randomly divided into treatment group and control group. 60 cases were treated with Bupiwei Xieyin Huo Shengyang Decoction and 60 cases were treated with western medicine HRT. Follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were measured before and 6 months after treatment. The clinical symptoms of the two groups were evaluated by improved Kupperman scoring method. The data were recorded in Excel table and the data were scored by SPSS17.0 software package. Results: The levels of FSH, LH and E2 in the blood of the patients in the Chinese medicine group and the western medicine group were measured in the laboratory before and after 6 months respectively, and then compared. The hormone levels of FSH, LH and E2 in the two groups were similar before treatment, and there was no significant difference between the two groups (P There were significant differences before and after treatment (P 0.05), indicating that there was statistical significance, which showed that the Chinese medicine group and the Western medicine group in the treatment of hormone levels have significant effect, but can not explain which group of treatment is more significant. There was no significant difference between the two groups. The score of 32 (53%) patients in the Chinese medicine group was still over 14, while that of 35 (58%) patients in the western medicine group was over 14. There was a difference between the two groups in the symptom score before treatment (P 0.05, no difference, Western medicine group before and after treatment compared with P 0.05, no statistical difference, Chinese medicine group before and after treatment, P 0.01, there is a significant difference, Chinese medicine group after treatment and Western medicine group after treatment, P 0.05, there is a difference. According to the improved Kupperman criteria, the total clinical efficacy showed that the total effective rate was 90% in the traditional Chinese medicine group and 72% in the western medicine group. Conclusion: Bupiwei Xieyin Huo Shengyang Decoction can obviously alleviate and improve some symptoms of perimenopausal syndrome patients, and the recovery rate after the original course of treatment is higher than that of Western medicine group, and the improvement effect of mental symptoms is better than that of Western medicine. In this study, the improved Kupperman scoring method was used to evaluate the perimenopausal period of the two groups before and 6 months after treatment. The improvement of symptoms of patients with syndrome objectively illustrates the curative effect of this medicine in the treatment of the disease, and also discusses the mechanism in detail, which provides a powerful basis for the treatment of perimenopausal syndrome mainly by the method of invigorating the spleen and replenishing qi.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.116

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