针药结合治疗肾虚肝郁型黄体功能不足月经先期的临床观察

发布时间：2018-09-08 09:01

【摘要】：目的:本课题评估天癸汤联合针灸对肾虚肝郁型黄体功能不足(luteal phasedefect,LPD)月经先期的疗效,并与地屈孕酮进行对比观察,评定临床有效性,阐明针药结合治疗LPD月经先期的作用机制,旨在为针药结合治疗该病的优势性提供可靠的临床及实验根据,展现中医药未病预防的观点,冀此降低日久LPD引发的不孕、流产等。研究方法:采取随机对照法实行前瞻性方案观察,病例纳入62例受试者随机分为治疗组31例,对照组31例,其中对照组1例脱落,最终入组治疗组31例,对照组30例,治疗组采纳口服天癸汤结合穴位针刺,对照组予以口服地屈孕酮,治疗时间均始于BBT上升第一天,连续10日,若经血下溢停止诊疗。3个月经周期后对比评价两组受试者疗前、疗后疾病疗效、黄体中期P、E2水平、中医症状及BBT变化情形。结果:1.当疗期结束后,据统计学解析,治疗组疾病总疗效、中医总症状改观情况优于对照组,差异有统计学意义(P0.05)。2.治疗组在受试者月经提前天数,BBT高温相持续天数,高低温差及血P值改善情况与对照组相当,差异无统计学意义(P0.05)。治疗组上升E2水平高于对照组,差异具显著性(P0.01)。3.观察预后的稳定性,随访显示治疗组复发率小于对照组,差异有统计学意义(P0.05)。结论:天癸汤结合针灸治疗肾虚肝郁型黄体功能不足月经先期临床疗效肯定,且优于对照组,其疗效机理以调治肾一天癸一冲任一胞宫轴的稳态,从而有效调节月经周期,改善受试者症状,升高血清激素水平,恢复黄体功能,且远期疗效好,安全性高。
[Abstract]:Objective: to evaluate the effect of Tiangui decoction combined with acupuncture and moxibustion on menstrual premenstruation in patients with deficiency of kidney and liver depression (luteal phasedefect,LPD), and to evaluate the clinical efficacy and the mechanism of acupuncture combined with medicine in the treatment of menstrual premenstruation of LPD. The purpose of this study was to provide reliable clinical and experimental basis for the combination of acupuncture and medicine in the treatment of the disease, to show the viewpoint of prevention of non-disease in traditional Chinese medicine, and to reduce infertility and abortion caused by LPD for a long time. Methods: 62 patients were randomly divided into treatment group (n = 31), control group (n = 31), final treatment group (n = 31) and control group (n = 30). The treatment group was treated with oral Tiangui decoction combined with acupuncture at acupoint, and the control group was treated with diproprogesterone. The treatment time began on the first day of BBT rise and lasted for 10 consecutive days, if the diagnosis and treatment were stopped through blood overflow. After 3 menstrual cycles, the subjects of both groups were compared and evaluated before treatment. After treatment, the curative effect of disease, the level of E _ 2 in luteal phase, the symptoms of TCM and the change of BBT. The result is 1: 1. After the end of the treatment period, according to statistical analysis, the total curative effect of the treatment group, the total symptoms of traditional Chinese medicine improved better than the control group, the difference was statistically significant (P0.05). 2. In the treatment group, the days of menstrual advance and the duration of BBT hyperthermia, the difference of high and low temperature and the improvement of blood P value were similar to those of the control group, and the difference was not statistically significant (P0.05). The level of E _ 2 in the treatment group was higher than that in the control group, and the difference was significant (P 0.01). 3. The stability of prognosis was observed and the recurrence rate of the treatment group was lower than that of the control group (P0.05). Conclusion: Tiangui decoction combined with acupuncture in the treatment of luteal insufficiency of kidney deficiency and liver-depression type has definite clinical effect in early stage and is superior to control group. The mechanism of its curative effect is to regulate the homeostasis of any axon of the uterus of one day a day of kidney, so as to regulate menstrual cycle effectively. Improve the symptoms, increase serum hormone levels, restore luteal function, and long-term efficacy, high safety.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.111

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