隔药饼灸治疗肾虚血瘀型子宫肌瘤的临床研究

发布时间：2018-10-24 12:16

【摘要】：目的运用隔药饼灸对肾虚血瘀型子宫肌瘤患者进行治疗,并设口服桂枝茯苓胶囊对照组进行比较,通过观察治疗前后中医证候总积分、肌瘤大小、各项临床症状及体征积分、孕酮、雌二醇和血红蛋白含量等指标的变化,客观评价隔药饼灸治疗肾虚血瘀型子宫肌瘤的临床疗效。方法按照纳入标准选择病例,采用随机数字表法将60例子宫肌瘤患者随机分为治疗组和对照组,每组30例。治疗组采用隔药饼灸,对照组采用口服桂枝茯苓胶囊治疗。根据肾虚血瘀证候评分表对中医证候进行评分,治疗3个疗程后观察疗效,将所得数据进行统计学分析并做出疗效评价。结果(1)治疗后,治疗组总有效率为80.00%;对照组总有效率为63.33%。两组总疗效相比,P0.05,差异有统计学意义,治疗组的综合疗效优于对照组。(2)治疗后两组患者中医证候总积分较治疗前均明显下降,P0.05,差异有统计学意义。治疗后两组患者中医证候总积分比较,P0.05,差异有统计学意义。统计结果表明:两种治疗方法均能降低子宫肌瘤患者中医证候总积分,但治疗组疗效优于对照组。(3)治疗后两组患者各项临床症状及体征积分较治疗前均明显下降,P0.05,差异有统计学意义。治疗后两组患者各项临床症状及体征积分比较,治疗组在腰膝酸软、耳鸣、脉象治疗后评分显著低于对照组,P0.05,差异有统计学意义。(4)治疗后两组患者子宫肌瘤体积较治疗前均明显下降,P0.05,差异有统计学意义。治疗后治疗组和对照组子宫肌瘤体积未见明显差异,P0.05,差异无统计学意义。(5)治疗后两组患者孕酮、雌二醇含量较治疗前均明显下降,血红蛋白含量较治疗前明显提升,P0.05,差异有统计学意义。治疗后两组患者血红蛋白比较,P0.05,差异有统计学意义。治疗后两组孕酮、雌二醇含量比较,P0.05未见明显差异。结论两种治疗方法均能改善子宫肌瘤患者的临床症状及体征,但治疗组综合疗效优于对照组。治疗组在改善患者中医证候总积分、血红蛋白、腰膝酸软、耳鸣、脉象方面的疗效均优于对照组。两组在改善子宫肌瘤大小、雌二醇、孕酮、经量变化、经期延长、经色、经质、带下量、小腹疼痛、小腹坠胀、乳房胀痛、舌质方面未见明显差异。治疗前后患者肝肾功均处在正常范围,说明隔药饼灸治疗子宫肌瘤是一种安全且有效的治疗方法。
[Abstract]:Objective to treat uterine leiomyoma patients with kidney deficiency and blood stasis type by medicine-separated cake moxibustion, and set up the control group of Guizhi Fuling capsule for comparison, and observe the total integral of TCM syndromes, the size of myoma, the integration of clinical symptoms and signs before and after treatment. The changes of progesterone, estradiol and hemoglobin content were used to evaluate the clinical effect of herbal cake moxibustion in the treatment of uterine leiomyoma with kidney deficiency and blood stasis. Methods 60 cases of uterine leiomyoma were randomly divided into treatment group and control group with 30 cases in each group. The treatment group was treated with medicated cake moxibustion, the control group was treated with Guizhi Fuling capsule. According to the score table of kidney deficiency and blood stasis syndrome, TCM syndromes were scored, the curative effect was observed after three courses of treatment, the data was statistically analyzed and the curative effect was evaluated. Results (1) after treatment, the total effective rate was 80.00in the treatment group and 63.33 in the control group. Compared with the two groups, P0.05, the difference is statistically significant, the comprehensive efficacy of the treatment group is better than the control group. (2) after treatment, the total score of TCM syndromes in the two groups were significantly lower than before treatment, P0.05, the difference was statistically significant. After treatment, the total score of TCM syndromes of the two groups, P0.05, the difference was statistically significant. The statistical results show that both methods can reduce the total integral of TCM syndromes in patients with uterine leiomyoma. But the curative effect of the treatment group was better than that of the control group. (3) after treatment, the scores of clinical symptoms and signs of the two groups were significantly lower than those before treatment, P 0.05, the difference was statistically significant. After treatment, the scores of clinical symptoms and signs of the two groups were compared. Pulse score after treatment was significantly lower than that of control group (P0.05), the difference was statistically significant. (4) after treatment, the volume of uterine myoma decreased significantly in both groups, and the difference was statistically significant (P0.05). There was no significant difference in the volume of uterine leiomyoma between the treatment group and the control group (P 0.05). (5) after treatment, the contents of progesterone and estradiol in the two groups were significantly lower than those before treatment. The content of hemoglobin was significantly higher than that before treatment, P 0.05, the difference was statistically significant. There was significant difference in hemoglobin between the two groups after treatment (P 0.05). After treatment, there was no significant difference in progesterone and estradiol content between the two groups (P0.05). Conclusion both methods can improve the clinical symptoms and signs of patients with uterine leiomyoma, but the comprehensive curative effect of the treatment group is better than that of the control group. The curative effect of the treatment group was superior to that of the control group in improving the total score of TCM syndromes, hemoglobin, sore waist and knee, tinnitus and pulse. There was no significant difference between the two groups in improving the size of uterine leiomyoma, estradiol, progesterone, changes in quantity, prolongation of menstrual period, color, quality, subband, abdominal pain, abdominal distension, breast distention and tongue quality. The liver and kidney function of the patients were in normal range before and after treatment, indicating that moxibustion separated medicine cake is a safe and effective treatment method for uterine leiomyoma.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.9

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