补肾活血汤治疗肾虚血瘀型子宫腺肌病月经过多的临床观察
发布时间：2019-01-19 19:43
【摘要】：目的:观察补肾活血汤(《伤科大成》)用于肾虚血瘀型子宫腺肌病月经过多的治疗前后各项观察指标的变化,客观评价补肾活血汤治疗肾虚血瘀型子宫腺肌病引起的月经过多的临床疗效,总结其疗效特点,并初步探索其可能的疗效机制,为今后临床运用本方治疗该病提供参考。方法:将收集符合要求的患者60例随机分为两组,每组30例,一组为补肾活血汤治疗组,予补肾活血汤加减方药每剂水煎300mL,早饭前晚饭后分别服用150mL,月经来潮第一日开始服用经期方药,连服七天后改服非经期方药,以此方式连续规范服用3个月经周期后停药。另一组为米非司酮对照组,口服米非司酮12.5mg(华润紫竹药业)日1次睡前口服,月经来潮第一日开始服药,此方法连续规范治疗3个月经周期停药。并嘱所有患者治疗期间避孕,经期使用统一规格卫生巾。记录患者各疗前、疗后观察指标。利用Microsoft Excel 2016中的资料数据表,统计治疗组、对照组各观察指标疗后与疗前的差异,并比较治疗组和对照组之间的疗效差异。应用spss17.0统计软件进行统计分析。结果:1.补肾活血汤治疗组和米非司酮对照组疗后患者月经量、血清糖类抗原CA125、痛经积分、妇科检查积分、子宫体积较疗前均具有显著差异性(P0.05),两组疗后组间比较无显著差异(*P0.05)。2.补肾活血汤治疗组和米非司酮对照组疗后患者中医证候积分、血红蛋白计数较疗前均具有极显著差异性(P0.01),两组疗后组间比较有极显著差异(*P0.01)。3.补肾活血汤治疗组综合疗效和中医证候疗效有效率愈显率明显高于米非司酮对照组(P0.05),二者在月经过多治疗方面有效率愈显率无显著差异(P0.05)。结论:1.补肾活血汤治疗肾虚血瘀型子宫腺肌病月经过多疗效显著,综合疗效有效率达85.71%,可明显减少子宫腺肌病患者的月经量、改善痛经症状,能降低患者血清糖类抗原CA125水平、减小子宫体积、改善患者盆腔局部体征,并且在纠正子宫腺肌病患者的贫血状态、改善患者中医证候两方面具有独特优势。2.通过随访发现,补肾活血汤治疗肾虚血瘀型子宫腺肌病月经过多的远期疗效稳定,复发率低。3.补肾活血汤可能是通过改善血液循环、增强机体免疫力、抗炎、止痛等机制,从而起到治疗作用的。
[Abstract]:Objective: to observe the changes of observation indexes before and after the treatment of kidney deficiency and blood stasis type uterine adenomyosis with Bushen Huoxue decoction. Objective to evaluate the clinical efficacy of Bushen Huoxue decoction in treating menorrhagia caused by kidney deficiency and blood stasis type uterine adenomyosis, summarize its curative effect characteristics, and explore its possible therapeutic mechanism, so as to provide reference for the treatment of this disease in the future. Methods: a total of 60 patients were randomly divided into two groups, 30 cases in each group. One group was treated with Bushen Huoxue decoction, 300 mL per dose of Bushen Huoxue decoction, and 150 mL before and after breakfast, respectively. Menstrual cycle began to take the first day of menstrual prescription, seven days after taking non-menstrual prescription, this way to continue to regulate the use of three menstrual cycles after withdrawal. The other group was mifepristone control group, which took mifepristone 12.5mg once a day before bedtime, and began to take medicine on the first day of menstruation. All patients were told to use contraceptive during treatment and use uniform sanitary napkins during menstrual period. The observation indexes before and after treatment were recorded. The data tables of Microsoft Excel 2016 were used to analyze the differences between the observation indexes of the treatment group and the control group after treatment and before treatment, and the difference of curative effect between the treatment group and the control group was compared. Spss17.0 statistical software was used for statistical analysis. Results: 1. There were significant differences in menstrual volume, CA125, score, gynecological score and uterine volume between the treatment group and Mifepristone control group (P0.05). There was no significant difference between the two groups after treatment (* P0.05). 2. Bushen Huoxue decoction treatment group and mifepristone control group after the treatment of TCM syndrome score, hemoglobin count than before treatment have extremely significant difference (P0.01), the two groups after treatment group has a very significant difference (* P0.01). 3. The effective rate of Bushen Huoxue decoction treatment group was significantly higher than that of Mifepristone control group (P0.05). There was no significant difference in the effective rate of menorrhagia between the two groups (P0.05). Conclusion: 1. The effect of Bushen Huoxue decoction on menorrhagia of kidney deficiency and blood stasis type uterine adenomyosis is remarkable. The comprehensive effective rate is 85.71. It can obviously reduce the menstrual volume of patients with adenomyosis and improve dysmenorrhea symptoms. It can reduce the level of serum carbohydrate antigen CA125, reduce the volume of uterus, improve the pelvic local signs of patients, and has unique advantages in correcting anemia status of patients with adenomyosis and improving TCM syndromes of patients. 2. It was found that Bushen Huoxue decoction had a stable long term curative effect and a low recurrence rate in the treatment of excessive menstruation of kidney deficiency and blood stasis type of uterine adenomyosis. Bushen Huoxue decoction may play a therapeutic role by improving blood circulation, enhancing immunity, anti-inflammation, analgesia and other mechanisms.
【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
本文编号：2411691
[Abstract]:Objective: to observe the changes of observation indexes before and after the treatment of kidney deficiency and blood stasis type uterine adenomyosis with Bushen Huoxue decoction. Objective to evaluate the clinical efficacy of Bushen Huoxue decoction in treating menorrhagia caused by kidney deficiency and blood stasis type uterine adenomyosis, summarize its curative effect characteristics, and explore its possible therapeutic mechanism, so as to provide reference for the treatment of this disease in the future. Methods: a total of 60 patients were randomly divided into two groups, 30 cases in each group. One group was treated with Bushen Huoxue decoction, 300 mL per dose of Bushen Huoxue decoction, and 150 mL before and after breakfast, respectively. Menstrual cycle began to take the first day of menstrual prescription, seven days after taking non-menstrual prescription, this way to continue to regulate the use of three menstrual cycles after withdrawal. The other group was mifepristone control group, which took mifepristone 12.5mg once a day before bedtime, and began to take medicine on the first day of menstruation. All patients were told to use contraceptive during treatment and use uniform sanitary napkins during menstrual period. The observation indexes before and after treatment were recorded. The data tables of Microsoft Excel 2016 were used to analyze the differences between the observation indexes of the treatment group and the control group after treatment and before treatment, and the difference of curative effect between the treatment group and the control group was compared. Spss17.0 statistical software was used for statistical analysis. Results: 1. There were significant differences in menstrual volume, CA125, score, gynecological score and uterine volume between the treatment group and Mifepristone control group (P0.05). There was no significant difference between the two groups after treatment (* P0.05). 2. Bushen Huoxue decoction treatment group and mifepristone control group after the treatment of TCM syndrome score, hemoglobin count than before treatment have extremely significant difference (P0.01), the two groups after treatment group has a very significant difference (* P0.01). 3. The effective rate of Bushen Huoxue decoction treatment group was significantly higher than that of Mifepristone control group (P0.05). There was no significant difference in the effective rate of menorrhagia between the two groups (P0.05). Conclusion: 1. The effect of Bushen Huoxue decoction on menorrhagia of kidney deficiency and blood stasis type uterine adenomyosis is remarkable. The comprehensive effective rate is 85.71. It can obviously reduce the menstrual volume of patients with adenomyosis and improve dysmenorrhea symptoms. It can reduce the level of serum carbohydrate antigen CA125, reduce the volume of uterus, improve the pelvic local signs of patients, and has unique advantages in correcting anemia status of patients with adenomyosis and improving TCM syndromes of patients. 2. It was found that Bushen Huoxue decoction had a stable long term curative effect and a low recurrence rate in the treatment of excessive menstruation of kidney deficiency and blood stasis type of uterine adenomyosis. Bushen Huoxue decoction may play a therapeutic role by improving blood circulation, enhancing immunity, anti-inflammation, analgesia and other mechanisms.
【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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