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  本文關(guān)鍵詞：溫腎化瘀法治療腎虛血瘀型子宮內(nèi)膜異位性疾病的臨床觀察　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 腎虛血瘀型 痛經(jīng) 溫腎化瘀 子宮內(nèi)膜異位癥 子宮腺肌病 子宮內(nèi)膜異位性疾病

【摘要】：目的:觀察以溫腎化瘀為治法的導(dǎo)師臨床經(jīng)驗方治療腎虛血瘀型子宮內(nèi)膜異位性疾病的臨床療效性及安全性,并初步探討其作用機(jī)制,以期進(jìn)一步為子宮內(nèi)膜異位性疾病的治療提供可行的思路、有效的方法及可靠的臨床證據(jù)。方法:選取32例以痛經(jīng)為主訴的腎虛血瘀型子宮內(nèi)膜異位癥和(或)子宮腺肌病患者作為臨床研究對象,予導(dǎo)師經(jīng)驗方治療3個月經(jīng)周期。觀察治療前、治療結(jié)束時患者的中醫(yī)證候評分、痛經(jīng)程度評分、VAS評分、血清CA125水平、B超等療效性指標(biāo)的變化,并通過監(jiān)測患者安全性指標(biāo)檢測該治療方法的安全性。治療結(jié)束3個月后對臨床治愈的受試者進(jìn)行中醫(yī)證候、疼痛程度的隨訪。結(jié)果:在治療過程中有2例患者脫落,最終完成本課題研究的合格受試者共30例。30例腎虛血瘀型子宮內(nèi)膜異位性疾病受試者經(jīng)過3個月經(jīng)周期的治療后,痊愈5例,顯效14例,有效8例,無效3例,總顯愈率為63.34%,有效率90%,中醫(yī)證候積分、痛經(jīng)程度評分、VAS評分及血清CA125水平均較治療前明顯降低,對縮小異位囊腫方面有一定作用;統(tǒng)計分析發(fā)現(xiàn)痛經(jīng)程度與療效具有相關(guān)性,痛經(jīng)程度越輕,療效越顯著,但年齡與療效無明顯相關(guān)性。檢測了本次研究的30例患者的相關(guān)安全性指標(biāo),在整個治療過程中受試者均未出現(xiàn)臨床不良反應(yīng),各項安全性指標(biāo)均在正常范圍內(nèi),研究結(jié)果證實該治療方法療效確切并且安全無副作用。治療結(jié)束后3個月對臨床治愈的5名受試者進(jìn)行了隨訪,均未發(fā)現(xiàn)有疼痛癥狀及相關(guān)伴隨癥狀的復(fù)發(fā),該研究結(jié)果表明本治療方法療效較穩(wěn)定。結(jié)論:溫腎化瘀法指導(dǎo)下的導(dǎo)師臨床經(jīng)驗方能明顯緩解子宮內(nèi)膜異位性疾病患者的痛經(jīng)癥狀,同時對改善患者肛門墜痛、非經(jīng)期下腹部不適、形寒肢冷等伴隨癥狀療效確切,能有效降低血清CA125水平,且能在一定程度上縮減異位囊腫,無明顯不良反應(yīng),療效穩(wěn)定,值得進(jìn)一步研究及臨床推廣運用。
[Abstract]:Objective: to observe the clinical efficacy and safety of tutor's clinical experience prescription in treating endometriosis of kidney deficiency and blood stasis type with warming kidney and removing blood stasis, and to explore its mechanism. In order to further provide feasible ideas for the treatment of endometriosis. Methods: 32 cases of endometriosis and / or adenomyosis with dysmenorrhea as main complaint were selected. The Chinese medicine syndrome score, dysmenorrhea degree score and serum CA125 level were observed before and after treatment. B ultrasound and other therapeutic indicators, and by monitoring the safety indicators of patients to detect the safety of the treatment method. 3 months after the end of the treatment of clinical cured subjects for TCM syndromes. Results: during the course of treatment, 2 patients dropped off. A total of 30 cases of endometriosis with kidney deficiency and blood stasis were successfully completed. After 3 menstrual cycles, 5 cases were cured, 14 cases were effective, and 8 cases were effective. The total effective rate was 63.34 and the effective rate was 90. The scores of TCM syndromes, dysmenorrhea and serum CA125 were significantly lower than those before treatment. It plays a certain role in reducing ectopic cysts. Statistical analysis showed that the degree of dysmenorrhea was correlated with the curative effect. The milder the degree of dysmenorrhea, the more significant the curative effect, but the age had no significant correlation with the curative effect. In the whole course of treatment, the subjects did not appear clinical adverse reactions, the safety indicators were in the normal range. The results of the study confirmed that the treatment was effective and safe without side effects. 5 subjects who were clinically cured were followed up 3 months after the treatment. No recurrence of pain and associated symptoms was found. The results of this study show that the therapeutic effect of this method is more stable. Conclusion: the clinical experience of mentor guided by warming kidney and removing blood stasis can obviously relieve dysmenorrhea symptoms of patients with endometriosis. At the same time to improve the patients with anal pain, non-menstrual lower abdominal discomfort, cold cold, and other associated symptoms, can effectively reduce the level of serum CA125, and can reduce ectopic cysts to a certain extent. No obvious adverse reaction, stable curative effect, worthy of further study and clinical application.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R271.9

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