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  本文選題：補腎活血方　切入點：腎虛血瘀型　出處：《湖北中醫(yī)藥大學》2014年碩士論文

【摘要】：目的: 通過觀察補腎活血方周期療法聯(lián)合來曲唑及克羅米芬治療腎虛血瘀型排卵障礙性不孕的臨床療效，客觀評價補腎活血方周期療法在促進卵泡生長、提高排卵率，改善臨床癥狀、促進子宮內(nèi)膜生長、提高妊娠率方面的作用。為臨床治療該病提供可靠的客觀依據(jù)。 方法: 將診斷為腎虛血瘀型排卵障礙性不孕癥的60例患者，隨機分為A組(治療組)、B組（對照組），每組各30例。對照組予以來曲唑（LE）、克羅米芬（CC）口服，，人絨毛膜促性腺激素(HCG)肌注治療；治療組在對照組治療方法的基礎上,加用補腎活血方周期療法，3個月經(jīng)周期為1療程，均治療2個療程。觀察治療前后兩組的臨床癥狀、卵泡發(fā)育、排卵率、妊娠率、子宮內(nèi)膜厚度、中醫(yī)癥候積分等方面的變化,進行統(tǒng)計學分析，對兩組方法的臨床療效進行評價。 結(jié)果: 1、兩組治療后卵泡大小、排卵率比較，治療組明顯優(yōu)于對照組（P＜0.05）；2、兩組促排卵綜合療效對比,顯愈率差異有顯著性(P＜0.05)；3、中醫(yī)證候積分比較，有顯著性差異（P＜0.05）；4、兩組子宮內(nèi)膜的厚度比較,治療組明顯優(yōu)于對照組（P＜0.05）；5、兩組妊娠率比較，有顯著性差異（P＜0.05）。 結(jié)論: 1、補腎活血方周期療法能提高卵巢對垂體促性腺激素的反應性，從而促進卵泡發(fā)育,調(diào)節(jié)黃體功能。2、LE、CC、補腎調(diào)周法聯(lián)合使用可以促進卵泡的生長、誘發(fā)排卵、改善子宮內(nèi)膜厚度、提高患者的妊娠率并改善臨床癥狀，既發(fā)揮了西藥高效促排卵作用,同時也彌補了西藥相關的副作用。3、補腎活血方周期療法，重在補腎壯陽、活血通絡，使機體氣血通暢、陰陽平衡、臟腑功能協(xié)調(diào)，從而充分調(diào)動腎-天癸-沖任-胞宮軸的生理功能，提高受孕率。
[Abstract]:Objective:. By observing the clinical efficacy of Bushen Huoxue prescription combined with letrozole and clomiphene in the treatment of ovulatory dysfunction of kidney deficiency and blood stasis type, the objective evaluation of Bushen Huoxue prescription cycle therapy was to promote follicular growth and increase ovulation rate. To improve the clinical symptoms, promote the growth of endometrium, improve the pregnancy rate, and provide a reliable objective basis for clinical treatment of the disease. Methods:. Sixty patients with ovulatory disorder of kidney deficiency and blood stasis type were randomly divided into two groups: group A (control group, 30 cases, each group, 30 cases), control group, oral administration of letrozolide and clomiphene (CCL). The treatment group was treated by intramuscular injection of human chorionic gonadotropin (HCG), the treatment group was treated with Bushen Huoxue prescription on the basis of the treatment method of control group, 3 menstrual cycles were one course of treatment, all of them were treated for 2 courses. The clinical symptoms of the two groups were observed before and after the treatment. The changes of follicular development, ovulation rate, pregnancy rate, endometrial thickness, TCM symptom score and so on were analyzed statistically to evaluate the clinical efficacy of the two groups. Results:. 1. After treatment, the follicle size and ovulation rate in the treatment group were significantly better than those in the control group (P < 0.05). The comprehensive efficacy of the two groups in promoting ovulation was compared with that in the control group (P < 0.05). There was a significant difference in the apparent recovery rate between the two groups (P < 0.05), and the score of TCM syndromes was higher than that in the control group (P < 0.05). There was significant difference in endometrial thickness between the two groups (P < 0.05). The treatment group was better than the control group (P < 0.05). The pregnancy rate of the two groups was significantly higher than that of the control group (P < 0.05). Conclusion:. 1. The periodic therapy of tonifying kidney and activating blood circulation prescription can improve the response of ovary to pituitary gonadotropin, thus promote follicle development, regulate luteal function. The combination of tonifying kidney and regulating week method can promote follicle growth, induce ovulation, and improve endometrial thickness. Increasing the pregnancy rate and improving the clinical symptoms not only play a role in promoting ovulation effectively by western medicine, but also make up for the side-effect of western medicine. The cycle therapy of tonifying kidney and activating blood circulation is focused on invigorating kidney and strengthening yang, activating blood circulation, making body qi and blood unobstructed. The balance of yin and yang and the coordination of viscera function can fully mobilize the physiological function of kidney-Tiangui-Chong Ren-uterus axis and improve the pregnancy rate.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R711.6

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