發(fā)布時(shí)間：2018-02-04 12:24

  本文關(guān)鍵詞： 補(bǔ)腎調(diào)周法 濕熱瘀結(jié)型 慢性盆腔炎 臨床觀察　出處：《湖北中醫(yī)藥大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:本研究通過(guò)重點(diǎn)觀察補(bǔ)腎調(diào)周法對(duì)慢性盆腔炎患者慢性盆腔痛及月經(jīng)不調(diào)的改善情況,以評(píng)價(jià)補(bǔ)腎調(diào)周法治療濕熱瘀結(jié)型慢性盆腔炎的臨床療效,并探討補(bǔ)腎調(diào)周法的作用機(jī)理,為臨床治療慢性盆腔炎提供依據(jù)。方法:所有觀察病例均來(lái)自武漢市中醫(yī)醫(yī)院2014年3月-2015年3月婦科專(zhuān)家門(mén)診就診的診斷為慢性盆腔炎(濕熱瘀結(jié)型)的患者,共觀察60例,按就診的先后順序,隨機(jī)分為治療組30例和對(duì)照組30例。治療組運(yùn)用補(bǔ)腎調(diào)周法治療,對(duì)照組采用中成藥婦科千金片治療。兩組患者均以1個(gè)月經(jīng)周期為1個(gè)觀察周期,共連續(xù)觀察3個(gè)月經(jīng)周期。通過(guò)觀察兩組患者經(jīng)過(guò)3個(gè)月經(jīng)周期治療后的綜合療效、局部體征療效、中醫(yī)證候療效以及治療后兩組患者婦科B超改善情況,并隨訪治療后3個(gè)月內(nèi)的復(fù)發(fā)率,并通過(guò)統(tǒng)計(jì)學(xué)軟件SPSS19.0進(jìn)行數(shù)據(jù)分析,計(jì)量資料采用t檢驗(yàn),計(jì)數(shù)資料采用χ2檢驗(yàn),等級(jí)資料采用Ridit分析。結(jié)果:1.兩組患者臨床綜合療效的比較:治療組痊愈8例,顯效17例,有效3例,無(wú)效2例,總有效率93.3%;對(duì)照組痊愈4例,顯效12例,有效6例,無(wú)效8例,總有效率73.3%;經(jīng)統(tǒng)計(jì)學(xué)分析,P0.05,說(shuō)明治療組的綜合療效優(yōu)于對(duì)照組。2.兩組患者中醫(yī)癥狀方面比較:治療后兩組中醫(yī)癥狀方面均有改善,尤其在下腹疼痛、腰骶酸痛、月經(jīng)異常、經(jīng)期腹痛加重、帶下異常、神疲乏力、大便異常癥狀方面,治療組和對(duì)照組相比有顯著性差異(P0.05),治療組療效優(yōu)于對(duì)照組;在小便異常、舌脈異常等方面,治療組與對(duì)照組無(wú)顯著性差異(P0.05),但治療組有效率高于對(duì)照組。3.兩組患者局部體征方面的比較:治療后兩組患者局部體征均有改善,經(jīng)統(tǒng)計(jì)學(xué)分析,在子宮活動(dòng)受限壓痛與骶韌帶增粗觸痛方面,治療組和對(duì)照組相比有顯著性差異(P0.05),說(shuō)明治療組療效優(yōu)于對(duì)照組;在附件增厚壓痛方面,兩組無(wú)顯著性差異(P0.05),但治療組有效率高于對(duì)照組。4.兩組患者在治療后B超檢查提示盆腔積液或附件包塊方面:治療組復(fù)常率66.67%,對(duì)照組復(fù)常率35.00%,兩組相比有統(tǒng)計(jì)學(xué)意義(P0.05),說(shuō)明治療組在治療盆腔積液或附件包塊方面療效優(yōu)于對(duì)照組。5.兩組患者在治療后三個(gè)月內(nèi)的復(fù)發(fā)率比較:治療組復(fù)發(fā)率為13.33%,對(duì)照組復(fù)發(fā)率為44.83%,兩組相比有統(tǒng)計(jì)學(xué)意義(P0.05),治療組的遠(yuǎn)期療效明顯優(yōu)于對(duì)照組。結(jié)論:補(bǔ)腎調(diào)周法治療濕熱瘀結(jié)型慢性盆腔炎臨床療效較好。根據(jù)月經(jīng)周期的不同時(shí)期腎陰陽(yáng)氣血變化的特點(diǎn),采用補(bǔ)腎調(diào)周四期療法,與不考慮月經(jīng)周期生理特點(diǎn)在非經(jīng)期采用婦科千金片治療相比,補(bǔ)腎調(diào)周法兼顧清利化瘀,標(biāo)本兼治,療效更優(yōu),更能明顯改善患者臨床癥狀及體征,且能降低患者治療后3個(gè)月內(nèi)的復(fù)發(fā)率。
[Abstract]:Objective: to observe the improvement of chronic pelvic pain and irregular menstruation in patients with chronic pelvic inflammatory disease by the method of tonifying kidney and regulating week, and to evaluate the clinical effect of tonifying kidney and regulating week on chronic pelvic inflammatory disease of dampness and heat stasis. The mechanism of tonifying kidney and regulating week was discussed. Methods: all the observed cases were diagnosed as chronic pelvic inflammatory disease from March 2014 to March 2015 in Wuhan traditional Chinese Medicine Hospital. Type of dampness and heat stasis. A total of 60 cases were observed and randomly divided into treatment group (n = 30) and control group (n = 30). The control group was treated with traditional Chinese patent medicine gynecological Qianjin tablet. The two groups were treated with one menstrual cycle as one observation cycle. A total of 3 consecutive menstrual cycles. By observing the two groups of patients after three menstrual cycles after treatment of comprehensive efficacy, local signs, TCM syndromes and the treatment of two groups of patients after the improvement of gynecological B ultrasound. The recurrence rate within 3 months after treatment was followed up. The data were analyzed by statistical software SPSS19.0. T test was used for measurement data and 蠂 2 test was used for counting data. Grade data were analyzed by Ridit. Results comparison of clinical comprehensive efficacy between the two groups: 8 cases were cured, 17 cases were markedly effective, 3 cases were effective, 2 cases were ineffective, and the total effective rate was 93.3% in the treatment group. In the control group, 4 cases were cured, 12 cases were markedly effective, 6 cases were effective and 8 cases were ineffective. The total effective rate was 73.3%. By statistical analysis of P0.05, it shows that the comprehensive efficacy of the treatment group is better than the control group .2.The two groups of patients compared with the traditional Chinese medicine symptoms: after treatment, two groups of TCM symptoms have improved, especially in the lower abdominal pain. Lumbosacral soreness, abnormal menstruation, abdominal pain in menstrual period, abnormal under the belt, fatigue, abnormal stool symptoms, there was significant difference between the treatment group and the control group (P 0.05), the curative effect of the treatment group was better than that of the control group. There was no significant difference between the treatment group and the control group in urine abnormality and tongue pulse abnormality (P0.05). But the effective rate of the treatment group was higher than that of the control group .3.The comparison of local signs of the two groups: after treatment, the local signs of the two groups were improved, by statistical analysis. In terms of limited tenderness of uterine activity and thickening and tenderness of sacral ligament, there was significant difference between the treatment group and the control group (P 0.05), which indicated that the curative effect of the treatment group was better than that of the control group. There was no significant difference in attachment thickening tenderness between the two groups (P 0.05). But the effective rate in the treatment group was higher than that in the control group. 4. The B ultrasound examination showed that the pelvic effusion or adnexal mass in the treatment group was 66.67 in the treatment group and 35.00% in the control group. There was significant difference between the two groups (P0.05). The treatment group in the treatment of pelvic effusion or adnexal mass curative effect is better than the control group. 5. two groups of patients in the treatment of three months after the recurrence rate comparison: the treatment group recurrence rate is 13.33%. The recurrence rate of the control group was 44.83%, which was significantly higher than that of the control group (P 0.05). The long-term curative effect of the treatment group is obviously better than that of the control group. Conclusion: the therapy of tonifying the kidney and regulating the week is better in the treatment of chronic pelvic inflammatory disease of dampness and heat stasis type. According to the characteristics of the changes of kidney yin and yang qi and blood in different periods of menstrual cycle. Using tonifying kidney and regulating Thursday period therapy, compared with non-menstrual cycle physiological characteristics in the treatment of gynecological Qianjin tablet, tonifying kidney and regulating week to take into account Qingli Huayu, both symptoms and symptoms, the curative effect is better. It can significantly improve the clinical symptoms and signs, and reduce the recurrence rate within 3 months after treatment.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R271.9

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