【摘要】：目的：觀察滋腎寧心湯治療應用GnRH-a后出現(xiàn)類絕經期癥狀且中醫(yī)辨證屬于腎陰虛證的子宮內膜異位癥術后患者的中醫(yī)臨床癥狀療效、絕經癥狀嚴重程度、各項癥狀的發(fā)生率及不良反應等。探討滋腎寧心湯治療應用GnRH-a致類絕經期癥狀的子宮內膜異位癥術后患者的臨床療效,為子宮內膜異位癥術后應用GnRH-a后出現(xiàn)類絕經期癥狀的治療提供臨床研究依據。方法：本研究選取病例均來自2014年01月01日至2016年05月31日于南京中醫(yī)藥大學附屬中西醫(yī)結合醫(yī)院行腹腔鏡手術且病理確診為子宮內膜異位癥,術后應用促性腺激素釋放激素激動劑(GnRH-a)治療時出現(xiàn)類絕經期癥狀的且中醫(yī)辨證屬腎陰虛證的患者100例(對照組35例,坤泰組32例,中藥組33例),隨機分為3組,排除脫落病例,最終完成每組各30例。所有患者均于術后月經周期第1天給予GnRH-a注射(戈舍瑞林3.6mg皮下注射),每28天注射1次,共4次。對照組僅予GnRH-a注射,坤泰組、中藥組分別于第二次給予GnRH-a同時加用坤泰膠囊、中藥方滋腎寧心湯,每四周為一個療程,共三個療程；比較三組患者在應用坤泰膠囊或滋腎寧心湯治療前后中醫(yī)臨床癥狀療效評價、絕經癥狀評分及不良反應。結果：1.三組患者治療后第12周相比,坤泰組及中藥組均較同組治療前臨床癥狀及體征積分明顯下降,差異有統(tǒng)計學意義(p0.05),而對照組與治療前比較差異無統(tǒng)計學意義(p0.05)。治療后第12周三組Kupermann評分均較同組治療前升高,且按對照組、坤泰組、中藥組的順序依次呈下降趨勢,且差異具有的統(tǒng)計學意義(p0.05)。2.對照組在治療期間出現(xiàn)了一系列的類絕經期癥狀,坤泰組及中藥組相應癥狀出現(xiàn)的例數(shù)均有所減少,且中藥組與坤泰組相比其類絕經期癥狀的嚴重程度明顯較輕。結論：滋腎寧心湯在臨床上可有效緩解子宮內膜異位癥術后患者應用促性腺激素釋放激素激動劑(GnRH-a)治療所引起的類絕經期癥狀,且療效優(yōu)于坤泰膠囊。
[Abstract]:Objective: to observe the effect of Zishen Ningxin decoction on the clinical symptoms and the severity of menopausal symptoms in patients with endometriosis with syndrome differentiation of kidney yin deficiency after GnRH-a. Incidence of symptoms and adverse reactions. To explore the clinical effect of Zishen Ningxin decoction in treating endometriosis patients with menopausal symptoms caused by GnRH-a, and to provide clinical research basis for the treatment of menopausal symptoms after GnRH-a. Methods: all cases were selected from January 01, 2014 to May 31, 2016 in Nanjing University of traditional Chinese Medicine affiliated to the hospital of integrated traditional Chinese and western medicine laparoscopic surgery and pathological diagnosis of endometriosis, After operation, 100 patients (35 cases in control group, 32 cases in Kuntai group and 33 cases in Chinese herbal medicine group) who had postmenopausal symptoms of gonadotropin releasing hormone agonist (GnRH-a) were randomly divided into 3 groups, excluding shedding cases. 30 cases in each group were finished. All patients were given GnRH-a injection (3.6mg subcutaneous injection) on the first day of menstrual cycle after operation, once every 28 days, a total of 4 times. The control group was only given GnRH-a injection, the Kun Tai group and the traditional Chinese medicine group were given GnRH-a plus Kun Tai capsule for the second time. The traditional Chinese medicine prescription Zishen Ningxin decoction was a course of treatment every four weeks for a total of three courses. To compare the curative effect evaluation, menopausal symptom score and adverse reaction of TCM before and after the treatment with Kun Tai capsule or Zishen Ningxin decoction. The result is 1: 1. At the 12th week after treatment, the scores of clinical symptoms and signs in Kuntai group and traditional Chinese medicine group were significantly lower than those in the same group (p0.05), but there was no significant difference between control group and pre-treatment group (p0.05). The Kupermann scores in the 12th Wednesday group were higher than those in the same group before treatment, and the order of control group, Kuntai group and Chinese medicine group showed a decreasing trend, and the difference was statistically significant (p0. 05). 2. In the control group, a series of menopausal symptoms appeared during the treatment period, and the corresponding symptoms in the Kun Tai group and the traditional Chinese medicine group were decreased, and the severity of the menopausal symptoms in the Chinese medicine group was significantly less than that in the Kuntai group. Conclusion: Zishen Ningxin decoction can effectively relieve the menopausal symptoms caused by gonadotropin releasing hormone agonist (GnRH-a) in patients with endometriosis after operation, and the curative effect is better than Kuntai capsule.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.116

【參考文獻】

相關期刊論文 前10條

1 賴玉芳;;GnRH-a聯(lián)合媽富隆治療重度子宮內膜異位癥療效觀察[J];深圳中西醫(yī)結合雜志;2015年21期

2 吳宏;;CA125、CA199在子宮內膜異位癥診斷中的應用價值[J];航空航天醫(yī)學雜志;2015年09期

3 王淑君;洛若愚;涂佳慧;皮潔;賈勝楠;;GnRH-a聯(lián)合反加療法對子宮內膜異位癥保守性手術后患者療效的Meta分析[J];中國婦幼保健;2015年18期

4 劉長青;秦愛新;姜芳芳;洪婷;王峰;;促性腺激素釋放激素激動劑聯(lián)合坤泰膠囊治療中重度子宮內膜異位癥的臨床觀察[J];中國中西醫(yī)結合雜志;2014年11期

5 劉巧玲;滕輝;王俊玲;劉昱磊;謝瑛;王雙魁;;火針治療子宮內膜異位癥臨床觀察[J];上海針灸雜志;2014年08期

6 朱冬琴;周德蘭;鄭真霞;陳珊;王秀麗;韓素萍;;GnRH-a治療子宮內膜異位癥中雌激素反向添加治療的個體化[J];江蘇醫(yī)藥;2014年14期

7 黃丹丹;郭英;程慧蓮;葛崇華;岳明明;盧艷麗;;GnRH-a聯(lián)合中藥防治卵巢子宮內膜異位癥術后復發(fā)的臨床研究[J];新疆中醫(yī)藥;2014年03期

8 薛江麗;;分型論治子宮內膜異位癥臨床觀察[J];山西中醫(yī);2013年09期

9 陳富強;汪愛萍;張愛鳳;王小波;;宮腔鏡子宮內膜去除術聯(lián)合左炔諾孕酮宮內節(jié)育系統(tǒng)治療子宮肌腺病的臨床研究[J];上海交通大學學報(醫(yī)學版);2013年08期

10 張玉華;;保守手術后聯(lián)合米非司酮鞏固治療子宮內膜異位癥的臨床觀察[J];河北醫(yī)藥;2013年09期

，

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