【作者】 张耀文；

【导师】 刘金星；

【作者基本信息】 山东中医药大学 ， 中医妇科学， 2010， 硕士

【摘要】 目的：观察补肾安坤汤治疗肾阴阳两虚型绝经期综合征的临床疗效,初步探讨其作用机理,以期为临床治疗绝经综合征寻找更多的途径。方法：将60例绝经综合征患者随机分成治疗组(30例,口服补肾安坤汤)和对照组(30例,口服HRT),观察治疗前后两组患者临床症状、体征的改善情况,治疗前后两组患者雌二醇(E2)、血清卵泡刺激素(FSH)、黄体生成素(LH)、骨钙素(BGP)、降钙素(CT)、甲状旁腺激素(PTH)、白细胞介素-2(IL-2),总胆固醇(CHOL),甘油三酯(TG),高密度脂蛋白(HDL-L),低密度脂蛋白(LDL-L)等指标的变化情况。结果：治疗组总有效率为93.33%,愈显率为73.33%；对照组总有效率为96.67%,愈显率为80%,组间比较,差异无显著性(P>0.05)；中医证候疗效比较,治疗组总有效率为96.67%,愈显率为86.67%,对照组总有效率为96.67%,愈显率为63.33%,组间比较,差异无显著性(P>0.05)。治疗后,治疗组与对照组Kupperman积分、中医症状积分均较治疗前降低,差异有极显著性(P<0.01),组间比较无显著性差异(P>0.05)。治疗后,治疗组E2升高,FSH、LH、FSH/LH降低(P<0.01)；BGP、CT升高,PTH降低(P<0.01)；IL-2升高(P<0.01); TG、CHOL、LDL-L降低(P<0.01)；HDL-L升高(P<0.01)；与对照组比较,FSH、LH、FSH/LH、BGP、HDL-L、LDL-L差异无显著性(P>0.05); E2、CT、PTH、IL-2、TG、CHOL差异有显著性(P<0.01,P<0.05)。结论：补肾安坤汤对肾阴阳两虚型绝经综合征有较好的治疗作用。补肾安坤汤治疗本病可能是通过调节下丘脑—垂体—卵巢轴的功能、调节神经递质及免疫功能、改善骨代谢及脂代谢等多个环节而发挥作用的。更多还原

【Abstract】 Objective:To observe the clinical therapeutical effect of BuShenAnKun Decoction (BSAKD) in treating the kidney deficiency on yin and yang of MPS and Preliminary research the mechanism of its action.Menthod:60 patients were divided into two groups at random:the treatment group(30 cases,treated with BSZXD) and the control group(30 cases,treated with hormone replacement therapy).Before and after treatment, observe the improvenents of clinical symptoms, physical sign and physical/chemical index, for instance the change of E2、FSH、LH、FSH/LH、BGP、CT、PTH、IL-2、TG、CHOL、HDL-L、LDL-L.And the differences between two groups were observed equally.Result:The total clinical efficacy rate was 93.33%, the markedly effective rate was 73.33% in the test group; and the total clinical efficacy rate was 96.67%,the markedly effective rate was 80% in the control group, there was no significant difference between them (P>0.05). The total effective rate of efficacy of TCM was 96.67%, the markedly effective rate was 86.67% in the test group; and the total effective rate was 96.67%,the markedly effective rate was 63.33% in the control group, The difference was no statistically significant between the two groups(P>0.05). After treatment, the Kupperman score and the TCM symptom score of the treatment group and control group were reduced, there was a significant difference between before and after treatment (P<0.01).The Kupperman points and TCM symptom score between the two groups showed no significant difference (P>0.05). After treatment, E2 was elevated, FSH, LH, FSH/LH were reduced (P<0.01);BGP, CT were elevated, PTH was reduced (P<0.01), IL-2 was elevated (P<0.01), TG, CHOL, LDL-L were reduced (P<0.01); HDL-L was elevated (P<0.01); Compared with control group, there were no significant difference in FSH, LH, FSH/LH, BGP (P>0.05). and were statistically significant differences in E2,CT, PTH, L-2, HDL-L, LDL-L (P<0.01, P<0.05)Conclusion:The BuShenAnKun Decoction has significant clinical effects on the kidney deficiency on yin and yang of MPS. BSAKD treatment of this disease probably play a role in regulating the function of the hypothalamus-pituitary-ovarian axis, neurotransmitter and immune, improve bone metabolism and lipid metabolism and other aspects.更多还原