【作者】 王舒婷；

【导师】 米建平；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2011， 硕士

【摘要】 背景经前期综合征(premenstrual syndrome, PMS)是临床上的常见病,多发于20～45岁妇女,以反复在行经前7～14天(黄体期),周期性出现一系列精神、躯体方面的症状为主,月经来潮后自然消失。PMS不仅影响生活,还会产生不良情绪,如焦虑、抑郁、情绪低落、愤怒等。PMS的现代医学发病机制主要跟内分泌失调、β-内啡肽释放失常、维生素B6缺乏及精神社会因素相关。西医药物治疗主要以抗抑郁、焦虑剂及激素类药物为主,远期疗效不尽理想,复发率较高。中医认为PMS主要与肝、脾、肾功能失调有关。各研究报道均说明中医治疗本病有一定优势,疗效显著,有良好发展前景。但临床上PMS的治疗多以中药治疗为主。本课题旨于探究以腹针疗法对肝郁气滞型经前期综合征的临床疗效,并与中药作对照,寻求治疗PMS更为简便、有效、安全的新疗法。腹针为主综合疗法是导师米建平主任医师在长期治疗肝郁气滞型PMS中,针对女子素体阴血偏虚,有余于气,易致肝失调达,气机不畅的病机提出来的。该法以腹针调理脏腑、养先后天为主,配合四关穴疏肝解郁、调理气血为辅,临床运用屡获良效。目的：通过随机对照研究探讨以腹针为主治疗肝郁气滞型经前期综合征患者的临床疗效。方法：按标准选取60例肝郁气滞型经前期综合征患者,利用简单随机化方法,根据样本含量,采用PEMS3.1软件实施随机分组,把就诊患者随机分为腹针组和药物组。其中腹针组采用腹针结合基础疗法,于经前7天开始治疗,每日一次,至行经时停止,1个月经周期为1疗程,连续治疗2个疗程；药物组采用口服逍遥散中药颗粒剂结合基础疗法,于经前7天开始治疗,每天1次,每次1剂,至行经时停止,1个月经周期为1疗程,连续治疗2个疗程。观察治疗前、治疗结束、治疗后2个月症状评分情况和治疗结束总有效率。结果：腹针组30例,治疗结束,痊愈11例,显效9例,有效7例,无效3例,总有效率90.0%；药物组30例,治疗结束,痊愈12例,显效9例,有效5例,无效4例,总有效率86.7%；腹针组治疗后第二个月经周期回访,痊愈7例,显效7例,有效11例,无效5例,总有效率83.3%；药物组回访,痊愈7例,显效9例,有效4例,无效10例,总有效率66.7%。两组疗效比较,治疗结时,差异无显著性意义(P>0.05)；治疗结束后第二个月经周期回访,差异有显著性意义(P<0.05)。两组治疗前后精神症状积分有显著性差异(P<0.05),腹针组治疗前后精神症状积分差值较药物组高。两组治疗前后躯体症状积分无显著性差异(P>0.05)。结论：腹针为主疗法与药物疗法对改PMS患者经前症状有一定作用,近期疗效两者相当,但腹针组对于PMS患者精神症状的改善优于药物组,远期疗效腹针疗法明显优于药物疗法。更多还原

【Abstract】 ObjectivesPMS (premenstrual syndrome, PMS) is a clinically common diseases, mainly in women aged 20 to 45 to repeatedly pass through the first 7 to 14 days (lutealphase), there aseriesof periodic mental,physical, etc. Symptoms, menst rual cramps after disappear naturally. PMS affects not only life, but also withthe negative mood-related,suchasanxiety, depression, depression, an ger andsoon. PMS inthe pathogenesisof themajor modernmedicine with endocri nedisorders,β-endorphin release disorders, vitamin B6 deficiency and related psychosocialfactors. Western medicaltreatment mainly depressio n, anxiety agents and hormone-based drugs,not the ideal long-term efficacy, recurrence rate is high.Chinesemedicine, PMS mainly spleen, liverand renaldysfunctionrelated. The studyreported that Chinesemedicine treatmentoftheisease have certain advantages, a significant effect, with good prospects for development.But the clinical treatmentofPMS andmore to traditionalChinesemedicine therap. Thistopic aims to explorethe abdominalacupuncture onthe Liver-QiStagnatio n, theclinical efficacy of premenstrual syndrome, and with the traditional Chinesemedicine for thecontrol, seekingtreatmentfor PMS ismore simple, effe ctiveand safenew therapies.Abdominal Acupuncture therapyisa comprehensive teacher-meter long-term treatment Jianping, chief physician in the PMS of Liver-Qi Stagnation, forthe women’sside ferrite Yinxue true, more than in the air, prone to cause disorders of the liver, the pathogenesis of gas-poor put forward. In this method, combined with abdominal acupuncture fire needle approach to abdominal acupuncture onditioning organs, has ay care-based, four customspoints with cupping Liver-QiStagnation, regulate qiandblood, givingthe clinical use of award-good effect. Randomized controlled study by the Treatmentof AbdominalAcupuncture Liver-Qitagnatio n, premenstrual syndrome clinical efficacy.MethodsSelected 60 cases by standard Liver-Qi Stagnation, premenstrual syndrome, the use of simple random method, according to sample size,the use of software implementationPEMS3.1 randomized to treatment were randomly divided into abdominal acupuncture group and medication group.One group was treated with abdominal abdominal acupuncture needle to open four Guan+cupping therapy,in the 7 days before the start of treatment by once a day, to stop when passing through the needle, a menstrual cycle as a course of treatment, continuous treatment of 2 courses;drug group used Xiaoyaosan oral medicine granules, in the 7 days before the start of treatment after day 1, every one, to stop taking the time passing, a menstrual cycle as a course of treatment, continuous treatment of 2 courses. Observed before the end of treatment,2 months after treatment, symptom scores overall situation and the end of the treatment efficiency.Results30 cases of abdominal acupuncture group, the end of treatment,11 patients recovered,9 cases were markedly effective in 7 cases,3 cases, total effective rate90.0%;drug group 30 cases, the end of treatment,12 patients cured, markedly effective in 9 cases,5 cases 4 cases were ineffective, the total effective rate was 86.7%;abdominal acupuncture group were followed up for 2 months after treatment, recovery in 7 cases,7 cases markedly effective in 11 cases,5 cases ineffective, the total effective rate was 83.3%;drugs were followed up,7 patients recovered, Effective in 9 cases, effective in 4 cases, ineffective in 10 cases, total effective rate 66.7%. Comparison of two groups, the end of treatment,the difference was not significant(P>0.05);2 months after treatment, the difference was significant(P<0.05). Mental symptom scores before and after treatment were significantly different(P<0.05), abdominal acupuncture points before and after treatment of psychiatric symptoms than the difference between the high drug group, suggesting that abdominal acupuncture group for the improvement of psychiatric symptoms in patients with PMS better than medication group. Somatic symptom scores before and after treatment in both groups no significant difference (P> 0.05).ConclusionAbdominal Acupuncture therapy and drug therapy on premenstrual symptoms in patients with PMS to change a certain role, the recent effect of the two equivalent, but abdominal acupuncture group for patients with mental symptoms of PMS better than the medication group to improve the long-term efficacy is superior to abdominal acupuncture Drug therapy.更多还原