【作者】 李平；

【导师】 李忠仁；

【作者基本信息】 南京中医药大学 ， 针灸推拿学， 2011， 硕士

【摘要】 目的：观察针灸配合中药汤剂与单纯中药汤剂治疗脾肾阳虚型围绝经期综合征的临床疗效差异及可能的机理,并为该疗法的临床推广应用提供一定的临床依据。方法：本研究共观察脾肾阳虚型围绝经期综合征患者(根据改良Kupperman评分标准)60例,数字法随机分为2组,其中针灸加中药汤剂组30例,单纯中药汤剂组30例。针灸加中药汤剂组的穴位：选用智三针穴、百会穴、内关穴、神门穴、关元穴、子宫穴、足三里穴、三阴交穴、太溪穴、太冲穴等,艾灸神阙穴,同时配合中药汤剂口服(处方同单纯中药汤剂组),药物对照组：予以江苏省中医院妇科门诊治疗脾肾阳虚证型的围绝经期综合征的协定方：钩藤15g后下丹皮参10g山萸肉10g鳖甲10g先煎淮山药10g熟地黄10g生地黄10g川断10g桑寄生10g枸杞子10g杜仲10g茯苓10g莲子心3g仙灵脾10g太子参10g夜交藤15g首乌10g冬桑叶6g合欢皮10g菟丝子10g红花6g玫瑰花6g。煎成汤剂口服。针灸加中药治疗组：上述诸穴予以针刺治疗,艾灸神阙穴,温和灸,灸至局部皮肤微微泛红为度,每周3次；同时口服中药汤剂,每日一剂,分两次服用,4周为一个疗程；单纯中药汤剂口服组：每日服用中药汤剂1剂,分两次服用,4周为一个疗程。根据改良Kupperman评分标准,分别评估各组患者治疗及服药前后症状评分及性激素水平的动态变化。结果：根据改良Kupperman评分标准分析,两组治疗均有显效,并优于治疗前评分；但二组间疗效比较,针灸配合中药汤剂组疗效明显优于单纯中药汤剂组(P<0.01),患者临床症状较治疗前明显改善,可是两组间比较,治疗后激素水平的改善并无统计学意义。结论：针灸配合中药汤剂组与单纯中药汤剂组治疗脾肾阳虚型围绝经期综合征均有一定的疗效。但针灸配合中药汤剂组对脾肾阳虚证型的围绝经期综合征患者的临床症状改善,显著优于单纯口服中药组,与治疗前相比改善更明显,值得临床进一步推广应用。更多还原

【Abstract】 [Purpose]Observe the difference of the clinical effect and possible mechanism between acupuncture with traditional Chinese medicine and simple Chinese medicine in treating premenopausal syndrome with yang deficiency of spleen and kidney to find the best therapy for clinical application and provide a scientific basis.[Method]In this study,60 cases of premenopausal syndrome with yang deficiency of spleen and kidney (according to modified Kupperman score standard) were digital randomly divided into 2 groups, including acupuncture with traditional Chinese medicine group of 30 patients, simple Chinese medicine group of 30 patients. acupuncture with traditional Chinese medicine group:we choose the points below:zhi san zhen points, bai hui point, nei guan point, shen men point, guan yuan point, zi gong point, zu san li point, san yin jiao point, tai xi point, tai chong point and so on, moxibustion on shen que point, meanwhile taking the traditional Chinese medicine(same with the simple Chinese medicine group). The simple chinese medicine group:using the specified formular for premenopausal syndrome with yang deficiency of spleen and kidney in Gynaecology department in JiangSu provincal hospital of TCM,includes:gou teng 15g(boiled last), dan pi 10g, dan shen 10g, shan yu rou 10g, bie jia 10g(boiled first), huai shan yao lOg shu di huang 10g, sheng di huang 10g, chuan duan 10g, sang ji sheng 10g, gou qi zi 10g, du zhong 10g, fu ling 10g, lian zi xin 3g, xian ling pi 10g, tai zi shen 10g, ye jiao teng 15g, shou wu 10g, dong sang ye 6g, he huan pi 10g, tu si zi 10g, hong hua 6g, mei gui hua 6g.all of them boiled into decoction for the patients. acupuncture with Chinese medicine group:using the common acupuncture therapy on the points mentioned above with moxibustion on shen que point,3 times a week. Meanwhile let the patients to take one decoction everyday,2 times a day. Four weeks for a course; the simple Chinese medicine group:daily take traditional chinese medicine decoction, two times a day, also four weeks for a course. according to the modified Kupperman score standard to judge the improvement of clinical effect and change of hormones levels before and after the two different kinds of therapy methods respectively.[Result]Analysis according to the modified Kupperman score standard,two groups of treatment are effective, and the score is better than that before the treatment. But the comparison of curative effecbetween two groups shows that acupuncture with Chinese medicine treatment result is obviously better than the curative effect of Chinese medicine group.(P<0.01), the clinical symptoms improved obviously comparing with the symptoms before treatment.But comparing between the two groups, before and after the treatment,the hormone levels have no statistically significant.[Conclusion]Acupuncture with Chinese medicine and the Chinese medicine group do all have the curative effect in treating premenopausal syndrome with yang deficiency of spleen and kidney. But for the acupuncture with Chinese medicine group, the clinical symptoms improved significantly better than simple chinese medicine group, compared with the symptoms before treatment,after the treatment,the clinical symptoms improved more obvious.It can deserve the widely clinical application.更多还原