【作者】 王雪琴；

【导师】 邓高丕；

【作者基本信息】 广州中医药大学 ， 中医妇科学， 2008， 硕士

【摘要】 目的:本课题通过收集近十年有关中医治疗围绝经期功能性子宫出血的文献,对其中出血期的中医证治规律及用药进行统计分析,探讨其中医证治及用药规律,为优化围绝经期功能性子宫出血(出血期)的中医治疗提供依据。方法:收集1997年1月至2007年12月生物医学期刊发表的有关围绝经期功能性子宫出血的中医临床研究文献。对符合研究标准的文献进行中医辨证、治法、用药的归纳,并用EXCEL软件进行数据统计分析。1将收集到的文献进行归类,筛选出血期的病例。2将文献中的病例数、中医辨证、治法、基本方的组成药物列成表格。3计算出各中医证型、治法在总病例中所占的百分比,做成图表。4统计出所采用的文献中不同中医治法中每味中药的使用频率,并将使用频率按高低排列,对前12味中药的中医治疗机理和现代药理进行分析。结果:围绝经期功能性子宫出血(出血期)的辨证主要为:1)脾肾亏虚型,占33.1%;2)血瘀型,占25.4%;3)肾阴虚型,占20.2%;4)肝肾阴虚型,占15.1%。围绝经期功能性子宫出血(出血期)的治法主要有:1)补肾健脾,固冲止血,占33.1%;2)益气活血,化瘀止崩,占25.4%;3)滋阴补肾,固护冲任,占20.2%;4)滋肾养肝,固冲调经,占15.1%。各证型治法中出现频率最高的12味药物主要有:1)脾肾亏虚型:党参、黄芪、白术、熟地、阿胶、续断、茜草、山茱萸、牡蛎、当归、山药、鹿角胶;2)血瘀型:三七、益母草、蒲黄、黄芪、茜草、仙鹤草、贯众、生地、党参、白术、地榆、阿胶;3)肾阴虚型:海螵蛸、山药、山茱萸、熟地、枸杞子、白芍、续断、龙骨、牡蛎、龟板胶、何首乌、菟丝子;3)肝肾阴虚型:山茱萸、熟地、五味子、黄芪、菟丝子、龟板胶、山药、枸杞子、鹿角胶、淫羊藿、白芍、甘草。结论:1、围绝经期功能性子宫出血(出血期)的主要证型为:1)脾肾亏虚型;2)血瘀型;3)肾阴虚型;4)肝肾阴虚型。2、围绝经期功能性子宫出血(出血期)的主要治法有:1)补肾健脾,固冲止血;2)益气活血,化瘀止崩;3)滋阴补肾,固护冲任;4)滋肾养肝,固冲调经。3、各证型治法的常用药物为:1)脾肾亏虚型:党参、黄芪、白术、熟地、阿胶、续断、茜草、山茱萸、牡蛎、当归、山药、鹿角胶;2)血瘀型:三七、益母草、蒲黄、黄芪、茜草、仙鹤草、贯众、生地、党参、白术、地榆、阿胶;3)肾阴虚型:海螵蛸、山药、山茱萸、熟地、枸杞子、白芍、续断、龙骨、牡蛎、龟板胶、何首乌、菟丝子;4)肝肾阴虚型:山茱萸、熟地、五味子、黄芪、菟丝子、龟板胶、山药、枸杞子、鹿角胶、淫羊藿、白芍、甘草。更多还原

【Abstract】 [Objective]:This topic through collects the literature of traditional chinese medicine treatment on perimenopause functional uterine bleeding near ten year,to statistical analysis for syndrome and therapy and medication of TCM in hemorrhage period,study on the rule of syndrome and therapy and medication of TCM,to provide basis for the treatment of TCM on perimenopause functional uterine bleeding(hemorrhage period).[Method]:Collects the literature published in biomedicine periodical 1997.1 to 2007.12,related clinical research of TCM on perimenopause functional uterine bleeding.The literature accord with research standard that induction on the syndrome’s type, therapeutic method and medication of TCM,and data statistical analysis with EXCEL:1 The literature carries on the classification,screening of hemorrhage period case.2 Making the form of case number,syndrome’s type of TCM,therapeutic method and medicine in basic prescription.3 Calculating with the percentage of TCM syndrome type and therapeutic method in all case,and making the form.4 Calculating out the usage frequency of chinese herbs in different therapeutic method,arrangement the usage frequency with high low sequence,making the form for the nature and flavor and the channel tropism of the top 12 chinese herbs,analysis on the treatment mechanism of TCM and the modern pharmacological research with the top 12 chinese herbs.[Result]:The syndrome’s type of TCM on perimenopause functional uterine bleeding (hemorrhage period)divide into;1)deficiency of the spleen and the kidney type,accounts for 33.1%;2)blood stasis type,accounts for.25.4%;3)kidney yin deficiency type,accounts for 20.2%;4)liver-kidney yin deficiency type,accounts for 15.1%.The mainly syndrome type on perimenopause functional uterine bleeding(hemorrhage period)divide into:1)reinforcing the kidney and invigorating the spleen,preserve Chong-Ren and hemostasis,accounts for 33.1%;2)supplementing qi and activating blood circulation,absorb clots and stop metrorrhagia,accounts for 25.4%;3)nourishing the kidney-yin,preserve Chong-Ren,accounts for 20.2%;4)nourishing the liver and kidney,preserve Chong-Ren and regulating menstruation,accounts for 15.1%.The top 12 chinese herbs in various therapeutic method mainly to have:1)deficiency of the spleen and the kidney type:lanceolata,astragalus,atractylodes,prepared radix rehmanniae,donkey hide gelatin,dipsacus,madder,cornus officinalis,oyster,angelica sinensis,chinese yam,antler gluc;2)blood stasis type:panax notoginseng,leonurus japonicus,typha orientalis,astragalus,madder,agrimony,dryopteris crassirhizomae,radix rehmanniae,lanceolata,atractylodes,garden burner,donkey hide gelatin;3)kidney yin deficiency type:cuttlebone,chinese yam,cornus officinalis,prepared radix rehmanniae,wolfberry fruit,white peony root,dipsacus,dragon Bone,oyster,tortoise shell glue,tuberfleeceflower,dodder;4)liver-kidney yin deficiency type:cornus officinalis,prepared radix rehmanniae,schisandra chinensis,dodder,tortoise shell glue,astragalus,chinese yam,wolfberry fruit,antler glue,barrenwort,white peony root,glycyrrhiza.[Conclusion]:1 The syndrome’s type of TCM on perimenopause functional uterine bleeding (hemorrhage period)divide into;1)deficiency of the spleen and the kidney type;2)blood stasis type;3)kidney yin deficiency type;4)liver-kidney yin deficiency type.2、The mainly syndrome type on perimenopause functional uterine bleeding (hemorrhage period)divide into:1)reinforcing the kidney and invigorating the spleen,preserve Chong-Ren and hemostasis;2)supplementing qi and activating blood circulation,absorb clots and stop metrorrhagia;3)nourishing the kidney-yin,preserve Chong-Ren;4)nourishing the liver and kidney,preserve Chong-Ren and regulating menstruation.3、The top 12 chinese herbs in various therapeutic method mainly to have:1)deficiency of the spleen and the kidney type:lanceolata,astragalus,atractylodes,prepared radix rehmanniae,donkey hide gelatin,dipsacus,madder,cornus officinalis,oyster,angelica sinensis,chinese yam,antler glue;2)blood stasis type:panax notoginseng,leonurus japonicus,typha orientalis,astragalus,madder,agrimony,dryopteris crassirhizomae,radix rehmanniae,lanceolata,atractylodes,garden burnet,donkey hide gelatin;3)kidney yin deficiency type:cuttlebone,chinese yam,cornus officinalis,prepared radix rehmanniae,wolfberry fruit,white peony root,dipsacus,dragon Bone,oyster,tortoise shell glue,tuberfleeceflower,dodder;4)liver-kidney yin deficiency type:cornus officinalis,prepared radix rehmanniae,schisandra chinensis,dodder,tortoise shell glue,astragalus,chinese yam,wolfberry fruit,antler glue,barrenwort,white peony root,glycyrrhiza.更多还原