【作者】 温丽娜；

【导师】 周惠芳；

【作者基本信息】 南京中医药大学 ， 中医妇科学， 2009， 硕士

【摘要】 目的:观察补肾助孕方治疗肾虚偏阳,夹有肝郁型黄体功能不全的临床疗效,并用动物实验进一步探讨补肾助孕方治疗黄体功能不全的作用机理。方法:临床上对肾虚偏阳,夹有肝郁型黄体功能不全患者36例随机分为两组进行观察,治疗组20例,以补肾助阳,疏肝解郁为原则,用补肾助孕方治疗;对照组16例,以地屈孕酮治疗。观察两组临床疗效及用药前后基础体温、性激素水平、细胞免疫水平的变化情况。用米非司酮干预建立了黄体功能不全大鼠模型,随机将清洁级未孕大鼠分为空白组、模型组、中药组。各组大鼠阴道涂片观察性周期,从进入第二个动情后期开始观察,分别于每个性周期的动情后期灌胃生理盐水(空白组、模型组)、中药浓缩水提液(中药组),直至处死前:第四个性周期动情期后10小时,予模型组及中药组米非司酮1mg/100g灌胃造模,第四个性周期动情期后20小时将各组大鼠处死。实验前后分别称体重,并眼眶采血,用化学发光法检测用药前后血清E2、P、LH水平。留取一侧卵巢及子宫标本病理检查,取另一侧卵巢标本电镜检查。结果:补肾助孕方能改善肾虚偏阳、夹有肝郁型黄体功能不全患者畏寒肢冷、腰膝酸软、经前乳胀、烦躁易怒等临床症状及基础体温高温相、黄体期LH、P水平及细胞免疫水平。动物实验证实本药有提高黄体期过低LH、P水平的作用,从而促进子宫内膜发育,使间质和腺体发育同步;促进卵巢黄体细胞增生、超微结构改善,使黄体功能恢复。结论:补肾助孕方治疗肾虚偏阳,夹有肝郁型黄体功能不全临床疗效确切,其作用机理可能是通过改善下丘脑—垂体—卵巢轴功能,调节细胞免疫,从而恢复神经、内分泌、免疫系统的平衡状态,改善黄体功能。更多还原

【Abstract】 Objective: To observe the clinical efficiency of prescription of enriching kidney and assisting pregnancy on luteal phase defect and establish a luteal phase defect rat model to investigate the mechanism of the treatment on one of the pathogeny aspects.Methods: On clinic the 36 patients according with the diagnosis standards have been treated by the prescription for 3 months,then compare the different sex hormones levels with that before the treatment and observe the vary of the basal body temperature(BBT), and the level of cytoimmunity.In the animal experiment, the model was formed by mifepristone that can lead to luteal phase defect. The rats were randomly divided into 3 groups,that is the control group. the model group and the herbs group: the control group / NS( normal control) the model group / NS+ mifepristonethe herbs group/ Prescription of enriching kidney and assisting pregnancy+ mifepristoneTwenty hours after estrus of the 4th sex periods, kill all the rats.Serum was separated and the method of chemiluminescence was applied to test E2,P,and LH.The sample of one side of ovary and uterus was left for pathological examination.The sample of another side of ovary was observed by electron microscopic.Results: Prescription of enriching kidney and assisting pregnancy can improve paticents’ menstruation and common syndromes, improve the hign-temperarure of BBT, and regulate both sex hormone(LH、P)and cytoimmunity effectively. Prescription of enriching kidney and assisting pregnancy can improve both the development of endometriun and the development of gland as well.It can promote the increasing of ovary Luteal phase cells,improving the structure of Luteal phase cells to strengthen the function of Luteal phase.更多还原