倪國勇 鈕雪松 曾瀚琳 王平
[摘要] 目的 評價針?biāo)幾剃帩撽柗ㄖ委熃^經(jīng)綜合征臨床療效。方法 方便選取2018年1—12月就診于該院陰虛陽亢絕經(jīng)綜合征患者90例,隨機(jī)分為對照1組(單純針刺)、對照2(單純中藥)組及治療組(針?biāo)幗Y(jié)合),每組各30例,觀察治療2、4周Kupperman及中醫(yī)癥候積分,以評價療效。結(jié)果 各組治療后Kupperman 積分、中醫(yī)癥候積分較治療前明顯改善,差異有統(tǒng)計學(xué)意義(P<0.05);對照1組總有效率為83.33%,對照兩組總有效率為86.67%,治療組總有效率93.33%,高于對照1、兩組,差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 針?biāo)幾剃帩撽柗ㄖ委熃^經(jīng)綜合征臨床療效顯著,值得在臨床中應(yīng)用。
[關(guān)鍵詞]? 臨床研究;腎陰虛;更年期
[Abstract] Objective To evaluate the clinical efficacy of acupuncture and nourishing yin and burying yang in treating menopausal syndrome. Methods Convenient select ninety patients with menopausal syndrome of Yin deficiency and Yang hyperactivity were enrolled from January to December 2018. They were randomly divided into control group 1 (acupuncture alone), control group 2 (only Chinese medicine) and treatment group (acupuncture and medicine). 30 patients in each group were observed Kupperman and TCM symptom scores for 2 and 4 weeks of treatment to evaluate the efficacy. Results The Kupperman score and TCM symptom score of each group were significantly improved compared with those before treatment, the difference was statistically significant (P<0.05); the total effective rate of the control group 1 was 83.33%, and the total effective rate of the control group 2 was 86.67%. The total effective rate was 93.33%, which was higher than those in the control group 1 and 2, and the difference was statistically significant (P<0.05). Conclusion Acupuncture and nourishing yin and yin-yang method are effective in treating menopausal syndrome, which is worthy of clinical application.
[Key words] Clinical research; Kidney yin deficiency; Menopause
絕經(jīng)綜合征,中醫(yī)學(xué)稱之為絕經(jīng)前后諸證,是指婦女在絕經(jīng)前后因卵巢功能逐漸衰退,雌激素下降,植物神經(jīng)功能紊亂,出現(xiàn)潮熱汗出、心悸失眠、煩躁易怒及月經(jīng)紊亂的一系列臨床癥狀。近年來,該病的發(fā)病率逐漸上升,對圍絕經(jīng)期女性生活質(zhì)量產(chǎn)生了較大影響。西醫(yī)認(rèn)為該病以激素替代治療為主,但激素因嚴(yán)格的適應(yīng)癥、禁忌證及不良反應(yīng),限制了其應(yīng)用[1],因此,研究中醫(yī)有效的方法治療該病,幫助婦女順利度過圍絕經(jīng)期,具有重要意義?!端貑枺可瞎盘煺嬲摗罚骸芭悠咂?,任脈虛,太沖脈衰少,天癸竭,地道不通,故形壞而無子也?!痹摬〔C(jī)以腎臟虛衰為主,腎的陰陽失調(diào),沖任虛衰,有腎陰虛、腎陽虛之分,其中以腎陰虛為多見。治療以調(diào)補(bǔ)腎中陰陽為法[2]。中醫(yī)針?biāo)幗Y(jié)合治療該病,具有獨(dú)到的優(yōu)勢。該研究以90例2018年1—12月陰虛陽亢型絕經(jīng)綜合征患者為研究對象,以針?biāo)幾剃帩撽柗ㄖ委煵⑦M(jìn)行臨床觀察?,F(xiàn)報道如下。
1? 資料與方法
1.1? 一般資料
方便選取的90例患者為該院門診患者,按數(shù)字隨機(jī)表法分為對照1組、對照兩組及治療組。每組30例。
1.2? 診斷標(biāo)準(zhǔn)
1.2.1? 西醫(yī)診斷標(biāo)準(zhǔn)? 根據(jù)謝幸主編8版《婦產(chǎn)科學(xué)》制定。①癥狀:年齡45~55歲女性;月經(jīng)紊亂或閉經(jīng)3個月及以上;出現(xiàn)潮熱,心悸、失眠、頭痛、耳鳴,記憶力減退,思情緒波動大等。②性激素:促卵泡激素(FSH)、促黃體生成激素(LH)升高 ,雌二醇(E2)下降。具備以上兩項標(biāo)準(zhǔn)即可診斷[3]。
1.2.2? 中醫(yī)診斷標(biāo)準(zhǔn)? 參照《中藥新藥臨床研究指導(dǎo)原則》、六版《中醫(yī)婦科學(xué)》教材擬定:主證:烘熱汗出,潮熱面紅;次癥:月經(jīng)紊亂,手足心熱,口干便秘,心煩不寧,失眠多夢;舌脈:舌紅少苔,脈細(xì)數(shù)。主癥必備,次癥兼見2項及以上即可診斷[4]。
1.3? 納入標(biāo)準(zhǔn)與排除標(biāo)準(zhǔn)
1.3.1? 納入標(biāo)準(zhǔn)? 符合絕經(jīng)綜合征中西醫(yī)診斷標(biāo)準(zhǔn);年齡45~55歲之間;近3個月內(nèi)未使用激素替代治療;愿意參加該試驗,簽署知情同意書者。