益肾化瘀法治疗肾虚血瘀型子宫肌瘤临床研究
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摘要
目的：
观察“益肾化瘀法”治疗在子宫肌瘤患者中的临床疗效,探讨“益肾化瘀法”治疗子宫肌瘤可能存在的作用机理。
方法：
在台湾云林县刘冠位中医诊所来访的,确诊为子宫肌瘤,并且中医辨证为肾虚血瘀型患者中,随机选择60例分为对照组和治疗组。对照组予“桂枝茯苓丸”(科学中药),治疗组予口服“益肾化瘀方”科学中药(主要由红景天、三棱、莪术、菟丝子、仙灵脾、夏枯草、炙甘草等药组成),每日3次,6克／次。每次月经干净后开始,连续服用1O天(经期暂停用药)为一周期,共3个周期为一个疗程。观察两组患者治疗前后的与肾虚血瘀型相关的中医临床症状、体征以及B超监测下子宫和肌瘤体积变化；并观察血液流变学指标的变化。对药物疗效及其相关性进行分析判定。
结果：
经过“益肾化瘀方”及“桂枝茯苓丸”干预后,子宫肌瘤患者的子宫体积及肌瘤瘤体的大小都较治疗前缩小。两者比较无显著性差异。治疗后全血高、低切相对粘度、血沉、红细胞压积、血浆粘度值均有下降,两者差异无显著性意义。“益肾化瘀法”治疗子宫肌瘤中医证候疗效：痊愈率36.67%,显效率30%,有效率26.67%,总有效率93.33%。“桂枝茯苓丸”治疗子宫肌瘤中医证候疗效：痊愈率20%,显效率13.33%,有效率53.33%,总有效率86.67%。“益肾化瘀方”和“桂枝茯苓丸”都能缓解患者经行腹痛程度,且两者效果相当。“益肾化瘀方”和“桂枝茯苓丸”都能减少肌瘤患者月经量、缩短经期,但“益肾化瘀方”优于“桂枝茯苓丸”。并且“益肾化瘀方”能显著缓解肾虚相关症状(腰膝酸软、头晕耳鸣),“桂枝茯苓丸”在此方面与治疗前相比无显著性差异。
结论：
1.肾虚血瘀型子宫肌瘤的患者经过自拟益肾化瘀方治疗后子宫体积及肌瘤瘤体的大小都较治疗前缩小。在降低全血高、低切相对粘度、红细胞压积、血浆粘度值、血沉方面与桂枝茯苓丸效果相当。益肾化瘀方能显著减少肌瘤患者月经量、缩短经期,疗效优于桂枝茯苓丸。并能显著缓解肾虚相关症状。
2.提出肾虚血瘀是子宫肌瘤的重要病机。肾虚可致血瘀,瘀久亦可致肾虚。补肾可以促进瘀血的消散。“益肾化瘀法”治疗子宫肌瘤有临床应用价值。
Objeetive
To observe the clinical effects of chinese medicine using reinforce kidney and removing stasis in treating uterine myoma with the chinese medicine pattern of kidney deficiency and blood stasis.
Methods:
60patients with uterine myoma and in the pattern of kidney deficiency and blood stasis in chinese medicine from Taiwan Liuguanwei clinic were ramdonmised into2groups. Group A were taken chinese medicine using the methods of reinforce kidney and removing stasis. Group B were taken chinese medicine only using the methods of removing stasis. All patients were taken medicine after menstruation for10days,3months in total. We collected scores of relative symptoms, sizes of uterine and myoma measured by ultrasound, data of hemorheology before and after treatment, to explore the effect of chinese medicine.
Resuits:
Both methods can shrinked the sizes of uterine and myoma, decreased the relatively high/low shear whole blood viscosity, erythrocyte sedimentaion rate, Plasmaviseosity, hematoerit. Kidney blood circulation method of treatment of hysteromyoma in TCM syndrome curative effect:the healing rate was36.67%, the efficiency is30%, effective rate was26.67%, total effective rate was93.33%. Bolus of cassia twig tuckahoe treat hysteromyoma syndromes curative effect:the healing rate was20%, the efficiency is13.33%, effective rate was53.33%, total effective rate was86.67%. Benefiting kidney blood and cassia twig tuckahoe pills can alleviate patients in abdominal pain, and the effect. Benefiting kidney blood and myoma of cassia twig tuckahoe pills can reduce menstrual quantity, shorten the menstrual cycle, but kidney blood is better than that of cassia twig tuckahoe pills. And kidney blood can significantly relieve kidney related symptoms (lumbar debility, dizziness, ringing in the ears), cassia twig tuckahoe pills in this regard compared with before treatment there was no significant difference.
Conclusion:
Kidney deficiency slow blood flow to organs and tissues because blood deficiency metamict many illnesses; On the other hand, blood circulation helps yin, yang metaplasia, and promote the recovery of renal function. Kidney and Activating Blood match, can enhance the body's blood, promote blood circulation improvement, the combination of kidney and blood circulation has obvious advantages compared to simple treatment of blood circulation. Treating uterine myoma by chinese medicine in a method of reinforce kidney and removing stasis is capable of shrinking patients'uterine and fibroid size, improving the patient's symptoms and signs in descriptions of traditional Chinese medicine; Can improve the blood rheology in patients, reduce the blood viscosity, and thus can improve the blood stasis of the patients condition. It is effective in the clinical treatment of kidney and blood stasis type of uterine fibroids.
观察“益肾化瘀法”治疗在子宫肌瘤患者中的临床疗效,探讨“益肾化瘀法”治疗子宫肌瘤可能存在的作用机理。
方法：
在台湾云林县刘冠位中医诊所来访的,确诊为子宫肌瘤,并且中医辨证为肾虚血瘀型患者中,随机选择60例分为对照组和治疗组。对照组予“桂枝茯苓丸”(科学中药),治疗组予口服“益肾化瘀方”科学中药(主要由红景天、三棱、莪术、菟丝子、仙灵脾、夏枯草、炙甘草等药组成),每日3次,6克／次。每次月经干净后开始,连续服用1O天(经期暂停用药)为一周期,共3个周期为一个疗程。观察两组患者治疗前后的与肾虚血瘀型相关的中医临床症状、体征以及B超监测下子宫和肌瘤体积变化；并观察血液流变学指标的变化。对药物疗效及其相关性进行分析判定。
结果：
经过“益肾化瘀方”及“桂枝茯苓丸”干预后,子宫肌瘤患者的子宫体积及肌瘤瘤体的大小都较治疗前缩小。两者比较无显著性差异。治疗后全血高、低切相对粘度、血沉、红细胞压积、血浆粘度值均有下降,两者差异无显著性意义。“益肾化瘀法”治疗子宫肌瘤中医证候疗效：痊愈率36.67%,显效率30%,有效率26.67%,总有效率93.33%。“桂枝茯苓丸”治疗子宫肌瘤中医证候疗效：痊愈率20%,显效率13.33%,有效率53.33%,总有效率86.67%。“益肾化瘀方”和“桂枝茯苓丸”都能缓解患者经行腹痛程度,且两者效果相当。“益肾化瘀方”和“桂枝茯苓丸”都能减少肌瘤患者月经量、缩短经期,但“益肾化瘀方”优于“桂枝茯苓丸”。并且“益肾化瘀方”能显著缓解肾虚相关症状(腰膝酸软、头晕耳鸣),“桂枝茯苓丸”在此方面与治疗前相比无显著性差异。
结论：
1.肾虚血瘀型子宫肌瘤的患者经过自拟益肾化瘀方治疗后子宫体积及肌瘤瘤体的大小都较治疗前缩小。在降低全血高、低切相对粘度、红细胞压积、血浆粘度值、血沉方面与桂枝茯苓丸效果相当。益肾化瘀方能显著减少肌瘤患者月经量、缩短经期,疗效优于桂枝茯苓丸。并能显著缓解肾虚相关症状。
2.提出肾虚血瘀是子宫肌瘤的重要病机。肾虚可致血瘀,瘀久亦可致肾虚。补肾可以促进瘀血的消散。“益肾化瘀法”治疗子宫肌瘤有临床应用价值。
Objeetive
To observe the clinical effects of chinese medicine using reinforce kidney and removing stasis in treating uterine myoma with the chinese medicine pattern of kidney deficiency and blood stasis.
Methods:
60patients with uterine myoma and in the pattern of kidney deficiency and blood stasis in chinese medicine from Taiwan Liuguanwei clinic were ramdonmised into2groups. Group A were taken chinese medicine using the methods of reinforce kidney and removing stasis. Group B were taken chinese medicine only using the methods of removing stasis. All patients were taken medicine after menstruation for10days,3months in total. We collected scores of relative symptoms, sizes of uterine and myoma measured by ultrasound, data of hemorheology before and after treatment, to explore the effect of chinese medicine.
Resuits:
Both methods can shrinked the sizes of uterine and myoma, decreased the relatively high/low shear whole blood viscosity, erythrocyte sedimentaion rate, Plasmaviseosity, hematoerit. Kidney blood circulation method of treatment of hysteromyoma in TCM syndrome curative effect:the healing rate was36.67%, the efficiency is30%, effective rate was26.67%, total effective rate was93.33%. Bolus of cassia twig tuckahoe treat hysteromyoma syndromes curative effect:the healing rate was20%, the efficiency is13.33%, effective rate was53.33%, total effective rate was86.67%. Benefiting kidney blood and cassia twig tuckahoe pills can alleviate patients in abdominal pain, and the effect. Benefiting kidney blood and myoma of cassia twig tuckahoe pills can reduce menstrual quantity, shorten the menstrual cycle, but kidney blood is better than that of cassia twig tuckahoe pills. And kidney blood can significantly relieve kidney related symptoms (lumbar debility, dizziness, ringing in the ears), cassia twig tuckahoe pills in this regard compared with before treatment there was no significant difference.
Conclusion:
Kidney deficiency slow blood flow to organs and tissues because blood deficiency metamict many illnesses; On the other hand, blood circulation helps yin, yang metaplasia, and promote the recovery of renal function. Kidney and Activating Blood match, can enhance the body's blood, promote blood circulation improvement, the combination of kidney and blood circulation has obvious advantages compared to simple treatment of blood circulation. Treating uterine myoma by chinese medicine in a method of reinforce kidney and removing stasis is capable of shrinking patients'uterine and fibroid size, improving the patient's symptoms and signs in descriptions of traditional Chinese medicine; Can improve the blood rheology in patients, reduce the blood viscosity, and thus can improve the blood stasis of the patients condition. It is effective in the clinical treatment of kidney and blood stasis type of uterine fibroids.
引文
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