摘要
研究目的:通过临床和实验研究,观察补肾化瘀调周法对肾虚血瘀型人流术后月经过少的临床症状、体征及相关激素,子宫内膜的影响,并探讨其作用机理。
研究方法:将30例诊断为肾虚血瘀型人流术后月经过少的患者按月经周期予口服中药补肾化瘀调周法治疗,治疗三个月经周期为一个疗程。一疗程后观察治疗前后月经恢复情况,临床症状、体症的改善情况,卵泡早期性激素的变化及子宫内膜分泌晚期内膜厚度与疗效的关系及副反应情况。
研究结果:根据月经失调治疗标准评价疗效,总有效率达86.67%。肾虚血瘀中医证候疗效,有效率达90%。病程对药物疗效有影响,病程3～6月组与7～12月组疗效明显优于＞12月组,前两组药物疗效相当。治疗前后卵泡早期性激素无明显差异(p＞0.05)。分泌晚期子宫内膜厚度对疗效有影响,内膜厚度≥0.8cm疗效最好,内膜厚度＜0.5cm的疗效最差。治疗前后分泌晚期子宫内膜的厚度有差异(p＜0.05),治疗后子宫内膜厚度大于治疗前。用药期间均未出现不良反应,提示采用补肾化瘀调周法治疗肾虚血瘀型人工流产术后月经过少是比较安全的。
结论:以补肾调周法为理论基础,将活血化瘀贯穿于整个治疗周期对肾虚血瘀型人流术后月经过少的治疗取得良好的疗效,并能改善肾虚血瘀的临床症状。其作用机理可能是通过改善内膜血流灌注,增加内膜营养,增加子宫内膜厚度。
Objective: Base on clinical and empirical study, observe the effect of tonifying kidney dissipate stasis and regulate menstrual cycle In Treating hypomenorrheal after artificial abortion Syndrome of Deficiency of Kidney and blood stasis.in treating the clinical symptoms, physical sign, hormon of endometriosis ,endometrial and to explore its mechanism.
Methods: select 30 patient of hypomenorrheal after artificial abortion with the clinical Syndrome of Deficiency of Kidney and blood stasis. Treat them with tonifying kidney dissipate stasis and regulate menstrual cycle, took 3 menstrual cycles as a reatment course. Observe the effect before and after treatment in patients with clinical symptoms, premature gonadal hormone of the follicle, and relation of emdomential thickness of advanced stage of secretion to treat effect, and so on.
Result: according to the treatment norm of menstrual disorder, evaluate the criterion of therapeutical effect, the total effective percentage is 86.67%. The total effective percentage of Syndrome of Deficiency of Kidney and blood stasis is 90%.the course of disease has some effect to curative effect, the curative effects of 3-6 months group and 7-12 months group are better than the 12 months group obviously. The forward two groups have comparative effectiveness. The premature gonadal hormone of the follicle have no difference fore and after (p>0.05). The advanced stage of secretion, emdomential thickness has some effects to curative effect. The emdomential (thickness≥0.8cm) has the best curative effect, but the one (thickness<0.5cm) has the worst .During taking medicine, all the patients have no untoward effect. It present that treating hypomenorrheal after artificial abortion syndrome of deficiency of kidney and gore with tonifying kidney dissipate stasis and regulate menstrual cycle is safe .
Conclusion:treatment bases on tonifying kidney and regulate menstrual cycle with activate blood and dissipate stasis throughout the whole menstruate cycle can receive fine effect. And can improve clinical syndrome of deficiency of kidney and blood stasis .The mechanism maybe improve the blood perfusion on endometrium and increase endometrium nutrition by means of provoke generation of AMPS.
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