摘要
目的:通过文献研究,探讨IUD导致子宫异常出血的中医辨证、治法和用药规律。对中医治疗IUD导致子宫异常出血的高频药物进行分析研究和整理,从中组合出治疗IUD导致子宫异常出血的常见中医证型的基本方药,并对其中医治疗机理和现代药理进行分析。
方法:选择1997年1月至2007年6月生物医学期刊发表的有关IUD导致子宫异常出血的中医临床研究文献。对符合标准的文献进行中医辨证、治法、用药进行归纳,并用EXCEL软件进行数据统计分析。对中医治疗IUD导致子宫异常出血高频药物进行分析研究和整理,从中组合出治疗IUD导致子宫异常出血的主要证型的基本方药。
结果:IUD导致子宫异常出血的常见中医证型为瘀热证、血瘀证、瘀热夹虚证、气虚血瘀证、气虚证和其他证型,分别为29.81%、26.96%、14.13%、7.44%、5.47%、16.19%。常用治法为活血清热法、活血化瘀法、益气化瘀清热法、益气活血法、益气养血法和其他治法,分别为29.81%、26.96%、14.13%、7.44%、5.47%、16.19%。常用治法的药物分类中补益药、止血药、清热药、活血化瘀药及理气药所占比例分别为31.66%、24.37%、19.82%、11.62%、4.33%,共占91.80%。补益药中补血药、补气药、补阴药、补阳药所占比例分别为40.29%、32.37%、15.83%、11.51%。止血药中化瘀止血药、凉血止血药、收敛止血药、温经止血药所占比例分别为57.94%、25.23%、12.15%、4.68%。清热药中清热凉血药、清热解毒药、清热燥湿药、清热泻火药所占比例分别为58.62%、20.69%、13.79%、4.60%、2.30%。活血化瘀药在药物整体分布中出现51味次,占11.62%。
结论:1、IUD导致子宫异常出血的主要中医证型为瘀热证、血瘀证、瘀热夹虚证、气虚血瘀证。2、IUD导致子宫异常出血的主要治法为活血清热法、活血化瘀法、益气化瘀清热法、益气化瘀法。3、主要证型的常用药物为:①瘀热证:茜草、蒲黄、生地、地榆、黄芩、丹皮、五灵脂、阿胶、赤芍、乌贼骨、益母草、仙鹤草。②血瘀证:当归、益母草、蒲黄、地榆、黄芪、茜草、生地、三七、桃仁、川芎、枳壳、甘草。③瘀热夹虚证:白术、续断、黄芪、白芍、地榆、乌贼骨、茜草、蒲黄、熟地、当归、党参、代赭石。④气虚血瘀证:茜草、党参、黄芪、白芍、阿胶、当归、生地、仙鹤草、三七、牡蛎、柴胡、丹皮。
Objective:
To explore the etiology,pathogenesis,differentiation of syndromes and the laws of treatment for abnormal uterine bleeding caused by intrauterine device.
Method:
We selected traditional Chinese medicine journals and use computer technology and excel statistics.
Results:
With computer technology,a database of the Common Syndromes of TCM was founded.There' re Stagnated heat Syndrome,Blood Stasis Syndrome, Stagnated heat mixed with Deficiency Syndrome,Qi Deficiency and Blood Stasis Syndrome,Qi deficiency syndrome and other Syndrome in proper order.They are29.81%、26.96%、14.13%、7.44%、5.47%、16.19%separately.The common therapeutic methods to treat abnormal uterine bleeding caused by intrauterine device are promoting blood circulation mixed with removing pathogenic heat from blood therapy,promoting blood circulation therapy, benefiting qi and resolving blood stasis with clearing heat therapy, supplementing qi and activating blood circulation therapy,benefiting qi and blood therapy and other therapies.They are 29.81%、26.96%、14.13%、7.44%、5.47%、16.19%separately.The proportion of tonics,hemostatic drug, heat-clearingdrug,stasis-eliminating drug and qi regulating drug are 31.66%、24.37%、19.82%、11.62%、4.33%separately,reaching a total of 91.80%. The proportion of hematinic,qi-invigorating herb,yin-reinforcing drug and yang tonics in tonics are 40.29%、32.37%、15.83%、11.51%separately. The proportion of removing blood stasis and hemostasis drug,liangxue hemostatic drug,concergence hemostatic drug and warming meridian mixed with hemostatic drug are 57.94%、25.23%、12.15%、4.68%separately.The proportion of cool- blood drug,antipyretic-detoxicatedrug,antipyretic drying damp drug and fire-purging drug are 58.62%、20.69%、13.79%、4.60%、2.30%separately.The proportion of high-frequency medicines convergeing to liver intestine channel of the main Syndromes are 41.38%,40.00%, 26.67%,43.48%.Blood-activiating and stasis-dissolving drugs appear 51 herb counts in the whole drug distribution,account for 11.62%
Conclusion:
The mian symdroms of abnormal uterine bleeding caused by intrauterine device are Stagnated heat Syndrome,Blood Stasis Syndrome ang Stagnated heat mixed with Deficiency Syndrome.The main therapeutic method to treat abnormal uterine bleeding caused by intrauterine device are promoting blood circulation mixed with removing pathogenic heat from blood therapy, promoting blood circulation therapy,Benefiting Qi and Resolving Blood Stasis with Clearing Heat therapy and supplementing Qi and activating blood circulation therapy.The Herbs of the main Syndromes are:①Stagnated heatSyndrome:Qiancao,Puhuang,Shengdi,Diyu,Huangqin,Danpi,Wulingzhi, Ajiao,Chishao,Wuzeigu,Yimucao,Xianhecao.②Blood Stasis Syndrome:Dang gui,Yimucao,Puhuang,Diyu,nuangqi,Qiancao,Shengdi,Sanqi,Taoren,Chuangx iong,Zhike,Gancao.③Stagnated heat mixed with Deficiency Syndrome:Baiz hu,Xuduan,Huangqi,Baishao,Diyu,Wuzeigu,Qiancao,Puhuang,Shudi,Danggui, Dangshen,Daizheshi.④Qi Deficiency and Blood Stasis Syndrome:Qiancao Dangshen,Huangqi,Baishao,Ajiao,Danggui,Shengdi,Xianhecao,Sanqi,Muli,C haihu,Danpi.
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