【作者】 张莉；

【导师】 张晓甦；

【作者基本信息】 南京中医药大学 ， 中医妇科学（专业学位）， 2018， 硕士

【摘要】 目的:通过观察调经止痛法对寒凝血瘀型原发性痛经的有效性、安全性、复发情况以及对于相关的内分泌激素的影响,初步探讨调经止痛法对于原发性痛经的作用机理,寻求治疗本病更加切实可行的方案,以及为临床治疗提供客观依据。方法:收集2017年1月至12月期间在南京市中医院妇科门诊就诊,符合寒凝血瘀型原发性痛经的患者60例,随机分为两组,各30例。治疗组根据月经的分期不同分别予以经期方、经后期方、经间期方以及经前期方;对照组在月经来潮前1周始服用月月舒颗粒,行经第3天终止;均治疗3个月为1个疗程。观察治疗前后两组患者的痛经VAS评分、COX痛经评分量表、中医证候评分、前列腺素等指标的变化。采用SPSS20.0统计软件进行数据处理,通过自身前后对照及组间对照来判断临床疗效,探讨调经止痛法的作用机制。结果:治疗组总体有效率优于对照组;治疗组对痛经评分的改善优于对照组;治疗组减少痛经时间的疗效优于对照组;治疗组对中医主要症候以及伴随症状的改善优于对照组;治疗组对升高黄体期P水平、降低黄体期E2水平的作用优于对照组;治疗组降低PGF2α、提高PGE2浓度的作用优于对照组;治疗结束后3个月内随访发现,治疗组降低远期复发率优于对照组。结论:在临床中观察到调经止痛法可以提高黄体期P水平和PGE2水平,降低黄体期E2水平和PGF2 α水平,通过调节女性生殖内分泌相关的因素最终达到改善痛经等症的目的,此法治疗寒凝血瘀证型原发性痛经的疗效确切,通过综合调理,不良反应少,停药后具有远期疗效。更多还原

【Abstract】 Objective:to observe the effectiveness,safety and recurrence of menstruation regulating and pain relieving method in treating primary dysmenorrhea of congealing cold blood stasis and its influences on relevant endocrine hormone,initially discuss the mechanism of action of menstruation regulating and pain relieving method on primary dysmenorrhea,seek a more feasible scheme for the disease and provide objective basis for clinical treatment.Method:collect 60 primary dysmenorrhea of congealing cold blood stasis patients in Gynecology Department of Nanjing Hospital of Chinese Medicine and randomly divide them into two groups with each group containing 30 patients.Treatment group was offered menstrual period prescription,postmenstrual period prescription,intermenstrual period prescription and premenstrual period prescription according to their menstrual phase;control group was offered Yueyueshu from one week before menstruation to the third day of menstruation;a course is three months for both groups.Observe the changes of dysmenorrhea VAS scores,COX dysmenorrhea scores table,Chinese medicine symptom complex score,prostaglandin and other indexes.Adopt SPSS20.0 statistical software to process data,judge clinical curative effects through before-after control and group control,and discuss the mechanism of action of menstruation regulating and pain relieving method.Results:treatment group has a higher effective rate than that of control group;treatment group has a better improved dysmenorrhea scores than control group;treatment group has a shorter dysmenorrhea time than control group;treatment group has better improved TCM symptoms than control group;treatment group has better effects on P level in rising luteal phase and E 2 level in decreasing luteal phase than control group;treatment group has better effects on lowering PGF2a and improving PGE2 concentration than control group;the follow-up visit within three months after treatment shows that treatment group has a lower long-term recurrence rate than control group.Conclusion:it was observed clinically that menstruation regulating and pain relieving method can improve P and PGE2 level in luteal phase,lower E2 and LGF2a level in luteal phase and improve dysmenorrhea by regulating the factors relating to the female reproductive endocrine.The method has real curative effects on primary dysmenorrhea of congealing cold blood stasis and less bad effects.And the method still has long-term curative effects after drug withdrawal.更多还原