调更汤加味联合耳穴贴压治疗更年期综合征的临床观察  

Clinical observation of Tiaogeng Decoction combined with auricular acupressure in the treatment of climacteric syndrome

作　　者：高仙维 高铭璟 傅逸君 李盛楠 丛超 刘小菲 王月娇 刘慧聪[1] 徐莲薇[1] GAO Xian-wei;GAO Ming-jing;FU Yi-jun;LI Sheng-nan;CONG Chao;LIU Xiao-fei;WANG Yue-jiao;LIU Hui-cong;XU Lian-wei(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中华中医药杂志》2021年第10期6245-6249,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81874482);中医妇科能力建设项目。

摘　　要：目的:探讨调更汤加味联合耳穴贴压治疗更年期综合征的临床疗效和安全性,旨在为更年期综合征患者提供安全有效的中医药治疗方案。方法:上海中医药大学附属龙华医院纳入的100例患者随机(1∶1)分为中药组(调更汤)和中药(调更汤)+耳穴组,上海市第六人民医院纳入的50例患者为西药组(雌二醇片/雌二醇地屈孕酮片复合包装),28d为1个疗程,共治疗3个疗程,观察并记录3组患者治疗前后的改良Kupperman评分量表(改良KI),绝经综合征评定量表(MRS),与更年期症状有关的中医临床证候评分表及血清促卵泡生长激素(FSH),促黄体生成激素(LH),雌二醇(E_(2)),肝、肾功能和妇科B超变化情况。结果:治疗1个疗程,中药+耳穴组与西药组患者的改良KI评分较治疗前显著降低(P<0.01),3组患者MRS评分、中医临床证候总积分均较治疗前显著降低(P<0.01)。治疗2个疗程,3组患者的改良KI评分、MRS评分、中医临床证候总积分均较治疗前显著降低(P<0.01)。治疗3个疗程,3组患者的改良KI评分与MRS评分较治疗前均显著降低(P<0.01),组间评分比较差异较治疗前无统计学意义;3组患者的中医临床证候总积分均显著降低(P<0.01),且中药+耳穴组较西药组显著降低(P<0.05);3组患者治疗后单项症状评分均较治疗前显著降低(P<0.01),且中药+耳穴组改善各项症状的疗效更优(P<0.01,P<0.05)。与本组治疗前比较,3组患者治疗后的FSH、LH水平均显著降低(P<0.01),E_(2)水平显著提高(P<0.01),且西药组E_(2)水平显著高于中药组和中药+耳穴组(P<0.01)。3组患者在整个研究过程中无不良反应发生,治疗前后肝、肾功能,妇科B超未见异常。结论:调更汤加味联合耳穴贴压治疗更年期综合征的临床疗效突出,安全性高,值得推广应用。Objective:To investigate the clinical efficacy and safety of Tiaogeng decoction combined with auricular acupressure in the treatment of climacteric syndrome,aiming at providing a safe and effective traditional Chinese medicine(TCM)treatment option for patients with climacteric syndrome.Methods:The 100 patients included in Longhua Hospital,Shanghai University of Traditional Chinese Medicine were randomly(1:1)divided into Chinese medicine group(Tiaogeng Decoction)and Chinese medicine(Tiaogeng Decoction)+auricular acupressure group.The 50 patients included in Shanghai Sixth People’s Hospital were divided into Western medicine group(Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets).28 days is a course of treatment and treatment for 3 courses.The Modified Kupperman Index Scale(KI),menopause rating scale(MRS),menopause symptom related TCM clinical syndrome scale,follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),liver and kidney function,and gynecological ultrasound were recorded before and after the treatment.Results:After 1 course of treatment,the modified KI score in the Chinese medicine+auricular acupuncture group and the Western medicine group decreased significantly(P<0.01),while the MRS score and total score of TCM clinical syndrome in the 3 groups were significantly lower than before treatment(P<0.01).After 2 course of treatment,the modified KI score,MRS score,and total score of TCM clinical syndrome in the 3 groups were significantly lower than before treatment(P<0.01).After 3 course of treatment,the modified KI score and MRS score of the 3 groups were significantly lower than before treatment(P<0.01),and the difference between the groups was not statistically significant.The total score of TCM clinical syndrome in the 3 groups decreased significantly(P<0.01),and the Chinese medicine+auricular acupressure group was significantly lower than the Western medicine group(P<0.05).The single score of TCM clinical syndrome in the 3 groups decreased significantly(P<0.01),

关 键 词：调更汤 耳穴贴压 更年期综合征 临床观察 

分 类 号：R271.116[医药卫生—中医妇科学]