Clinical observation of Chinese medicine cycle therapy combined laparoscopic ovarian drilling phlegmWord文件下载.docx

Clinical observation of Chinese medicine cycle therapy combined laparoscopic ovarian drilling phlegmWord文件下载.docx

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0.05）,B,CgroupofLH,Tvalues&

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beforeandaftertreatment,nosignificantdifferencesexualsignificanceaftertreatmentofgroupA,LH,Tvalues&

withtheothertwogroupscomparedifferencessignificantsignificance（P&

0.05）（P&

gt;

0.05）;

BandCgroupLH,Tvaluecomparison,thedifferencewasnotsignificant（P&

0.05）groupApregnancyratewiththeothertwogroups,thedifferencewasstatisticallysignificant（P&

0.05）;

pregnancyrateofgroupC,thedifferencewasnotsignificantsignificance（P&

0.05）.[Conclusion]LaparoscopicsurgerycombinedwithtraditionalChinesemedicinecycletherapytoimprovethereproductivehealthstatusofphlegmrefractoryPCOSpatientshavecertainadvantages.

[Words]polycysticovarysyndrome/IntegrativetherapylaparoscopyTCMcyclicaltherapyPolycysticovarysyndrome（polycysticovarysyndrome,PCOS）isaheterogeneousgroupofdiseasesoftheexactcauseisunknown,firstproposedbySteinLeventhalin1935,knownasSteinLeventhalsyndrome,PCOSrenamedsincethe1960s.PCOSiscommoninwomenofchildbearingage,lifelongdiseaseinvolvingendocrine,metabolic,andmanyotherfactors,theclinicalmanifestationswerepolymorphic,significantlydifferentfromtheexistenceofdifferentraces,theperformanceofthegroupandthepathophysiologyofthediseasedifficulttotreatseriousimpactonwomen’sreproductivehealth,incurablediseasesandgynecologicalresearchfocushasbeeninrecentyears,theauthorlaparoscopicsurgerycombinedwithChinesemedicinecycletherapytotreatthedisease,withthethelaparoscopicsurgeryCanwestdruginducedovulation,purelaparoscopicsurgerywerecompared,theresultsreportedbelow.

1Clinicaldata1.1diagnosticcriteria1.1.1PCOSclinicaldiagnosisin2003bytheEuropeanAssociationforHumanReproduction（ESHREandtheAmericanSocietyforReproductiveMedicine（ASRMpreparedESHRE/ASRMinRotterdamdiagnosticcriteria[1]:

①sporadicovulation（oranovulation;

②clinicaland（presenceofhyperandrogenismorbiochemicalindicatorsprompt,andtheexclusionofcongenitaladrenalhyperplasia,androgensecretingtumorsandCushing’ssyndromeandotherfactorsthatmaycausedisease.theclinicalhyperandrogenismperformanceincludingacne,hirsutism,balding,biochemicalindicatorstheaspectsemphasizedtheclinicalsignificanceoffreetestosterone;

（3）bothovariespolycysticchange:

bothovariesincreaseinsize,eachwiththediameterofmorethan10normalmenstrualcyclein2~8mmsmallfollicles.cycle3tofivedaystransvaginalB-ultrasoundformenstrualcramps,B-Tipbothovarieswerenotdominantfollicledetection.meetthetwocanbediagnosedinmorethanthreePCOS.

1.1.2refractoryPCOSdiagnosis

（1）complywithinfertility,PCOSclinicaldiagnosticcriteria;

②;

③drugstopromoteovulationsystemtreatmentoversixmonths,andfollow-upto1yearandinvalid.

1.1.3laparoscopicdiagnosis[2]ovarianenlargement,capsularthickening,smoothsurface,seeneovascularization,corticalgraycysticfolliclesseenmanydifferentsize.

1.1.4TCMstandardswithreferencetothethescience&

&

NewTCMclassificationcriteria[3]dialecticalphlegmtype:

menstruation,delayedmenstruationoramenorrhea,prolongedmenstrualperiod,vaginaldischargeandmorebodyfat,hirsutism,facialacne,marriageinfertility,redorwhite,greasyfur,slipperypulsestring.

1.2TheinclusionandexclusioncriteriaMeetthediagnosticcriteriaandagreetoaccepttheappropriatetreatmentincludedintheobservation.Excludecriteria:

tubalfactor,malefactor,genitalmalformations,immunefactors,causesofinfertility;

Othercausesofirregularmenstruation;

doesnotcooperatewithtreatmentefficacycannotbeassessor;

midwaychangedtreatmentprograms.

1.3GeneralInformationObservedcasesfromAugust2004toMarch2006,FirstAffiliatedHospitalofGuangzhouUniversityofTraditionalChineseMedicine,thetwogynecologicalwardofdiagnosisandtreatmentofrefractoryPCOSpatientswithatotalof40cases,aged22to35yearsold,onaverage（27.40+-2.70years;

historyof1to6years;

Allpatientshadirregularmenstruation（includingraremenstruationoramenorrhea,including46casesofprimaryinfertility,secondaryinfertilitycasesacceptallendocrinehormonescheckandB-ultrasoundshowedthatovulationdisordersdigitalrandomtablemethodinthepremiseofnotcontrarytotheethicalprinciplesofvoluntaryandpatientswererandomlydividedintoGroupA（laparoscopicsurgeryplusChinesemedicinecycletherapytreatmentgroup,Bgroup（laparoscopicsurgery加克罗米芬treatmentgroup,Cgroup（purelaparoscopicsurgicalgroup,threeagegroups,thedisease,thecourseStatistically,thedifferenceswerenotsignificantsignificance（P&

0.05）,comparable.

2treatmentsOUTCOMEMEASURES2.1AgroupoflaparoscopicsurgerycombinedwithTCMperiodictherapy.2.1.1GermanyAESCULAP&

fullrangeoflaparoscopicinstrumentslaparoscopicsurgeryundergeneralanesthesiaintheupperedgeoftheumbilicusorloweredgeoftherampantcutinsert10mmTrocarthusputlaparoscopic,respectively,inbilaterallowerabdomenrow2,3puncturepoint,monopolarcauterypuncheachsideovariandrilling8to10,attheendofsurgery,intraperitonealinjectionofdextran300mLorsodiumhyaluronate4mL.

2.1.2TCMcycletherapyBasicRecipe:

herb10g,Atractylodes10g,ZhejiangFritillaria15g,thegramineus15g,theDanshen10g,Cyperusrotundus10g.Menstrualperiod:

BasicRecipepeachkernel10g,Panax10g,Motherwort15g,treatment3~5d;

menstrualcleanwithbasicsideplusDodder15g,Angelica9g,Rehmannia10g,thecornus10g,Poria15g,treatment7~~10d;

followedbyCarolinebasicsideleadto20g,Curcuma10g,Beiqi20g,Guizhi9g,treatment3d;

thentheBasicRecipeDodder15g,angelica10g,Epimedium10g,cinnamon6g,7~10d.everythreetreatmentmenstrualcycleforacourseoftwocourses,thefollow-uptime1year.

2.2Bgroupwithlaparoscopicsurgerycombinedwithwesternmedicineovulationinduction.Thesurgicalapproachibid.,clomiphenecitrate50mg/dinthefirstfivedaysofthemenstrualcyclefor5days,ifinvalid,eachcycleincreasedto100mg/d,themaximumamountofnotmorethan150mg/dtreatmentIbid.

2.3Cgroupweretreatedwithlaparoscopicsurgery,postoperativeobservationtimeIbid.2.4observedindicators（anendocrinehormoneofdetectionindicatorsincludingfollicle-stimulatinghormone（FSH,yellowbodygenerateshormone（LH,malehormones（T,etc.,allthecaseswereinthemenstrualcycle5Tiandetection,beforetreatmentandaftereachdetection1times,alldetectedbyhospitalgynecologicallaboratoryusingthesamereagentsandmethods;

（2ovulation（B-monitoring,withbasalbodytemperatureorLHteststripsdeterminationandpregnancysituationobserved.

2.5StatisticalMethodsSPSS10.0statisticalsoftwarefordataanalysisandprocessing.3Results3.1beforeandaftertreatmenttheendocrinehormoneschangethecomparisonresultsinTable1,AgroupLH,Tvalues&

beforeandaftertreatment,thedifferencewasstatisticallysignificant（P&

B,groupCLH,Tvaluebeforeandaftertreatmentthedifferencewasnotsignificantsignificance（P&

0.05）comparethreehormonevalues&

betweenthetwogroupsbeforetreatment,thedifferencewasnotsignificantsignificance（P&

0.05）aftertreatment,groupA,LH,Tvalues&

withother2groups,thedifferencewassignificant（P&

0.05）,BandCgroupLH,Tcomparison,thedifferencewasnotstatisticallysignificant（P&

0.05.postedinthefreepapersDownloadCenterhttp:

//3.2aftertreatmentovulationrateandintrauterinepregnancyratecomparisonTable2shows,Agroupofovulationandtheothertwogroups,thedifferencewasnotstatisticallysignificant（P&

0.05）.Agrouppregnancyrateandtheothertwogroups,thedifferencewasstatisticallysignificant（P&

B,Cgrouppregnancyrate,thedifferencewasnotstatisticallysignificant（P&

0.05）Table13groupsbeforeandaftertreatmentofFSH,LH,TmeasurementresultsinTable23ovulationtreatment,intrauterinepregnancyratestatisticalmethods:

χ2test;

（1）:

P&

0.05,withgroupA（vsgroupA②:

0.05,comparedwithgroupB（vsgroupB

4DiscussionPhysicalandpsychologicalharmcausedbythe4.1PCOSCurrenttreatmentofPCOSpatientshasincreasinglyattractedattentionbutitsexactetiologyisnotclearofthediseaseformorethanagroupbecauseofsexual,multi-systemchronicendocrinedisorders,clinicalmanifestationsandendocrineshowedahighdegreeofheterogeneity,hyperandrogenismandhighLHlevelsaredifficulttotreatPCOSkeymodern