针灸治疗围绝经期潮热的研究进展

围绝经期女性潮热发作的强度和持续时间各不相同,严重的潮热通常导致生活质量下降,出现生理不适和情志异常,扰乱睡眠,并可能导致抑郁.目前越来越多的研究证实针灸治疗围绝经期潮热的有效性,本文将从针灸治疗更年期潮热的临床应用、现代研究方面展开论述.     

白薇化学成分的研究

白薇始载于《神农本草经》,具有清热凉血、利尿通淋、解毒疗疱的功效。临床用于间歇发作的灼热、血分伏热、衰弱病之消耗热、肺结核之骨蒸潮热等症。白薇品种复杂,《中国药典》收载均为萝科植物白薇Cynanchum atratum Bunge.和蔓生白薇C.versicol-or Bunge.干燥根及根茎。白薇中主要含有C21甾苷类成分。张壮鑫、邱声祥等分别从直立白薇中分离得到18种C21甾体苷元及苷[1~3],从蔓生白薇分离出7种C21甾体苷元及苷[4,5],本研究针对安徽省滁县产的直立白薇进行了有效成分分离,从中首次分离得到3个C21甾苷和1个烷基酸混合物成分(Ⅳ),经鉴定分…     

桂枝新加汤治疗更年期综合征一得

更年期综合征中医学亦称＂经断前后诸证＂,因妇女将届经断之年,先天肾气渐衰,任脉虚,太冲脉衰,天癸将竭,导致机体阴阳失调,临床表现以月经紊乱,阵发性潮热,出汗,失眠、焦虑等一系列以植物神经功能失调为主的症候群。近年来,笔者采用《伤寒论》桂枝新加汤治疗更年期综合征,疗效较好。现举一病例如下。黄某,女,48岁。2012年8月28日诊。患者诉四肢乏力,夜不安寐,时有潮热汗出5年余,平素易感冒,易疲乏,曾多地求治,疗效不显,     

针刺结合振腹治疗更年期综合征

目的观察针刺结合振腹对更年期综合征患者症状评分与性激素的影响。方法 64例患者随机分为2组,治疗组采用针刺与振腹疗法相结合进行治疗,对照组服用坤泰胶囊治疗,疗程9周。观察烘热、汗出、头晕耳鸣、腰膝酸软、失眠多梦、皮肤干燥等症状变化,采用症状程度评分对治疗前后疗效进行对比。测定2组治疗前后血清卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E2)水平。对评分和测定值进行统计学比较。结果 2组治疗后,症状评分均较治疗前明显改善。治疗组32例,有效率87.5%,对照组32例,有效率71.8%,2组有效率经统计学处理有显著差异(P<0.05),治疗组疗效优于对照组。FSH、LH及E2水平没有明显变化,无统计学意义。结论针刺肝俞、肾俞、关元等穴位可调肝养血,滋阴补肾,育阴潜阳。振腹按摩可激发经络之气,升降气机,疏通经络,调理脏腑。针刺结合振腹疗法在改善更年期综合征症状方面具有较好的作用。     

利福平致急性肾功能衰竭1例

利福平是常用的抗痨药物之一，其引起急性肾功能衰竭在临床中较为少见。我科收治1例，现报导如下：1病例患者，女，55岁，农民。半月前无诱因感午后潮热、稍咳、伴乏力，在当地卫生院摄胸片诊断为“肺结核”，给予口服利福平450mg／日，异烟肼0．3／日及维生素B6治疗。三天后出现全程浓茶水样小便，尿量减少，每日尿量约200ml，一周后无尿，伴腰痛、腹胀、恶心、呕吐，无皮疹。     

雌二醇屈螺酮片治疗绝经后妇女绝经相关症状的多中心临床研究

Objective To study the efficacy and safety of estradiol and drospirenone tablets (Angeliq)in treatment of menopausal symptoms among postmenopausal Chinese healthy women.Methods Total 244 postmenopausal Chinese healthy women who had moderate to severe hot flushes were randomly assigned for 16 weeks in this randomized multi-center double-blind placebo-controlled study.During the trial.the follow-up visits were conducted at week 4,8,12,16 of treatment and 2 weeks after treatment respectively.Height,weight,vital signs,hot flushes,other relevant menopausal symptoms and vaginal bleeding were observed in each follow-up visit,while the clinical global impression scale Was assessed at 16 weeks as well.Results It showed that hot flushes were reduced significantly more in observation group than that in placebo group ( P＜0.01 ), although both treatments were effective. The absolute values of mean severity index of total hot flushes decreased by - 0. 6± 0. 5 in observation group and - 0. 4 ± 0. 4 in placebo group from baseline respectively, which reached significant difference ( P ＜ 0. 05 ). However, the absolute values of mean severity index of moderate to severe hot flushes decreased by - 0. 6± 0. 8 in observation group and -0. 3± 0.6 in placebo group from baseline respectively, which had no significant difference (P ＞ 0. 05 ).After 16 weeks treatment, it also showed that estradiol and drospirenone had significant better efficacy than placebo on moderate to severe sweating, vaginal dryness and clinical global impression scale (P ＜0. 01 ).During the trial, blood pressure in observation group was stable. The rate of vaginal bleeding in observation group was higher than that in the placebo group, especially during the week 4 to week 8 when 48. 9% (87/178) in observation group and 10. 7% (6/56) in placebo group of patients bled. Although the cumulative amenorrhea rate of observation group was lower than that of placebo group in each cycle (28 days), it increased gradually along with duration of the treatment. The commonest adverse event in observation group was breast tenderness which accounted for 12.0% (22/183 ). The level of serum potassium was in the normal range in observation group mostly. Meanwhile, the other adverse events rate was low. Serious adverse events reported in this trial were assessed as not study drug related or as unlikely study drug related. Conclusion Estradiol and drospirenone tablets which could effectively alleviate menopausal symptoms in postmeuopausal Chinese healthy women is a novel hormone replacement therapy regimen with high safety and efficacy.     

雌二醇屈螺酮片治疗绝经后妇女绝经相关症状的多中心临床研究

Objective To study the efficacy and safety of estradiol and drospirenone tablets (Angeliq)in treatment of menopausal symptoms among postmenopausal Chinese healthy women.Methods Total 244 postmenopausal Chinese healthy women who had moderate to severe hot flushes were randomly assigned for 16 weeks in this randomized multi-center double-blind placebo-controlled study.During the trial.the follow-up visits were conducted at week 4,8,12,16 of treatment and 2 weeks after treatment respectively.Height,weight,vital signs,hot flushes,other relevant menopausal symptoms and vaginal bleeding were observed in each follow-up visit,while the clinical global impression scale Was assessed at 16 weeks as well.Results It showed that hot flushes were reduced significantly more in observation group than that in placebo group ( P＜0.01 ), although both treatments were effective. The absolute values of mean severity index of total hot flushes decreased by - 0. 6± 0. 5 in observation group and - 0. 4 ± 0. 4 in placebo group from baseline respectively, which reached significant difference ( P ＜ 0. 05 ). However, the absolute values of mean severity index of moderate to severe hot flushes decreased by - 0. 6± 0. 8 in observation group and -0. 3± 0.6 in placebo group from baseline respectively, which had no significant difference (P ＞ 0. 05 ).After 16 weeks treatment, it also showed that estradiol and drospirenone had significant better efficacy than placebo on moderate to severe sweating, vaginal dryness and clinical global impression scale (P ＜0. 01 ).During the trial, blood pressure in observation group was stable. The rate of vaginal bleeding in observation group was higher than that in the placebo group, especially during the week 4 to week 8 when 48. 9% (87/178) in observation group and 10. 7% (6/56) in placebo group of patients bled. Although the cumulative amenorrhea rate of observation group was lower than that of placebo group in each cycle (28 days), it increased gradually along with duration of the treatment. The commonest adverse event in observation group was breast tenderness which accounted for 12.0% (22/183 ). The level of serum potassium was in the normal range in observation group mostly. Meanwhile, the other adverse events rate was low. Serious adverse events reported in this trial were assessed as not study drug related or as unlikely study drug related. Conclusion Estradiol and drospirenone tablets which could effectively alleviate menopausal symptoms in postmeuopausal Chinese healthy women is a novel hormone replacement therapy regimen with high safety and efficacy.     

潮热汗出与更年期综合征的相关性分析

更年期综合征是指因性腺功能逐渐衰退,性激素水平下降所引起的以自主神经功能紊乱、代谢障碍为主的一系列症候群。通常情况下,女性多发生于45～55岁间,男性发生于50～60岁左右,主要表现为自发性潮热、自汗、心悸、疲劳感、及厌世、烦躁等抑郁症状,约80％更年期妇女有此类症状。     

从潮热发生机理探讨中医辨证论治特色

古今医家通过实践,发现阳明腑实、阴血津液内亏、瘀血阻滞阴分、湿热阻遏气机、虚阳浮越均可引起潮热,但因病因病机不同,治疗亦有差异.临床应审证求因,把握本质病机,发挥"辨证论治、同病异治"等中医特色.