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研究生:陳彥霖
研究生(外文):YAN LIN CHEN
論文名稱:黑木耳方在多囊性卵巢症候群的臨床應用評估
論文名稱(外文):Preliminary Clinical Therapeutics in Polycystic Ovary Syndrome by Treatment of Auricularia polytricha Formula Preliminary Clinical Therapeutics in Polycystic Ovary Syndrome by Treatment of Auricularia polytricha Formula
指導教授:陳啟楨陳啟楨引用關係
指導教授(外文):CHEE JEN CHEN
學位類別:碩士
校院名稱:南台科技大學
系所名稱:生物科技系
學門:生命科學學門
學類:生物科技學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:120
中文關鍵詞:高胰島素桂枝茯苓丸加黑木耳方多囊性卵巢症候群肥胖六味地黃丸加黑木耳方閉經
外文關鍵詞:hyperinsulinemiaGui-Zhi-Fu-Ling-Wan and Auricularia polytrichaPCOS(Polycystic ovary syndrome )obesityLiu-Wei-Di-Huang-Wan and Auricularia polytrichaamenorrhea
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多囊性卵巢症候群(PCOS)是生育年齡婦女相當常見的內分泌疾病,其盛行率約5-7%,近年來,肥胖對於健康的影響,引起社會和醫界極度的重視。許多研究顯示,多囊性卵巢症候群的婦女當中,50%都有肥胖的問題,因為多囊性卵巢症候群長久帶來的影響,還會引起代謝異常症候群,出現高血壓、冠狀動脈心臟病、中風、甚至於糖尿病,這些情形特別是在肥胖的PCOS患者尤其容易發生,因此不容忽視。
爲證實黑木耳方對於多囊性卵巢症候群肥胖者減重及降血脂之療效,我們
採用肥胖研究,公認最佳指標如:腰圍、臀圍、腰臀比、體重、BMI、局部脂肪等為主;本試驗以隨機、對照方式進行,研究對象以郭綜合醫院中醫科及婦產科門診之PCOS肥胖病人為主,腰圍大於88公分及BMI大於24kg/㎡,並符合PCOS納入/排除標準之患者,被隨機分為兩組:六味地黃丸加黑木耳組(A組)及安慰組(B組)。A組每位患者每次給予黑木耳加中藥粉包每日16g,B對照組給予安慰劑澱粉包每日16g,黑木耳購自彥廷農場,中藥粉來自順天GMP藥廠。給藥治療方法係每位患者給予上述處方,一天三次,早中晚口服。每位患者每週看診一次記錄臨床變化等。16週後抽血檢查生化物質變化。
結果,黑木耳加中藥組(A組),主要療效指標(BMI、腰圍)在治療前後比較,都達統計顯著標準,腰圍減少3.45±1.40公分(p<0.05),BMI(kg/㎡)減少1.81±0.80 (p<0.05) 體重減少4.52±1.98公斤(p<0.05);生化值方面,黑木耳加中藥組(A)治療前後三酸甘油脂減少9.56mg/dl、膽固醇減少14.53mg/dl、收縮壓減少7.45 mmHg、舒張壓減少5.90 mmHg、飯前血糖降低4.83mg/dl,皆達顯著水準(p<0.05 ),對照(B)組在治療前後飯前血糖,膽固醇體重,BMI及腰臀比變化皆未達顯著水準。而且黑木耳加中藥組月經週期的縮短及睪固酮降低皆有顯著的意義(p<0.05)。整體而言(六地加減及桂苓加減兩方)黑木耳方在治療組生活品質及中醫症狀,都有較佳之改善趨勢,尤其是生活品質之生理層次方面(p<0.05),及中醫之便秘(p<0.05)及消穀善飢(p<0.05)之症狀最明顯,並達統計之水準。
Polycystic ovary syndrome (PCOS) is a common endocrine disease that affects around 5-7% of women of childbearing age. In recent years the effects of obesity on health has gained much attention from the medical world as well as society at large. There are numerous researches that show about 50% of women with polycystic ovary syndrome suffer from obesity. PCOS is considered a complex metabolic disorder related to infertility and obesity. It is also thought to be a major risk factor for the development of diabetes mellitus, cardiovascular disease, and endometrial cancer.  
In order to verify the ability of Auricularia polytricha to effect weight loss in obese people with PCOS, we chosed various measurements as indicators. Such indicators were selected from various researches done on weight loss, including; waistline, hip size, waist/hip proportion, weight, body mass index (BMI), and that of fat distribution. Participants were selected primarily from the patients in the gynecology department of Kuo General Hospital Tainan,Taiwan.Only those patients whose waistlines were bigger than 88cm, had a BMI greater than 24 kg/m², and conformed to the criterion of PCOS were admitted. These people were then randomly assigned into two groups. Group A was given Auricularia polytricha plus concentrated granules of liu wei di huang. Group B was given 16 grams of placebo powder per day. The herbs for both groups were divided into three doses taken in the morning, noon, and night. Each patient was examined in the clinic once a week to record any physical changes. Every 16 weeks each patient had a blood test checking for biochemical changes. The Auricularia polytricha used in the study offered from Yen-Ten Farm, while the concentrated herb granules were provided by Sun Ten Pharmaceutical Company(Taipei,Taiwan.ROC).
Results showed that those patients in group A had an overall reduction in waistline of 3.45 ±1.40cm (p<0.05) and a reduction of BMI of 1.81 ±0.80 (p<0.05) with a drop in weight of 4.52 ±1.98kg (p<0.05). Between the groups there were marked differences. Among the differences in group A, before and after treatment, were a reduction of triglyceride by 9.56mg/ml;cholesterol reduction of 14.53 mg/ml; a reduction of systolic pressure by 7.45 mg/ml; reduction of diastolic pressure by 5.90 mg/ml; pre-prandial blood sugar reduction of 4.83 mg/ml (p<0.05). Changes in levels of fasting blood sugar levels, cholesterol, BMI, and waist/hip proportion in group B did not fall within the margin of error. Moreover the reduction of testosterone and the shortening of the duration of menses is significant (p<0.05).
In summary, liu wei di huang wan plus Auricularia polytricha offers a better quality of life for patients and a good choice of treatment PCOS for Chinese medicine practitioners. It also proved to be effective for constipation (p<0.05), excessive appetite (p<0.05) and various other biological functions (p<0.05).
目錄
中文摘要………………………………………………………………………..…..…1
英文摘要…………………………………………………………………………..…..2
目錄………………………………………………………………………………..…..3
表目錄…………………………………………………… ……………………….…..4
圖目錄………………………………………………………………………………....5
第一章、前言…………………………………………………………………………6
一、研究背景………………………………………………………………………6
二、研究動機………………………………………………………………………7
三、研究目的………………………………………………………………………8
四、研究架構……………………………………...……………………………….8

第二章、文獻回顧………………………..…………………………………………..9
一、多發性卵巢囊腫症候群的文獻回顧西醫看法…………………..…..……..9
(一)歷史回顧……………………………………………………………...…10
(二)什麼是多囊性卵巢症候群……………………………….…………...…12
(三)多囊性卵巢症候群臨床症狀……………………………….………...…13
(四)多囊性卵巢症候群的病因病理……………………………….……...…14
(五)多囊性卵巢症候群的診斷…………………………….……………...…25
(六)多囊性卵巢症候群的治療………………………….………………...…28
二、多發性卵巢囊腫的症候群文獻回顧中醫看法…………….…………..……32
(一)肥胖的歷史回顧…………………………………………………………32
(二)經閉的歷史回顧…………………………………………………………34
(三)多囊性卵巢綜合症病因病理學…………………………………………36
(四)多囊性卵巢綜合症的中醫辨證分型……………………………………36
(五)多囊性卵巢綜合症的中醫治……………………………………………37

三、黑木耳方的文獻回顧………………………..……………………………….37
(一)黑木耳的文獻回顧………………………………………………………38
(二)六味地黃丸之文獻回顧…………………………………………………44
(三)桂枝茯苓丸之文獻回顧…………………………………………………51

第三章、研究材料與方法………………………..…………………………………53
一、研究設計………………………..……………………………………………53
二、研究指標………………………..……………………………………………54
三、研究實驗檢驗操作方式………………………..……………………………54
四、研究不良事件反應………………………..…………………………………55
五、研究資料之統計分析………………………..………………………………55
第四章、結果………………………..………………………………………………57
一、基本資料統計分析…………………………………………………………...57
二、主要療效指標(Primary endpoint)統計分析…………………………………57
三、次要療效指標(Secondary endpoint) 統計分析……………………………..57
四、生活品質統計分析………………………………………………………...…58
五、中醫問卷在治療前後化分析………………………………………………...58
第五章、討論………………………..……………………………………………….59
一、本文之重要性在於首次使用雙盲試驗,結果發現黑木耳方在pcos減重調
經有顯著的意義。…………………………………………………………...59
二、服食metformin(豪樂)易有噁心嘔吐等副作用, 黑耳六地方及黑耳桂苓方
都沒有此副作用發生…………………………………………………..………61
三、與國內外研究之不同…………………………………………………………63
四、本實驗之缺點…………………………………………………………………65第六章、結論………………………..………………………………………..………66
第七章、參考文獻……………………..……………………………………..………67
附錄 ………………………..…………………………………………………....…..114
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中醫臨床雜誌2006,12(1):26-39.(附一)………………………….……………..…114
(2)陳彥霖、 李耀泰、翁紹評、施景中、鄭鴻祥、陳啟楨. 桂枝茯苓丸加黑木耳
方對於肥胖性多發性卵巢囊腫症候群的臨床初步療效評估台灣中醫醫學雜誌
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