自拟益气养血护胎方联合黄体酮注射液对早期先兆流产合并绒毛膜下血肿气血虚弱证患者疗效及β-人绒毛膜促性腺激素水平的影响

Effect of Self-made Yiqi Yangxue Hutai Decoction Combined with Progesterone Injection on Efficacy and β-human Chorionic Gonadotropin Level for Patients with Early Threatened Abortion Complicated with Subchorionic Hematoma of Qi-blood Deficiency Syndrome

目的:观察自拟益气养血护胎方联合黄体酮注射液对早期先兆流产合并绒毛膜下血肿气血虚弱证患者疗效及β-人绒毛膜促性腺激素(β-hCG)水平的影响。方法:将88例早期先兆流产合并绒毛膜下血肿患者(气血虚弱型)以随机数字及随机余数分组法分为观察组(n=44,黄体酮注射液+自拟益气养血护胎方治疗)与对照组(n=44,黄体酮注射液治疗),连续治疗2周。比较两组临床疗效、疾病相关指标,记录治疗前、治疗2周后两组中医证候积分、绒毛膜下血肿情况及血清相关因子水平。结果:观察组临床总有效率为97.73%,明显高于对照组的86.36%(P<0.05),观察组阴道流血持续时间(4.32±0.95)d、阴道流血量(15.26±2.31)mL、腹痛持续时间(1.23±0.51)d均短于对照组(6.87±1.01)、(20.33±2.59)、(2.64±0.55)(P<0.05)。治疗2周后,两组中医证候积分(阴道出血、小腹坠痛、腰膝酸软、心悸气短、面色无华)、绒毛膜下血肿情况(血肿面积、血肿面积/孕囊面积)、糖类抗原125(CA125)水平均较治疗前下降,且观察组低于对照组(P<0.05);β-hCG水平均较治疗前升高,且观察组高于对照组(P<0.05)。结论:自拟益气养血护胎方联合黄体酮注射液治疗早期先兆流产合并绒毛膜下血肿(气血虚弱证)疗效显著,能有效改善患者临床症状,促进绒毛膜下血肿吸收。

Objective:To observe the efficacy of Self-made Yiqi Yangxue Hutai Decoction combined with Progesterone Injection for patients with early threatened abortion complicated with subchorionic hematoma of Qi-blood deficiency syndrome and its effects on the level ofβ-human chorionic gonadotropin(β-hCG).Methods:88 patients with early threatened abortion and subchorionic hematoma(Qi-blood deficiency syndrome)were divided into an observation group(n=44,undergoing progesterone injection+Self-made Yiqi Yangxue Hutai Decoction treatment)and a controlled group(n=44,receiving Progesterone Injection treatment)by means of random number table method and random remainder grouping method.Both groups were continuously treated for 2 weeks.The clinical efficacy and disease-related indicators were compared,and the scores of TCM syndromes,subchorionic hematoma and levels of serum-related factors were recorded before treatment and after 2 weeks of treatment.Results:The total clinical effective rate of 97.73%in the observation group was significantly higher than 86.36%in the controlled group(P<0.05),and the duration of vaginal bleeding,vaginal bleeding volume and duration of abdominal pain of(4.32±0.95)d,(15.26±2.31)ml and(1.23±0.51)d were shorter or less than(6.87±1.01)d,(20.33±2.59)ml and(2.64±0.55)d in the controlled group(P<0.05).After 2 weeks of treatment,the scores of TCM syndromes(vaginal bleeding,lower abdominal bearing-down pain,soreness and weakness of waist and knees,palpitations and shortness of breath,lusterless complexion),subchorionic hematoma status(hematoma area,hematoma area/gestational sac area)and level of carbohydrate antigen 125(CA125)of both groups were reduced compared to before treatment,and the above indicators were lower in the observation group(P<0.05).The level ofβ-hCG was enhanced compared with that before treatment,and the level in the observation group was higher(P<0.05).Conclusion:Self-made Yiqi Yangxue Hutai Decoction combined with Progesterone Injection has a significant efficacy in treating early threatened abortion with subchorionic hematoma(Qi-blood deficiency syndrome).It can effectively improve the clinical syndromes,and promote the absorption of subchorionic hematoma.