保胎饮治疗脾肾两虚型早期复发性自然流产的临床研究

Clinical Observation on Baotaiyin in Treating Early Recurrent Spontaneous Abortion with Kidney-spleen Deficiency Syndrome

目的观察保胎饮对脾肾两虚型早期复发性自然流产的临床疗效以及对血清促绒毛膜性腺激素(HCG)、孕酮(P)水平的影响,探讨HCG和P在预测流产预后中的价值。方法采用随机分组对照,治疗组予保胎饮,对照组予黄体酮,以10 d为1个疗程,观察2组疗效及对HCG、P水平的影响。结果①治疗组总有效率为77.4%,对照组为73.3%,治疗组疗效优于对照组(P<0.05);②2组治疗后阴道止血情况差异显著(P<0.05);③2组P水平在治疗前后无明显变化,2组患者β-HCG在治疗前后有非常显著性差异(P<0.01);④不同妊娠结局在治疗前后血清P水平上有非常显著差异(P<0.01)。结论①保胎饮治疗复发性先兆流产,能显著改善患者的阴道出血情况,缓解症状、体征,疗效确切,使用安全;②β-HCG、P值与妊娠结局密切相关,联合监测血β-HCG及P水平,可以较准确的预测妊娠的结局,在治疗过程中β-HCG及P水平持续升高,保胎成功率越高;③妊娠结局与自然流产次数成正比,流产次数与保胎成功率密切相关。

Objective To explore the curative effect of Baotaiyin on early recurrent spontaneous abortion with kidney-spleen deficiency syndrome and its effect on human chorionic gonadotropin （HCG） and progesterone （P）, and explore the value of HCG combined with P in predicting prognosis of abortion. Methods 61 patients were randomly divided into two groups, the treatment group （31 cases） were treated with Baotaiyin, and the control group （30 cases） with progesterone for 10 days. The curative effect of two groups and the content changes of HCG and P before and after the treatment were observed. Results The effective rate was 77.4% in the treatment group and 73.3% in the control group, and there was a significant difference （P〈 0.05）. There was a significant difference in vaginal bleeding condition between two groups after treatment （P〈 0.05）. There was no significant difference in the level of serum P before and after the treatment in the two groups, but there was a significant difference in the level of β-HCG （P〈0.01）. The levels of serum P and β- HCG were closely related to the pregnancy results, and the change of serum P level before and after the treatment had obvious difference among patients with different pregnancy result. Conclusion Baotaiyin can significantly improve vaginal bleeding and relieve symptoms, and is safe, effective and economical in the treatment of recurrent spontaneous abortion, without obvious side effects. The changes of serum P and β-HCG level could accurately predict prognosis of abortion, and the achievement ratio of tocolysis is higher while the levels of serum P and β-HCG increase consistently. The pregnancy results are remarkably positively correlated to the times of spontaneous abortion, and the latter are closely related to the achievement ratio of tocolvsis.