滋阴活血法结合补液治疗晚期妊娠羊水过少对羊水量及围生期结局的影响

The effect of the method of associating invigorating yin and promoting blood flow with fluid replacement on amniotic fluid index and perinatal sequel of late pregnancy oligohydramnios patients

目的:探讨滋阴活血法结合补液对羊水过少患者羊水量及围生期结局的影响。方法:收集羊水过少患者42例随机分入滋阴活血法结合补液治疗组与补液治疗组,并取13例饮水治疗作为对照,观察各组治疗前、治疗1周后、4周后羊水指数(AFI)及围生期胎儿窘迫、胎儿生长受限、剖宫产、新生儿窒息、死亡情况。结果:滋阴活血结合补液组治疗前、治疗1周、4周后AFI分别为(4.67±0.26)、(7.51±0.87)、(6.69±0.70);补液组为(4.65±0.22)、(6.75±0.88)、(5.64±0.71);对照组为(4.68±0.27)、(5.18±0.58)、(5.02±0.42),两治疗组治疗1周、4周后AFI均较治疗前增加(P<0.05),对照组治疗前后无差异;滋阴活血结合补液组与补液组治疗1周后AFI增加量无差异,但4周后滋阴活血法结合补液组AFI增加量优于补液组。滋阴活血结合补液组胎儿窘迫、剖宫产构成比分别为14.3%、38%,低于补液组的42.8%、71.4%(P<0.05)和对照组的61.5%、76.9%(P<0.05);三组胎儿生长受限、新生儿窒息、死亡构成比无显著性差异。结论:滋阴活血法结合补液治疗晚期妊娠羊水过少可增加其羊水量并减少胎儿窘迫发生、降低剖宫产率,其机理可能与中医滋阴活血法可改善胎盘功能有关。

Objective：To approach the effect of the method of associating invigorating yin and promoting blood flow with fluid replacement on amniotic fluid index and perinatal period of late pregnancy oligohydramnios patients. Methods：42 patients of oligohydramnios were randomly divided into the associating invigorating yin and promoting blood flow with fluid replacement group（experimental group 1） and fluid replacement group（experimental group 2）,and 13 patients simply dink water as control group. Observe the amniotic fluid index （AFI） of prior treatment,post treatment one week and four weeks and the ratio of fetal distress,fetal growth restriction（FGR）,uterine-incision delivery（U-D）,neonatal asphyxia and death of each group. Results：The AFI of prior treatment,post treatment one week and four weeks of experimental group 1 were （4.67±0.26）,（7.51±0.87）,（6.69±0.70）,that of experimental group 2 were（4.65±0.22）,（6.75±0.88）,（5.64±0.71）,that of control group were（4.68±0.27）,（5.18±0.58）,（5.02±0.42）. There were significant differences between the AFI of post treatment one week,four weeks and prior treatment of both two experimental groups（P〈0.05）,and there no difference of that of control group. The ratio of fetal distress of the experimental group 1 was 14.3%,and the ratio of U-D was 38%. That were less than the numbers of experimental group 2（42.8%,71.4%）（P〈0.05）and that of control group（61.5%,76.9%）（P〈0.05）. There were no difference of the ratio of FGR,neonatal asphyxia and death. Conclusion：The method of associating invigorating yin and promoting blood flow with fluid replacement can increase AFI of patients of oligohydramnios,step down the ratio of fetal distress and U-D,the mechanism may be that method of invigorating yin and promoting blood flow could improve placental function.