脱花煎联合米非司酮及米索前列醇对早期药流效果的影响

The curative effect and safety of Tuohuajian combined mifepristone and misoprostol in the treatment of early drug abortion

目的研究脱花煎联合米非司酮及米索前列醇对早期药流及尿人绒毛膜促性腺激素(HCG)转阴时间等指标的影响。方法选取2015年2月至2017年2月我院收治的欲行药物流产的早期妊娠者102例。根据随机数字表法分成观察组与对照组,每组51例。对照组予以米非司酮及米索前列醇,观察组则在对照组的基础上加用脱花煎。分别对比2组流产效果、尿HCG转阴时间、阴道出血时间、绒毛蜕膜组织坏死率、蜕膜增殖细胞核抗原(PCNA)蛋白表达情况,以及不良反应发生情况。结果观察组完全流产人数占比(98. 04%)显著高于对照组(80. 40%)。观察组尿HCG转阴时间、阴道出血时间均显著短于对照组,而绒毛蜕膜组织坏死率显著高于对照组(均P <0. 05)。观察组蜕膜PCNA蛋白表达强阳性人数占比显著低于对照组(33. 33%),而弱阳性人数占比(66. 67%)显著高于对照组(17. 65%)。观察组患者恶心、呕吐以及体温升高的发生率与对照组相比,差异均无统计学意义(均P> 0. 05)。结论脱花煎联合米非司酮及米索前列醇用于早期药流可显著提高流产成功率,且能有效缩短尿HCG转阴时间、阴道出血时间,降低蜕膜PCNA蛋白表达。安全性较好。

Objective To study the Tuohuajian combined mifepristone and misoprostol on the curative effect of early drug abortion and influences on the targets of turn urine HCG time,etc. Methods 102 cases of early pregnancy with drug abortion from February 2015 to February 2017 were recruited in this study. According to the random number table method,it was divided into observation group and control group,with 51 cases in each group. In the control group,mifepristone and misoprostol were given for abortion,while in the observation group,decoction was used for abortion. The results of abortion,the time of uria HCG conversion,the time of vaginal bleeding,the necrosis rate of villous molar tissue,the expression of cell nuclear antigen(PCNA) and adverse reactions were compared in two groups. Results The proportion of total abortions among patients in the observation group was 98. 04%,significantly higher than the 80. 40% in the control group. In the observation group,the time of urinary HCG conversion and vaginal bleeding was significantly lower than that of the control group,while the necrosis rate of villous molting tissue was significantly higher than that of the control group(all P < 0. 05). The number in the observation group with a strong positive expression of molting membrane PCNA was significantly lower than the control group’s 33. 33%,while the weak positive population accounted for 66. 67%. This was significantly higher than the 17. 65% of the control group(all P > 0. 05). The incidence of nausea,vomiting,and elevated body temperature in the observed group was not significantly different from the control group(all P > 0. 05). Conclusion Tuohuajian combined with mifepristone and misoprostol can significantly increase the success rate of abortion with early drug flow,and can effectively shorten the time of urinary HCG transyin and vaginal bleeding,while reducing the expression of membrane PCNA protein.And the drug safety is good.