地屈孕酮联合黄体酮治疗先兆流产的临床效果观察

Efficacy of dydrogesterone combined with progesterone in treatment of threatened abortion

目的探讨地屈孕酮联合黄体酮治疗黄体功能不全因素所致先兆流产的临床效果。方法将2013年10月~2014年5月本院产科门诊收治的97例先兆流产患者随机分为观察组（48例）和对照组（49例）。对照组患者给予地屈孕酮片40 mg,口服,8 h后改为10 mg,2次/d10观察组患者在对照组治疗的基础上给予肌内注射黄体酮40 mg,1次/d,症状缓解改为20 mg。对比两组患者血清孕酮和人绒膜促性腺激素水平、临床症状缓解和消失时间、保胎效果、新生儿情况以及药物不良反应。结果治疗后两组孕酮和人绒膜促性腺激素水平均较治疗前明显升高,组内差异有统计学意义（P〈0.05）;且观察组治疗后明显高于对照组,组间差异有统计学意义（P〈0.05）。观察组患者症状缓解和消失时间均明显短于对照组,差异有统计学意义（P〈0.05）;两组均无新生儿畸形发生,新生儿体质量比较差异无统计学意义（P〉0.05）。观察组保胎成功率为91.67%,高于对照组的75.51%,差异有统计学意义（P〈0.05）。观察组不良反应发生率为6.25%,明显低于对照组的16.33%,差异有统计学意义（χ2=3.449,P〈0.05）。结论地屈孕酮联合黄体酮治疗黄体功能不全因素所致的先兆流产,药物起效时间快,保胎效果优于单用地屈孕酮,且不良反应轻,值得临床推广应用。

Objective To study the efficacy of dydrogesterone combined with progesterone in the treatment of threat- ened abortion due to progesterone therapy factors. Methods 97 cases of patients with threatened abortion admitted to our hospital from October 2013 to May 2014 were randomly divided into observation group （48 cases） and control group （49 cases）.The control group were treated with dydrogesterone tablets 40 mg,orally,8 h later renamed 10 mg,2 times a day.The observation group were given with progesterone intramuscular injection on the basis of control group,40 mg, once daily,symptom relief to 20 mg.The serum progesterone and human chorionic gonadotropin levels,the time of clinical remission of symptoms and disappearance,the effect of miscarriage,neonatal conditions and adverse drug reactions were compared between the two groups. Results After treatment,the serum progesterone and human chorionic go- nadotropin levels was increased compared with before treatment （P〈0.05）,and the observation group was higher than that of control group （P〈0.05）.The time of clinical remission of symptoms and disappearance in observation group was shorter than that in control group （P〈0.05）;There were no neonatal malformations,neonatal weight had no significant difference （P〉0.05）.The successful rate of miscarriage in observation group was 91.67%,higher than 75.51% in control group,the difference was significant （P〈0.05）.The incidence of adverse reaction in observation group was 6.25%,lower than 16.33% in control group,the difference was significant （P〈0.05）. Conclusion Dydrogesterone combined with progesterone in the treatment of threatened abortion due to progesterone therapy factors has rapid drug onset time,the miscarriage effect is better than that only using dydrogesterone,and the adverse reaction is less,it is worthy of clinical application.