雌孕激素序贯治疗对人工流产不全的临床研究

Clinical study of estrogen-progestin sequential therapy for patients with incomplete abortion

目的研究雌孕激素序贯治疗对人工流产不全的作用。方法将120例人工流产吸刮术后不全流产患者随机分为3组,治疗组给予雌孕激素序贯联合治疗,清宫组给予再次清宫治疗,对照组予中药生化汤治疗,观察三组患者治疗效果及子宫恢复情况。结果治疗组、对照组、清宫组治疗有效率分别为75.0%(30/40)、50.0%(20/40)和92.5%(37/40),差异有统计学意义(P<0.05);两两比较显示,对照组治疗有效率明显低于治疗组和清宫组,治疗组治疗有效率明显低于清宫组,差异有统计学意义(P均<0.05)。治疗组、清宫组、对照组治疗后阴道不规则流血时间分别为(8.3±2.5)、(10.7±4.8)和(14.5±5.1)d,差异有统计学意义(P<0.01);两两比较显示,治疗组治疗后阴道不规则流血时间明显少于清宫组和对照组,清宫组治疗后阴道不规则流血时间明显少于对照组,差异有统计学意义(P均<0.05)。治疗组、清宫组、对照组治疗后月经复潮时间分别为(28.4±5.5)、(33.2±6.7)和(37.3±8.6)d,差异有统计学意义(P<0.01);两两比较显示,治疗组治疗后月经复潮时间明显少于清宫组和对照组,清宫组治疗后月经复潮时间明显少于对照组,差异有统计学意义(P均<0.05)。三组不良反应发生率相比较差异无统计学意义。结论雌孕激素序贯治疗应用人工流产不全疗效较好,副作用小,治疗后的子宫恢复较再次清宫及中药组快,值得临床推广应用。

Objective To assess the effictiveness of estrogen-progestin sequential therapy for incomplete abortion.Methods 120 women with a diagnosis of incomplete abortion after suction curettage were recruited and randomly divided into the treatment group（orally administrated with estrogen-progestin sequentially）,curettage group（surgical curettage again） and control group（orally administrated with Shenghua decoction）. Therapeutic effects and uterine recovery were observed. Results The efficacy of the treatment group, control group and curettage group were 75.0%（30 / 40）, 50.0%（20 / 40） and 92.5%（37 / 40）, respectively. The differences was statistically significant（P〈0.05）. The efficacy of control group was significantly lower than that of treatment group and curettage group（P〈0.05）; the efficacy of treatment group was significantly lower than that of curettage group（P〈0.05）. After treatment, time of irregular vaginal bleeding was（8.3±2.5）d,（10.7±4.8）d and（14.5±5.1）d in treatment group, curettage group and control group respectively. The results showed a significant difference（P〈0.01）. It was significantly shorter in treatment group than that in curettage and control group（P〈0.05）. Meanwhile, it was significantly shorter in curettage group than that in control group（P〈0.05）.After treatment, time of menstruation recovery was（28.4±5.5）d,（33.2±6.7）d and（37.3±8.6）d in treatment, curettage and control group, respectively. The difference was statistically significant（P〈0.01）. Furthermore,it was significantly shorter in treatment group than that in curettage and control group（P〈0.05）. It was obviously shorter in curettage group than that in control group（P〈0.05）. The rates of adverse effect of different groups were not significantly different（P〉0.05）. Conclusion This randomized control study demonstrated that estrogen-progestin sequential therapy was worthy of applying to treat incomplete abortion on account of the efficacy, safety and low cost.