腹腔镜辅助中医药周期疗法治疗早期复发性自然流产临床观察

Clinical Observation of Traditional Chinese Medicine Therapy Combined with Laparoscopic Surgery in Treating Early Recurrent Spontaneous Abortion

目的:观察腹腔镜辅助中医药治疗早期复发性自然流产患者的临床疗效。方法:将封闭抗体阴性且反复早期自然流产患者随机分为两组,治疗组34例行腹腔镜检查,术后予内服中药治疗;对照组20例患者行淋巴细胞免疫治疗及抗凝治疗。比较两组的血β-HCG检测阳性率、孕后5周和8周孕酮P及血β-HCG水平、再次流产率、持续妊娠率。结果:(1)治疗组腹腔镜检查术中发现盆腔腹膜型子宫内膜异位症(Endometriosis)有28例;(2)治疗后,两组的血β-HCG检测阳性率比较,差异无统计学意义(P>0.05);(3)治疗后,两组孕后5周和8周孕酮P及血β-HCG水平比较,差异无统计学意义(P>0.05);(4)治疗后,治疗组的再次早期流产率(16.67%)低于对照组(56.25%),差异有统计学意义(P<0.05);(5)治疗后,治疗组的持续妊娠率(73.53%)高于对照组(35%),差异有统计学意义(P<0.05)。结论:(1)子宫内膜异位症可能是早期复发性自然流产的原因;(2)对于早期复发性自然流产患者,腹腔镜处理子宫内膜异位病灶后,予中医药治疗,在降低流产率、提高持续妊娠率上有良好的效果。

Objective： To observe the clinical effects of TCM therapy combined with laparoscopic surgery in treating early re- current spontaneous abortion. Methods The qualified 54 patients with early recurrent spontaneous abortion and negative-blocking antibodies were randomized into treatment group and controlled group. The treatment group （N = 34） was given Chinese herbal medicine after laparoscopic surgery, and the controlled group （N= 20） was used active immunization combined with anticoagulant therapy. Positive rate of --HCG, the level of serume progesterone, serume 13-hCG in 5 weeks and 8 weeks, abortion rate, ongo- ing pregnancy rate were observed in both groups. Results ： Totally 28 cases were diagnosed as having endometriosis by laparoscopy in the treatment group. After treatment, there was no statistical difference between two groups in the positive rate of --HCG （ P 〉 0. 05）. There was no statistical difference between two groups in the level of serume progesterone, serume 13-hCG in 5 weeks and 8 weeks （P 〉 0. 05）. The abortion rate in treatment group was 16. 67%, which was significantly lower than that of the controlled group （P 〈 0. 05）. The ongoing pregnancy rate in the treatment group was 73. 53%, which was significantly higher than that of the controlled group （P 〈 0. 05）. Conclusion： Endometriosis may be the.cause of early recurrent spontaneous abortion. For the patients with early recurrent spontaneous abortion, the application of traditional Chinese medicine treatment after laparoscopic treatment of endometriosis can effectively reduce the abortion rate and increase the ongoing pregnancy rate.