填精益血汤联合黄体酮治疗先兆流产的临床观察

Clinical Observation on Tianjing Yixue Decoction Combined with Progesterone in the Treatment of Threatened Abortion

目的以血清雌二醇(E2)、孕酮(P)及β-人绒毛膜促性腺激素(β-HCG)水平变化及B超孕囊直径为指标,分析填精益血方联合黄体酮治疗先兆流产的临床效果。方法选择2015年3月—2017年2月门诊或住院的先兆流产患者85例,根据治疗方法不同分为观察组(口服填精益血汤方联合肌肉注射黄体酮治疗,45例)和对照组(肌肉注射黄体酮,40例)。评定2组临床疗效,于治疗前后检测血清E2、P、β-HCG水平,B超检查观察孕囊直径,并记录症状缓解时间、消失时间及不良反应发生情况。结果观察组临床总有效率为93. 33%(42/45),明显高于对照组75. 00%(30/40)(P <0. 05)。与治疗前相比,治疗后2组E2、P、β-HCG水平均明显升高,B超孕囊直径明显增长(P <0. 05),与对照组相比,治疗后观察组血清E2、P、β-HCG水平均明显升高,B超孕囊直径明显较长(P <0. 05)。观察组症状缓解时间、消失时间显著较对照组短(P <0. 05)。2组均未见明显的不良反应。结论填精益血方配合黄体酮治疗先兆流产可通过显著改善患者血清E2、P、β-HCG水平及孕囊直径提高临床疗效,从而可促进症状缓解。

Objective To take the changes of serum estradiol（E2）,progesterone（P） and β-human chorionic gonadotropin（β-HCG） and the diameter of gestational sac in B ultrasound as indicators to analyze the clinical effect of Tianjing Yixue decoction combined with progesterone in the treatment of threatened abortion. Methods 85 cases of patients with threatened abortion admitted in outpatient or hospitalization in our hospital from March 2015 to February 2017 were divided into the observation group（treated with oral administration of Tianjing Yixue decoction combined with intramuscular injection of progesterone,n = 45） and the control group（intramuscular injection of progesterone,n = 40） according to the different treatment methods. The clinical efficacy was evaluated between the two groups,and the serum levels of E2,P and β-HCG were detected before and after treatment,and the diameter of gestational sac was observed by B ultrasonic examination. And the times of symptom relief or disappearance and the incidence rate of adverse reactions were recorded. Results The total effective rate in the observation group was 93. 33%（42/45）,which was significantly higher than 75. 00%（30/40） in the control group（P〈0. 05）. Comparing with before treatment,the levels of serum E2,P,β-HCG after treatment were significantly increased and the diameter of the gestational sac in B ultrasound was significantly longer in the two groups（P〈0. 05）,and comparing with the control group,the levels of serum E2,P,β-HCG after treatment were significantly increased and the gestational sac diameter in B ultrasound was significantly longer in the observation group（P〈0. 05）. The relief time and disappearance time of symptoms in the observation group were significantly shorter than those of the control group（P〈0. 05）. There were no significant adverse events in the two groups. Conclusions Tianjing Yixue decoction combined with progesterone can improve the clinical efficacy of patients by improving the levels of serum E2,P,β-HCG and gestational sac diameters to promote symptom relief in the treatment of threatened abortion.