益气化瘀汤对气虚血瘀型患者药物流产后止血作用及预后的影响

Effect of the Hemostasis and Prognosis after Drug Abortion by Yiqihuayu Decoction in the Treatment of Patients with Qi Deficiency and Blood Stasis

目的:探讨益气化瘀汤对气虚血瘀型患者药物流产后止血作用及预后影响。方法:选取2015年5月至2016年5月于本院妇产科门诊确诊为早孕,自愿要求药物流产的健康孕妇,共计82例,按照随机数字表法分为两组,对照组41例予米非司酮和米索前列醇片行药物流产;观察组41例在对照组基础上予益气化瘀汤。观察并记录两组患者治疗前后血清基质金属蛋白酶-3(matrix metalloproteinases 3,MMP-3)、基质金属蛋白酶-9(matrix metalloproteinases 9,MMP-9)、子宫三径水平以及治疗后中医证候疗效、流产成功率、阴道出血时间、出血总量评分以及月经恢复时间。结果:对照组总有效率80.49%低于观察组95.15%,差异有统计学意义(P <0.05);药流术后,观察组患者完全流产率显著高于对照组,不全流产和流产失败率显著低于观察组,差异有统计学意义(P <0.05);药流术后,观察组患者阴道出血时间、阴道出血总量评分与月经恢复时间显著低于对照组,差异有统计学意义(P <0.05);与治疗前比较,两组患者治疗后血清子宫三径、MMP-3、MMP-9水平均明显降低,差异有统计学意义(P <0.05),且观察组低于对照组(P <0.05);两组治疗过程中,对照组不良反应为9.76%,观察组为7.32%,两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论:益气化瘀汤能有效降低气虚血瘀型患者药物流产后出血时间和出血量,缩短月经周期恢复时间,具有较好的止血作用和促进预后的临床疗效,可能与其抑制MMP-3及MMP-9因子,减少炎症因子的释放有关。

Objective: To investigate the effect of the hemostasis and prognosis after drug abortion by Yiqihuayu decoction in the treatment of Patients with Qi deficiency and blood stasis.Methods: 82 pregnant women were selected from May2015 to May 2016 in our hospital,they were divided into two groups according to the admitted order,41 cases in each group.The control group was given mifepristone and Misoprostol tablets drug abortion,,the clinical group was given Yiqihuayu decoction on the base of control group.Then the changes of serum MMP-3,MMP-9,three level and uterine size of TCM syndrome curative effect index of two groups of patients before and after the treatment,and the treatment success rate of abortion,vaginal bleeding time and total score,menstrual time changes in the level of recovery were compared.Result: Afer the treatment,two groups of patients with serum MMP-3,MMP-9,uterine diameter of the three levels were significantly reduced.Compared with the control group,the patients in the experimental group after treatment,serum MMP-3,MMP-9,three level uterine and vaginal bleeding time,size of the total amount of bleeding score,menstrual recovery time were lower than the control group,TCM efficacy index,abortion success rate is higher than the control group(P < 0.05).Conclusion: Yiqihuayu decoction can effectively reduce the drug in patients with Qi deficiency and blood stasis after abortion,bleeding time and bleeding volume,shorten the recovery time of the menstrual cycle.It has good clinical effect to promote the prognosis,it is worthy to be used in clinical application and promotion.