寿胎丸内服+益肾保胎膏穴位贴敷联合黄体酮+地屈孕酮治疗先兆流产(肾虚)随机平行对照研究

Shoutai Pill/寿胎丸 Oral + Yishen Preservative Cream/益肾保胎膏 Acupoint Application Combined with Progesterone +Dydrogesterone Treatment of Threatened Abortion(Kidney Deficiency/肾虚) Randomized Controlled Study

[目的]观察寿胎丸内服+益肾保胎膏穴位贴敷联合黄体酮+地屈孕酮治疗先兆流产(肾虚)疗效。[方法]使用随机平行对照方法,将92例住院患者按病志号抽签简单随机分两组。对照组46例黄体酮,20mg/次,1次/d,肌注;地屈孕酮,2次/d,10mg/次。治疗组46例寿胎丸(续断、菟丝子、桑寄生、地榆炭各10g,枸杞子5g,白芍20g,杜仲盐10g,太子参、黄芩、紫苏梗各10g,砂仁、甘草炙各3g,阿胶2g)。1剂/d,水煎1000mL,早晚口服;益肾保胎膏(菟丝子、桑寄生、续断各10g,阿胶5g,太子参、党参、黄芩、砂仁各10g),研磨细粉加蜂蜜调成膏状,医用胶布蘸取适量贴敷肾俞、足三里,1次/d;黄体酮+地屈孕酮治疗同对照组。连续治疗3周为1疗程。观测临床表现、中医症候积分、绒毛膜促性腺激素(β-HCG)、孕激素(P)、雌二醇(E2)、不良反应。治疗1疗程,判定疗效。[结果]治疗组治愈20例,显效13例,有效8例,无效5例,总有效率89.13%;对照组痊愈16例,显效11例,有效6例,无效13例,总有效率71.74%;治疗组疗效优于对照组(P<0.05)。中医症候积分两组均有明显降低(P<0.01),治疗组降低优于对照组(P<0.01)。绒毛膜促性腺激素(β-HCG)、孕激素(P)、雌二醇(E2)两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。不良反应发生率两组无明显差异(P>0.05)。[结论]寿胎丸内服+益肾保胎膏穴位贴敷联合黄体酮+地屈孕酮治疗先兆流产(肾虚),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the curative effect of Shoutai Pill Oral + Yishen Baotai Ointment acupoint application combined with progesterone + dydrogesterone in the treatment of threatened abortion(kidney deficiency). [Methods] A randomized parallel control method was used to randomly divide 92 hospitalized patients into two groups according to the disease number. In the control group, 46 cases of progesterone, 20 mg/time, 1 time/d, intramuscular injection;dydrogesterone, 2 times/d, 10 mg/time. In the treatment group,46 cases of Shoutai Pills(continued, dodder, mulberry, earthworm charcoal 10 g, hazelnut 5 g, white peony root 20 g, eucommia barium 10 g, ginseng ginseng, astragalus, perilla stem 10 g, Amomum villosum L., licorice Each 3 g, Ejiao 2 g). 1 dose/d, decoction 1000 mL, morning and evening oral;Yishen Baotai cream(dodder,mulberry, sinensis 10 g, Ejiao 5 g, Taizishen, Codonopsis, Astragalus, Amomum 10 g), ground fine powder and honey In the form of paste, the medical tape was taken with appropriate amount of Shenshu and Zusanli,once a day;the progesterone + dydrogesterone treatment was the same as the control group. Continuous treatment for 3 weeks is a course of treatment. Observed clinical manifestations, TCM syndrome scores,chorionic gonadotropin(β-HCG), progesterone(P), estradiol(E2), adverse reactions. Treatment for 1 course of treatment, to determine the efficacy. [Results] In the treatment group, 20 cases were cured, 13 cases were markedly effective, 8 cases were effective, 5 cases were ineffective, and the total effective rate was 89.13%.In the control group, 16 cases were cured, 11 cases were markedly effective, 6 cases were effective, 13 cases were ineffective, and the total effective rate was 71.74%. The treatment group was better than the control group(P<0.05). The TCM syndrome scores were significantly lower in both groups(P<0.01), and the treatment group was better than the control group(P<0.01). The levels of chorionic gonadotropin(β-HCG),progesterone(P) and estradiol(E2) were improved(P<0.01), and the improvement of the treatment group was better than that of the control group(P<0.01). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). [Conclusion] Shoutai Pill Oral + Yishen Baotai Ointment acupoint application combined with progesterone + dydrogesterone in the treatment of threatened abortion(kidney deficiency), satisfactory results, no serious adverse reactions, worth promoting.