补肾健脾方联合地屈孕酮对早期先兆流产的疗效及妊娠结局的影响

Curative efficacy of Bushen Jianpi recipe combined with dydrogesterone in the treatment of early threatened abortion and its effects on pregnancy outcome

目的研究补肾健脾方联合地屈孕酮对早期先兆流产的疗效及妊娠结局的影响,为患者的临床治疗提供指导。方法回顾性分析金山区中西医结合医院妇产科2016年5月至2018年5月接诊的60例早期先兆流产患者的临床资料,根据治疗方法不同分为观察组和对照组,每组30例。对照组给予地屈孕酮治疗,观察组给予补肾健脾方联合地屈孕酮治疗。1周为1个疗程,治疗4个疗程。4个疗程后,比较两组患者治疗后的临床疗效,治疗前后的β-绒毛膜促性腺激素(β-HCG)和孕酮水平,以及妊娠结局和不良反应发生情况。结果治疗后,观察组患者的治疗总有效率为93.33%,明显高于对照组的70.00%,差异有统计学意义(P<0.05);治疗前,两组患者的β-HCG、孕酮水平比较差异均无统计学意义(P>0.05);治疗后,观察组患者的孕酮和β-HCG水平分别为(38.73±5.64)ng/mL、(17645.41±2453.36)U/L,明显高于对照组的(30.36±3.87)g/mL、(14552.34±1633.28)U/L,差异均有统计学意义(P<0.05);观察组患者足月妊娠率为86.67%,明显高于对照组的60.00%,流产率为6.67%,明显低于对照组的26.67%,差异均有统计学意义(P<0.05);观察组患者的不良反应总发生率为13.33%,对照组为10.00%,差异无统计学意义(P>0.05)。结论早期先兆流产患者采用补肾健脾方联合地屈孕酮治疗可有效改善患者内分泌激素水平,妊娠结局较好,且不会增加不良反应。

Objective To study the curative efficacy of Bushen Jianpi recipe combined with dydrogesterone in the treatment of early threatened abortion and its effects on pregnancy outcome. Methods The clinical data of 60 patients with early threatened abortion in the Department of Gynecology and Obstetrics, Shanghai Jinshan District Hospital of Integrated Traditional Chinese and Western Medicine from May 2016 to May 2018 were retrospectively analyzed. According to the different treatment methods, the patients were divided into observation group and control group, with 30 patients in each group. The control group was treated with dydrogesterone, and the observation group was treated with Bushen Jianpi recipe and dydrogesterone, with one week for a course, for 4 courses. After 4 courses of treatment, the clinical effects, the levels of β-hCG and progesterone, the outcome of pregnancy, and adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the observation group was 93.33%, whcih was significantly higher than 70.00% of the control group(P<0.05). Before treatment, there was no statistically significant difference in the levels of β-h CG and progesterone between the two groups(P>0.05). After treatment, the levels of progesterone and β-hCG in the observation group were(38.73±5.64) ng/mL,(17 645.41±2 453.36) U/L, which were significantly higher than(30.36±3.87) ng/mL,(14 552.34±1 633.28) U/L in the control group(P<0.05). The full-term pregnancy rate in the observation group was 86.67%, which was significantly higher than 60.00% in the control group, and the abortion rate in the observation group was 6.67%, which was significantly lower than 26.67% in the control group(P<0.05). The total incidence of adverse reactions was 13.33% in the observation group and 10.00% in the control group,with no statistically significant difference(P<0.05). Conclusion Bushen Jianpi recipe combined with didrogesterone has a significant effect in the treatment of early threatened abortion, which can effectively improve the level of endocrine hormones and pregnancy outcomes, without increasing adverse reactions.