补肾化瘀法治疗血栓前状态所致复发性流产临床疗效观察

Clinical Effect Observation Tonifying the Kidney and Removing Blood Stasis Method on Recurrent Spontaneous Abortion Due to Prethrombotic State

目的探讨补肾化瘀法治疗血栓前状态所致复发性流产临床疗效。方法选取2018年8月-2018年12月我院收治血栓前状态所致复发性流产患者58例,依据随机数字表法随机分为对照组和治疗组,各29例,对照组给予基础黄体支持治疗,加予低分子肝素治疗,治疗组在此基础上应用补肾化瘀法进行治疗,两组患者进行为期28 d的治疗。观察两组患者治疗前后中医症状积分与凝血功能改善情况,并比较两组患者孕12周胚胎存活率及临床疗效。结果治疗组患者中医症状积分降低较对照组更为明显,结果差异具有统计学意义(P<0.05);两组治疗前后凝血功能相关指标D-二聚体、纤维蛋白原均明显改善(P<0.05),且治疗组较对照组改善更显著(P<0.05);对照组孕12周胚胎存活率为62.07%,治疗组孕12周胚胎存活率为82.76%,治疗组存活率更高(P<0.05);治疗后,治疗组临床总有效率为89.66%,对照组临床总有效率为72.41%,治疗组的临床疗效优于对照组(P<0.05)。结论补肾化瘀法具有活血通经、化瘀止痛、补益肾气之效,可以改善血栓前状态所致复发性流产患者临床症状和体征,改善凝血功能,提高孕12周胚胎存活率,对于血栓前状态所致复发性流产有较好的治疗效果,值得临床推广应用。

Objective The purpose of this study was to investigate the clinical efficacy observation of tonifying the kidney and removing blood stasis method on recurrent spontaneous abortion due to prethrombotic state.Methods 58 patients with recurrent spontaneous abortion due to prethrombotic state admitted to our hospital from August 2018-December 2018 were selected and randomly divided into treatment group and control group with 29 cases in each group according to the table of random number.The control group was administered with basic luteal support therapy combined with low molecular weight heparin therapy,while the treatment group was administered with tonifying the kidney and removing blood stasis method on the basis of the control group.The patients in both groups were treated for 28 days.Observed the improvement of TCM symptom scores and improvement of coagulation function before and after treatment in both groups of patients,and compared the embryo survival rate at 12 weeks of gestation and clinical efficacy in both groups of patients.Results After treatment,the reduction of TCM symptom scores in the treatment group was more significant than that in the control group,the differences were statistically significant(P<0.05).Coagulation function related indicators such as D-Dimer and fibrinogen in the two groups were significantly improved before and after treatment(P<0.05),the improvement in the treatment group was more significant than that in the control group.The embryo survival rate at 12 weeks of gestation in the control group and treatment group was 62.07%and 82.76%,respectively.The survival rate was higher in the treatment group(P<0.05).After treatment,the total clinical effective rate of the control group and treatment group was 72.41%and 89.66%,respectively,the clinical effect of the treatment group was better than that of the control group(P<0.05).Conclusion The tonifying the kidney and removing blood stasis method has the effects of activating blood and stimulating the menstrual flow,removing blood stasis and relieving pain,and tonifying kidney qi.It can improve clinical symptoms and signs of recurrent abortion patients caused by prethrombotic state,improve coagulation function and improve embryo survival rate at 12 weeks of pregnant.It has good therapeutic effect on recurrent abortion caused by prethrombotic state,and is worthy of clinical popularization and application.