清宫活血汤配合中医情志疗法在药物流产中的临床疗效观察

Clinical Observation of Effect of Qinggong Huoxue Decoction Combined with Traditional Chinese Medicine Emotional Therapy on Medical Abortion

【目的】观察清宫活血汤配合中医情志疗法在药物流产(简称药流)中的临床疗效。【方法】将90例早孕患者随机分为观察组和对照组,每组各45例。所有患者均给予口服米非司酮及米索前列醇,待孕囊排出后,对照组予以常规治疗(包括抗感染和常规护理),观察组在对照组基础上加用清宫活血汤和中医情志疗法,疗程为1周并随访2个月。观察2组患者治疗前后血清雌二醇(E2)、孕酮(P)、人绒毛膜促性腺激素(HCG)水平的变化情况,比较2组患者治疗后的阴道出血时间、月经恢复时间、宫内残留物消失时间和不良心理评分[包括抑郁自评量表(SDS)评分和焦虑自评量表(SAS)评分]的差异。【结果】(1)治疗后,2组患者的血清E2、P、HCG水平均较治疗前明显降低(P<0.01);组间比较,观察组的血清E2水平明显高于对照组,P、HCG水平明显低于对照组,差异均有统计学意义(P<0.01)。(2)治疗后,观察组患者的阴道出血时间、月经恢复时间、宫内残留物消失时间均明显短于对照组,差异均有统计学意义(P<0.05或P<0.01)。(3)治疗后,观察组患者的SDS评分和SAS评分均明显低于对照组,差异均有统计学意义(P<0.05或P<0.01)。【结论】清宫活血汤配合中医情志疗法在药流中的临床疗效显著,既能有效降低米非司酮对患者卵巢功能的抑制作用,促进患者宫内残留物排出,缩短阴道出血时间,加快恢复患者月经再潮功能,又能有效缓解患者的抑郁和焦虑等不良情绪。

Objective To observe the clinical effect of Qinggong Huoxue Decoction combined with the emotional therapy of Traditional Chinese Medicine(TCM)on medical abortion.Methods Ninety cases of early pregnancy were randomly divided into observation group and control group,45 cases in each group.All of the early pregnancy cases received oral use of mifepristone and misoprostol to achieve abortion.After the discharge of gestational sac,the control group was treated with routine anti-infection treatment and conventional nursing,and the observation group was treated with Qinggong Huoxue Decoction orally and the TCM emotional therapy on the basis of treatment for the control group.The treatment for the two groups lasted for one week,and the follow-up covered 2 months.Before and after treatment,the changes of serum levels of estradiol(E2),progesterone(P),and human chorionic gonadotropin(HCG)in the two groups were examined.After the treatment,the duration of vaginal bleeding,time for the recovery of menstrual cycle,time for the disappearance of intrauterine residue,and the scores of negative emotions such as depression and anxiety in the two groups were observed.Results(1)After treatment,the serum levels of E2,P and HCG in the two groups were obviously decreased in comparison with those before treatment(P<0.01).The inter-group comparison showed that the observation groups had higher E2 level and lower P and HCG levels than the control group,and the differences were statistically significant(P<0.01).(2)After treatment, the duration of vaginal bleeding, time for the recovery of menstrual cycle, and time for thedisappearance of intrauterine residue in the observation group were shortened in comparison with those in thecontrol group,and the differences were statistically significant(P<0.05 or P<0.01).(3)After treatment,thescores of self-rating depression scale(SDS)and the scores of self-rating anxiety scale(SAS)in the observationgroup were obviously lower than those in the control group,and the differences were statistically significant(P<0.05 or P<0.01). Conclusion Qinggong Huoxue Decoction combined with TCM emotional therapy has significantclinical effect on medical abortion. The combined therapy is effective on decreasing the inhibitory effect ofmifepristone on ovarian function, promoting the discharge of intrauterine residue, shortening the duration ofvaginal bleeding, accelerating the recovery of menstrual cycle, and relieving the negative emotions such asdepression and anxiety.