加味两地汤治疗复发性自然流产临床观察

Clinical Observation on Modified Liangdi Decoction in the Treatment of Recurrent Spontaneous Abortion

目的探讨加味两地汤治疗复发性自然流产的疗效及可能机制。方法选取大连市妇女儿童医疗中心中医门诊及生殖门诊就诊患者40例,年龄20~40岁女性,既往连续发生2次或2次以上的自然流产者,中医辨证属肾阴亏耗、瘀血内阻型。将其随机分为对照组和治疗组,对照组备孕前口服阿司匹林肠溶片50 mg,每日1片,连服3个月。治疗组备孕前口服两地汤(生地黄、地骨皮、玄参、麦冬各15 g,白芍20 g,阿胶10 g(烊化),加味丹参20 mg。结果妊娠率对照组高于治疗组,组间比较差异无统计学意义;妊娠12周成功率治疗组高于对照组,组间比较差异有统计学意义(P<0.05);活产率治疗组高于对照组,组间比较差异有统计学意义(P<0.05)。对照组抗核抗体,抗心磷脂抗体转阴率41.67%(5/12);治疗组转阴率53.85%(7/13))。2组比较差异有统计学意义(P<0.05)。结论加味两地汤可以治疗肾阴亏耗、瘀血内阻型复发性流产,可提高患者的妊娠率、妊娠12周成功率及活产率,且活产率显著高于治疗组。治疗机制可能与改善患者血栓前状态及免疫学异常情况有关。

Objective To observe the clinical efficacy of the modified Liangdi decoction to treat recurrent spontaneous abortion.Methods A total of 40 patients(20-40years old)with recurrent spontaneous abortion due to“kidney deficiency and blood disorder”in our hospital were selected and randomly divided into the control group and the treatment group:a control group with 50mg aspirin a day,for 3 months,and a treatment group with modified Liangdi decoction,for 3 months.Results Pregnancy rate of the treatment group was higher than the control group,and there was no significant difference between the groups.The 12-weeks pregnancy success rate:the treatment group was higher than the control group,there was significant difference between the groups(P<0.05).Pregnancy outcome:the treatment group was higher than the control group,there was a significant difference between the groups and the groups(P<0.05).Negative rate:the control group was 41.67%,the treatment group was 53.85%,and the difference between the two groups was statistically significant(P<0.05).Conclusion There is a clinical efficacy of the modified Liangdi decoction in the treatment of recurrent spontaneous abortion.Modified Liangdi decoction can improve the pregnancy rate,12-weeks pregnancy success rate and live birth rate.