补肾活血汤联合低分子肝素治疗孕早期复发性流产血栓前状态的效果和安全性分析

Analysis of the effect and safety of Bushen Huoxue Decoction combined with Low Molecular Weight Heparin in the treatment of prethrombotic recurrent miscarriage in early pregnancy

目的分析补肾活血汤联合低分子肝素治疗孕早期复发性流产血栓前状态的效果和安全性。方法选取2017年1月~2019年1月于北京同仁堂中医医院妇科门诊就诊的60例血栓前状态所致复发性流产患者作为研究对象,按照自愿原则随机分组,将其分为对照组和实验组,每组各30例。两组患者均进行基础黄体支持治疗,在此基础上,对照组患者给予低分子肝素进行治疗,实验组患者在对照组基础上加服补肾活血汤进行治疗。经过42 d治疗后,比较两组患者的子宫动脉血流参数、凝血功能指标、中医证候积分、治疗总有效率以及不良反应总发生率。结果治疗后,实验组患者的左侧子宫动脉阻力指数(RI)为(0.771±0.056)、右侧RI为(0.784±0.047)、子宫动脉收缩期最大血流速度/舒张末期血流速度(S/D)之和为(10.66±1.35)、纤维蛋白原为(2.22±0.16)g/L、D-二聚体为(161.53±45.38)μg/mL,均低于对照组的(0.817±0.076)、(0.844±0.053)、(11.73±1.39)、(3.48±0.27)g/L和(262.70±43.51)μg/mL,差异有统计学意义(P<0.05);实验组患者的中医证候积分为(7.83±2.33)分,低于对照组的(11.89±1.88)分,差异有统计学意义(P<0.05);实验组患者的治疗总有效率(93.34%)高于对照组(76.66%),差异有统计学意义(P<0.05);实验组患者的不良反应总发生率(6.67%)低于对照组(16.67%),差异有统计学意义(P<0.05)。结论与一般的西药治疗相比,补肾活血汤联合低分子肝素治疗血栓前状态所致复发性流产的效果显著,对改善患者机体的各项指标更加有利,使得治疗总有效率大幅度提升,安全可行。

Objective To analyze the effect and safety of Bushen Huoxue Decoction combined with Low Molecular Weight Heparin in the treatment of prethrombotic recurrent miscarriage in early pregnancy.Methods A total of 60 patients with recurrent miscarriage at prethrombotic state who visited the Gynecological Clinic of Beijing Tongrentang Hospital of Traditional Chinese Medicine from January 2017 to January 2019 were selected as the research subjects.They were randomly grouped according to the principle of voluntariness,and divided into control group(n=30)and experimental group(n=30).The two groups were treated with Low Molecular Weight Heparin under basic corpus luteum support.In the experimental group,Bushen Huoxue Decoction on the basis of the control group was added.After 42 days of treatment,the uterine artery blood flow parameters,blood coagulation function index,traditional Chinese medicine(TCM)syndrome integral,total effectiveness rate of treatment and total adverse reaction rate were compared between the two groups.Results After treatment,the left resistance index(RI)was(0.771±0.056),right RI was(0.784±0.047),uterine artery maximum blood flow velocity/end diastolic blood flow velocity(S/D)was(10.66±1.35),fibrinogen was(2.22±0.16)g/L,and D-dimer was(161.53±45.38)μg/mL,all lower than those of the control group of(0.817±0.076),(0.844±0.053),(11.73±1.39),(3.48±0.27)g/L and D-dimer(262.70±43.51)μg/mL,with statistical significances(P<0.05).The integral of TCM syndromes of the experimental group was(7.83±2.33)points,which was lower than that of the control group of(11.89±1.88)points,with statistical significance(P<0.05).The total effectiveness rate of treatment in the experimental group was 93.34%,which was higher than that in the control group accounting for 76.66%with statistical significance (P<0.05). The total adverse reaction rate in the experimental group was 6.67%, which was lower than that in the control group accounting for 16.67%, and the difference was statistically significant (P<0.05). Conclusion Compared with Western medicine treatment, Bushen Huoxue Decoction combined with Low Molecular Weight Heparin has a significant effect on the treatment of prethrombotic recurrent miscarriage, which is more beneficial to improve the various indicators of the patient′s body, so that the total effectiveness rate of treatment is greatly improved, and it is safe and feasible.