中药汤剂辅助地屈孕酮治疗早期先兆流产的效果分析

Effect of Chinese Herbal Decoction combined with dydrogesterone in the treatment of early threatened abortion

目的探讨自拟固肾安胎汤剂辅助地屈孕酮治疗早期先兆流产的效果,以期为临床早期先兆流产治疗提供用药参考。方法选取2017年1月—2019年12月在杭州师范大学附属医院接受治疗的早期先兆流产患者80例,按随机数字表法将其分为观察组与对照组,每组40例。对照组患者给予地屈孕酮治疗,观察组在对照组的基础上加用固肾安胎中药汤剂。比较2组患者治疗后临床疗效,临床指标改善情况、孕激素水平、妊娠12~14周时胎儿颈项透明层厚度(nuchal translucecy,NT)、顶臀长(crown rump length,CRL)水平,以及保胎成功率和不良反应发生率。结果治疗后,观察组治疗总有效率与保胎成功率均为92.5%(37/40),明显高于对照组[75.0%(30/40)、72.5%(29/40),均P<0.05];治疗后,观察组腰部酸痛缓解时间、腹痛缓解时间、止血时间均明显短于对照组(P<0.05);治疗后,观察组患者β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-HCG)、孕酮(progesterone,P)、雌二醇(estradiol,E_(2))水平均明显高于对照组(均P<0.05);2组患者妊娠12~14周时胎儿NT、CRL水平及不良反应发生率比较差异无统计学意义(P>0.05)。结论固肾安胎中药汤剂治疗早期先兆流产疗效显著,可有效稳定患者孕激素水平,缓解腹痛腰痛症状,增加保胎效率,且安全可靠。

Objective To explore the effect of self-made Gushen Antai Decoction combined with dydrogesterone in the treatment of early threatened abortion in order to provide a reference for the clinical treatment of early threatened abortion.Methods Eighty cases of early threatened abortion at the Affiliated Hospital of Hangzhou Normal University from January 2017 to December 2019 were selected and randomly divided into observation group and control group(40 cases in each group).The control group was treated with dydrogesterone,whereas the observation group was treated with Gushen Antai Decoction on the basis of the control group.The clinical efficacy,improvement of clinical indicators,progesterone level,nuchal translucency thickness(NT)and crown hip length(CRL)of foetuses,success rate of foetal preservation and incidence of adverse reactions at 12-14 weeks of gestation were compared between the two groups.Results After treatment,the total effective rate and the success rate of foetal preservation in the observation group were 92.5%(37/40),which were significantly higher than those in the control group[75.0%(30/40)and 72.5%(29/40),respectively.P<0.05].After treatment,the relief time of waist pain,abdominal pain and haemostasis in the observation group were significantly shorter than those in the control group(all P<0.05).The levels ofβ-human chorionic gonadotropin,progesterone and estradiol in the observation group were significantly higher than those in the control group(all P<0.05).No significant difference was observed in foetal NT and CRL levels and the incidence of adverse reactions between the two groups of patients at 12-14 weeks of gestation(P>0.05).Conclusion Gushen Antai Decoction has a significant effect on the treatment of early threatened abortion.It can effectively stabilise the patient’s progesterone level,relieve the symptoms of abdominal pain and back pain,increase the efficiency of foetal preservation and is safe and reliable.