养血固冲汤联合地屈孕酮治疗妊娠早期先兆流产临床研究

Clinical Study on Yangxue Guchong Tang Combined with Dydrogesterone for Early Threatened Abortion

目的:观察养血固冲汤治疗妊娠早期先兆流产的临床疗效及其对母婴结局的影响。方法:将146例肾虚型妊娠早期先兆流产患者随机均分为2组各73例。2组均予维生素E及叶酸治疗,对照组予地屈孕酮治疗,观察组予地屈孕酮联合养血固冲汤治疗。比较2组临床疗效,测定并比较2组治疗前后中医证候积分及血清激素[人绒毛膜促性腺激素(β-HCG)、孕酮(P)、雌二醇(E2)]含量,观察并随访2组妊娠情况(妊娠结局、并发症发生率)及新生儿不良结局(窒息、畸形)发生率。结果:治疗后,2组临床疗效比较,差异有统计学意义(P<0.05);临床疗效总有效率观察组94.52%,对照组79.45%,2组临床疗效总有效率比较,差异有统计学意义(P<0.05)。2组E2、P、β-HCG含量均较治疗前明显提高,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组中医证候积分均较治疗前明显降低,且观察组低于对照组(P<0.05)。观察组患者保胎成功率明显高于对照组,差异有统计学意义(P<0.05)。2组妊娠并发症包括妊娠期高血压、产后出血、前置胎盘、胎膜早破的发生率比较,差异均无统计学意义(P>0.05)。2组新生儿不良结局发生率比较,差异无统计学意义(P>0.05)。结论:养血固冲汤联合地屈孕酮治疗妊娠早期先兆流产的效果优于单纯西药治疗,有助于成功保胎,且不增加患者相关并发症及新生儿不良结局发生风险。

Objective:To observe the clinical effect of Yangxue Guchong tang for early threatened abortion and its effect on maternal-infant outcomes.Methods:A total of 146 cases of patients with early threatened abortion of kidney deficiency type were randomly divided into two groups,73 cases in each group.Both groups were treated with vitamin E and folic acid;the control group was additionally treated with dydrogesterone;the observation group was additionally treated with dydrogesterone combined with Yangxue Guchong tang.The clinical effect in the two groups was compared;the Chinese medicine syndrome scores and the contents of serum hormone including human chorionic gonadotropin(β-HCG),progesterone(P)and estradiol(E2)before and after treatment in the two groups were detected and compared;the pregnancy conditions including pregnancy outcomes and the incidence of complications as well as the incidence of adverse neonatal outcomes like asphyxia and deformity in the two groups were observed and followed up.Results:After treatment,there was significant difference being found in the comparison of the clinical effect between the two groups(P<0.05);the total effective rate of clinical effect was 94.52% in the observation group and 79.45% in the control group,the difference being significant(P<0.05).The contents of E2,P and β-HCG in the two groups were significantly increased when compared with those before treatment,and the contents in the observation group were higher than those in the control group,differences being significant(P<0.05).Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment,and the score in the observation group was lower than that in the control group(P<0.05).The success rate of fetal protection in the observation group was significantly higher than that in the control group,the difference being significant(P<0.05).There was no significant difference being found in the comparison of the incidence of pregnancy complications such as hypertension during pregnancy,postpartum hemorrhage,placenta previa and premature rupture of membranes between the two groups(P>0.05).There was no significant difference being found in the comparison of the incidence of adverse neonatal outcomes between the two groups(P>0.05).Conclusion:The therapy of Yangxue Guchong tang combined with dydrogesterone for early threatened abortion has better effect than that of simple western medicine,which is helpful to successfully protect the fetus,without increasing the occurrence risk of related complications and adverse neonatal outcomes.