补肾活血法联合地屈孕酮片治疗先兆流产合并宫腔积血

Clinical Observation on Bushen Huoxue Formula Combined with Dydrogesterone Tablet in the Treatment of Threatened Abortion with Intrauterine Hemorrhage

目的:探讨补肾活血法联合地屈孕酮片治疗先兆流产合并宫腔积血的临床疗效。方法:选取2017年9月至2020年3月广州中医药大学第一附属医院收治的先兆流产合并宫腔积血患者60例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组30例。观察组给予补肾活血方+地屈孕酮片口服,对照组给予补肾活血方口服,观察2组治疗前后中医主次证候总积分、胚芽长度、宫腔积血面积、妊娠3项水平变化,并比较2组治疗后的疗效,分析痛经史与治疗结局的相关性。结果:2组治疗后中医主次证候总积分、宫腔积血面积、胚芽长度、孕酮水均较治疗前改善,与治疗前比较,差异均有统计学意义(均P<0.05)。观察组有效率为83.3%,对照组为73.3%,2组比较差异有统计学意义(P<0.05)。结论:单用中药及中西药联合治疗均能改善患者临床症状,缩小宫腔积血面积,提高孕酮水平,促进胚胎生长发育,中西药联合的临床疗效优于单用中药。患者的痛经史与临床疗效具有一定的相关性,无痛经史者临床疗效好。

Objective:To explore the clinical effect of Bushen Huoxue Therapy combined with Dydrogesterone tablets in the treatment of threatened abortion with hematocele.Methods:From September 2017 to March 2020,a total of 60 patients with threatened abortion and hematopoietic uterus who were admitted to the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine were selected as the research objects.According to the random number table method,they were randomly divided into a control group and an observation group,with 30 cases in each group.The observation group was given Oral Bushen Huoxue Decoction+Dydrogesterone tablets,and the control group was given Oral Bushen Huoxue Decoction.The total scores of the primary and secondary syndromes of traditional Chinese medicine before and after treatment,the germ length,the area of uterine hemorrhage,and pregnancy were compared and compared in the 2 groups.The correlation between the history of dysmenorrhea and the outcome of treatment was analyzed.Results:After treatment,the total score of TCM primary and secondary syndrome,uterine hemorrhage,germ length and progesterone level in the 2 groups were improved as compared with those before treatment,and the difference was statistically significant(P<0.05).The effective rates of the observation group and the control group were 83.3% and 73.3% respectively,and the clinical effect of the former was better than that of the latter(P<0.05).Conclusion:The use of singal Chinese medicinal and the combination of traditional Chinese and Western medicine in the treatment of threatened abortion with uterine hemorrhage can improve the clinical symptoms,reduce the area of uterine hemorrhage,increase the level of progesterone and promote the growth of embryo.The clinical effect of combination of traditional Chinese and Western medicine is better than that of traditional Chinese medicine alone.The dysmenorrhea history of patients has certain correlation with clinical efficacy,patients without dysmenorrhea has better clinical efficacy.