益气化瘀汤联合黄体酮治疗药物流产后阴道出血临床研究

Clinical Study of Yiqi Huayu Decoction Combined with Progesterone in the Treatment of Vaginal Bleeding after Drug Abortion

目的:探讨益气化瘀汤联合黄体酮治疗药物流产后阴道出血的临床疗效及对孕酮(P)、雌二醇(E_(2))的影响。方法:选取2018年3月至2021年1月北京中西医结合医院期间收治的药物流产后阴道出血患者102例作为研究对象,按照随机数字表法分为对照组和观察组,每组51例。对照组给予黄体酮治疗,观察组在此基础上联合益气化瘀汤治疗。比较2组治疗前后激素指标及中医证候积分变化,治疗后出血控制及月经恢复情况;分析其疗效与不良反应。结果:与对照组总有效率(82.35%)比较,观察组(96.08%)更高(P<0.05);观察组治疗后阴道出血持续时间、月经复潮时间短于对照组,阴道出血量与月经复潮量均低于对照组(P<0.05);2组治疗前激素水平、中医证候积分比较差异无统计学意义(P>0.05),治疗后观察组E_(2)水平高于对照组,P、β-人绒毛膜促性腺激素(β-HCG)、中医证候积分均低于对照组(P<0.05);与对照组不良反应发生率(19.61%)比较,观察组(3.92%)更低(P<0.05)。结论:对药物流产后阴道出血患者采取益气化瘀汤联合黄体酮治疗的临床效果较好,可有效改善激素水平和症状,促进子宫恢复,减少不良反应发生,安全有效。

Objective:This paper investigated the clinical efficacy of Yiqi Huayu Decoction combined with progesterone in the treatment of vaginal bleeding after drug abortion and the influence on progesterone and estradiol.Methods:A total of 102 patients with vaginal bleeding after medical abortion who were admitted to Beijing Hospital of Integrated Traditional Chinese and Western Medicine from March 2018 to January 2021 were divided into the control group and observation group according to the random number table method,51 in either group.The control group was treated with progesterone,and the treatment group with Yiqi Huayu Decoctio and progesterone.The changes in hormone indicators and TCM symptom score before and after treatment were compared between the two groups,and bleeding control and menstruation recovery after treatment,the curative effect,and occurrence of adverse reactions were analyzed.Results:The total effective rate of the treatment group was higher than that of the control group(96.08%vs.82.35%)(P<0.05).The duration of vaginal bleeding and the time of menstruation recovery in the treatment group were shorter than those in the control group,and the amount of vaginal bleeding and menstrual blood volume in the treatment group were less than those in the control group(P<0.05).The hormone levels and TCM syndrome scores were insignificantly different between the two groups before treatment(P>0.05).After treatment,the estradiol level in the treatment group was higher,and levels of progesterone and human chorionic gonadotropinβ(β-HCG)and TCM syndrome score were lower in the treatment group than in the control group(P<0.05).The incidence of adverse reactions in the treatment group was lower than that in the control group(3.92%vs.19.61%)(P<0.05).Conclusion:For patients with vaginal bleeding after medical abortion,the clinical effect of Yiqi Huayu Decoction combined with progesterone is better.It can effectively improve hormone levels and symptoms,promote uterine recovery,reduce adverse reactions,which is safe and effective.