生化散瘕汤联合米非司酮治疗药物流产术后宫腔残留的临床疗效研究

Clinical effect of Shenghua Sanjia decoction combined with mifepristone in treatment of uterine cavity residual after medical abortion

目的研究生化散瘕汤联合米非司酮治疗药物流产术后宫腔残留的临床治疗效果。方法以2021年1月至6月于滕州市中心人民医院收治的行药物流产术后宫腔残留80例患者为研究对象,按照是否采用中西药结合的治疗方法分为两组,各40例。观察组采用米非司酮加用生化散瘕汤治疗[年龄(31.03±6.20)岁],对照组单用米非司酮治疗[年龄(31.95±6.79)岁]。观察两组患者的临床疗效,同时观察药物不良反应。采用t检验、χ^(2)检验或Fisher确切概率法进行比较。结果观察组药物治疗失败行手术治疗者2例,治疗成功者38例(95.0%),对照组治疗失败者8例,治疗成功者32例(80.0%),两组治疗成功率比较,差异有统计学意义(χ^(2)=4.114,P=0.043)。治疗1周后,观察组宫腔残留包块大小[(0.89±0.23)cm比(1.28±0.37)cm,P<0.001]、阴道出血消失时间[(10.16±1.85)d比(12.03±1.91)d,P<0.001]、宫腔残留包块消失时间[(11.00±2.68)d比(12.63±3.09)d,P=0.021]、血HCG降至正常时间[(10.18±1.69)d比(11.19±2.05)d,P=0.028]及月经复潮时间[(31.08±5.48)d比(33.31±3.11)d,P=0.045]均小于对照组。药物不良反应的比较差异无统计学意义(P>0.05)。治疗前,两组血人绒毛膜促性腺激素(HCG)及血管内皮生长因子(VEGF)比较差异均无统计学意义(均P>0.05);治疗后,观察组血HCG[(283.57±253.86)mIU/ml比(428.81±256.15)mIU/ml,P=0.020]及VEGF[(83.17±35.31)mg/L比(101.71±38.55)mg/L,P=0.040]明显低于对照组。结论生化散瘕汤联合米非司酮能够促进药物流产术后宫腔残留吸收,降低血HCG,减少阴道流血,加快月经复潮,中西医治疗临床疗效好。

Objective To investigate the clinical effect of Shenghua Sanjia decoction combined with mifepristone in the treatment of uterine cavity residual after medical abortion.Methods Eighty patients with uterine residue after medical abortion treated in Tengzhou Central People's Hospital from January 2021 to June 2021 were selected as the study objects.According to whether they were treated by Chinese and western medicine,the patients were divided into a control group and an observation group,with 40 cases in each group.The observation group were(31.03±6.20)years old,and were treated with Shenghua Sanjia decoction and mifepristone.The control group were(31.95±6.79)years old,and were treated with mifepristone.The clinical effects and incidences of adverse reactions in both groups were observed.t test,χ^(2) test,and Fisher's test were used for the comparison.Results Two cases failed in the drug treatment and took surgery,and 38 cases(95.0%)succeeded in the observation group;8 failed and 32(80.0%)succeeded in the control group;there was a statistical difference in the succeeded rate between these two groups(χ^(2)=4.114,P=0.043).One week after the treatment,the size of residual intrauterine mass[(0.89±0.23)cm vs.(1.28±0.37)cm,P<0.001],the disappearance time of vaginal bleeding[(10.16±1.85)days vs.(12.03±1.91)days,P<0.001],the disappearance time of residual intrauterine mass[(11.00±2.68)days vs.(12.63±3.09)days,P=0.021],the time for blood human chorionic gonadotropin(HCG)being reduced to normal[(10.18±1.69)days vs.(11.19±2.05)days,P=0.028],and the time for menstrual return[(31.08±5.48)days vs.(33.31±3.11)days,P=0.045]in the observation group were better than those in the control group.There was no difference in the incidence of adverse reactions between these two groups(P>0.05).There were no differences in the levels of blood HCG and vascular endothelial growth factor(VEGF)between the two groups before the treatment(both P>0.05);after the treatment,the levels of HCG and VEGF in the observation group were obviously lower than those in the control group[(283.57±253.86)mIU/ml vs.(428.81±256.15)mIU/ml,P=0.020;(83.17±35.31)mg/L vs.(101.71±38.55)mg/L,P=0.040].Conclusion Shenghua Sanjia decoction combined with mifepristone in the treatment of uterine cavity residual after medical abortion can accelerate the absorption of mass,decrease blood HCG,reduce vaginal bleeding,and recover menstruation,so the combination of Chinese and western medicine has a significant therapeutic effect.