补肾安胎汤联合穴位贴敷辅助西药治疗脾肾两虚型胎动不安(先兆流产)临床研究

Clinical Study on Bushen Antai Tang Combined with Point Application Assisting Western Medicine for Restless Fetus(Threatened Abortion) of Spleen-Kidney Deficiency Type

目的:观察补肾安胎汤联合穴位贴敷辅助西药治疗脾肾两虚型胎动不安(先兆流产)的临床疗效及对血清血绒毛膜促性腺激素β亚单位(β-HCG)、孕激素(P)、雌二醇(E_(2))的影响。方法:选取97例脾肾两虚型胎动不安患者为研究对象,依据随机数字表法将其分为中西药组49例和西药组48例。西药组给予黄体酮和人绒毛膜促性腺激素(HCG)肌肉注射,中西药组在西药组的基础上用补肾安胎汤联合穴位贴敷治疗。比较2组临床疗效及相关指标变化情况。结果:中西药组总有效率95.92%,高于西药组81.25%(P<0.05)。与同组治疗前比较,治疗后2组各中医证候积分、子宫血流阻力指数(RI)、动脉搏动指数(PI)及血清白细胞介素-2(IL-2)、γ-干扰素(INF-γ)水平均降低(P<0.05),血清E_(2)、P、β-HCG、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)水平均升高(P<0.05);与西药组治疗后比较,中西药组治疗后中医证候积分、子宫RI、PI及血清IL-2、INF-γ水平均较低(P<0.05),血清E_(2)、P、β-HCG、IL-4、IL-10水平均较高(P<0.05)。结论:补肾安胎汤联合穴位贴敷辅助西药治疗可显著改善脾肾两虚型胎动不安(先兆流产)患者各项临床症状及子宫血流动力学指标,有效调节血清性激素水平和炎性细胞因子水平,且临床效果显著,有利于维持妊娠。

Objective:To observe the clinical effect of Bushen Antai tang combined with point application assisting western medicine for restless fetus(threatened abortion)of the spleen-kidney deficiency type and their effects on human chorionic gonadotropinβ(β-HCG),progesterone(P),and estradiol(E_(2))in serum.Methods:A total of 97 cases of patients with restless fetus of the spleen-kidney deficiency type were selected and divided into the Chinese and western medicine group and the western medicine group according to the random number table method,with 49 and 48 cases in each group respectively.The western medicine group was given progesterone and human chorionic gonadotropin(HCG)intramuscularly,and the Chinese and western medicine group was additionally treated with Bushen Antai tang combined with point application based on the treatment of the western medicine group.The clinical effects and changes of related indexes were compared between the two groups.Results:The total effective rate was 95.92%in the Chinese and western medicine group,higher than that of 81.25%in the western medicine group(P<0.05).After treatment,Chinese medicine syndrome scores,uterine blood flow resistance index(RI),arterial pulsatility index(PI)and levels of interleukin-2(IL-2)andγ-Interferon(INF-γ)in serum in the two groups were decreased when compared with those before treatment(P<0.05),and levels of E_(2),P,β-HCG,interleukin-4(IL-4),and interleukin-10(IL-10)in serum were increased(P<0.05).After treatment,Chinese medicine syndrome score,uterus RI,PI and levels of IL-2 and INF-γin serum in the Chinese and western medicine group were lower than those in the western medicine group(P<0.05),and level of E_(2),P,β-HCG,IL-4,and IL-10 in serum were higher(P<0.05).Conclusion:For patients with restless fetus(threatened abortion)of the spleen-kidney deficiency type,Bushen Antai tang combined with point application assisting western medicine can significantly improve their clinical symptoms and uterine hemodynamic indexes,effectively regulate the levels of sex hormones and inflammatory cytokines in serum,and has a significant clinical effect,which is conducive to maintaining pregnancy.