苏叶黄连汤直肠滴入治疗重症妊娠剧吐32例

Thirty-two cases of severe pregnancy gravidarum treated by rectal drip of Suye Huanglian decoction

目的探讨苏叶黄连汤直肠滴入治疗重症妊娠剧吐的临床疗效。方法纳入2019年3月至2021年4月在南阳市中心医院产科住院治疗确诊为重症妊娠剧吐病人共64例,按随机数字表法分为治疗组和对照组,各32例。对照组按照妊娠剧吐临床处理专家共识给予治疗,治疗组在西医治疗基础上配合苏叶黄连汤直肠滴入,比较两组在改善症状、尿酮体转阴时间、复发率方面的差异。结果治疗后5 d和治疗后10 d,两组恶心呕吐妊娠专用量化表评分(PUQE)均明显降低(P<0.05);治疗组在治疗后5 d和治疗后10 d PUQE评分分别为(11.91±1.51)分、(7.97±1.47)分,均低于对照组(13.05±2.13)分、(11.13±2.20)分(均P<0.05)。治疗组尿酮体转阴时间显著短于对照组[(2.39±0.80)d比(2.81±0.83)d,P<0.05];随访至孕28周观察两组病人的复发情况,两组病人在治疗后复发率方面比较差异无统计学意义(P>0.05)。结论苏叶黄连汤直肠滴入联合西药治疗重症妊娠剧吐疗效显著,能有效改善重症妊娠剧吐病人的症状、缩短尿酮体转阴时间。

Objective To investigate the clinical efficacy of Suye Huanglian decoction on severe hyperemesis gravidarum.Methods A total of 64 patients diagnosed with severe hyperemesis gravidarum who were hospitalized in the obstetrics department of Nanyang Central Hospital from March 2019 to April 2021 were included,and were divided into a treatment group and a control group according to the random number table method,with 32 cases each.The control group was treated according to the expert consensus on the clinical management of severe hyperemesis gravidarum,and the treatment group was given rectal drip of Suye Huanglian decoction based on Western medicine treatment to compare the differences between the two groups in terms of improvement of symptoms,time to turn negative urinary ketone bodies,and recurrence rate.Results The pregnancy-specific quantification scale score(PUQE)for nausea and emesis was significantly lower in both groups at 5 days and 10 days after treatment(P<0.05).The PUQE scores in the treatment group were 11.91±1.51 and 7.97±1.47 at 5 d and 10 d after treatment,respectively,which were lower than those in the control group(13.05±2.13 and 11.13±2.20,respectively)(both P<0.05).The urinary ketone body conversion time was significantly shorter in the treatment group than in the control group[(2.39±0.80)d vs.(2.81±0.83)d,P<0.05].The recurrence of patients in both groups was observed at follow-up until 28 weeks of pregnancy,and there was no statistically significant difference between the two groups in terms of recurrence rate after treatment(P>0.05).Conclusion The combination of rectal drip of Suye Huanglian decoction and Western medicine was effective in treating severe hyperemesis gravidarum,which could effectively improve the symptoms and shorten the time of urinary ketone body conversion.