补肾益气活血方治疗羊水过少临床妊娠结局观察

Clinical observation on pregnancy outcome of oligohydramnios treated with the formula of tonifying the kidney and invigorating the blood

目的观察补肾益气活血方治疗羊水过少的临床疗效。方法选择2020年11月至2022年4月在中国科学技术大学附属第一医院就诊的羊水过少患者40例,根据随机数字表法将其分为研究组和对照组,每组各20例。对照组给予常规补液治疗,研究组在补液治疗的同时给予补肾益气活血方口服,连续治疗14 d,观察比较两组治疗前后临床疗效、羊水指数(amniotic fluid index,AFI)、羊水最大暗区垂直深度(amniotic fluid volume,AFV)、脐动脉收缩期峰值流速/舒张期流速(umbilical artery peak systolic/diastolic velocity,S/D)、血栓弹力图(thromboelastography,TEG)、D-二聚体(D-dimer,D-D)、妊娠结局、出生孕周、分娩方式、新生儿体重、新生儿Apgar评分。结果治疗后,研究组总有效率(85%)高于对照组(50%),差异有统计学意义(P<0.05)。两组AFI、AFV较治疗前升高,且治疗后研究组高于对照组,两组S/D、纤维蛋白原功能Angle、D-D较治疗前降低,且治疗后研究组低于对照组,研究组凝血因子活性R较治疗前增高,且研究组高于对照组(P<0.05),两组纤维蛋白原功能K、血小板功能MA与治疗前比较,差异无统计学意义(P>0.05)。研究组剖宫产率(20%)、早产率(5%)、新生儿低体重发生率(0%)均低于对照组(55%、35%、30%),分娩孕周大于对照组,差异均有统计学意义(P<0.05),两组宫内窘迫、产后出血发生率、新生儿Apgar评分相比,差异无统计学意义(P>0.05)。结论补肾益气活血方治疗羊水过少疗效确切,可有效改善患者羊水指标,增加羊水量,改善患者高凝状态,降低剖宫产率,改善早产、新生儿低体重发生率,改善临床妊娠结局,值得临床应用推广。

Objective To observe the clinical effect of the tonifying the kidney and invigorating the blood recipe on oligohydramnios.Methods A total of 40 patients with oligohydramnios who were treated in the First Afiliated Hospital of USTC from November 2020 to April 2022 were selected.According to the random number table method,the 40 patients with oligohydramnios were randomly divided into a research group of 20 cases and a control group of 20 cases.The control group was given routine rehydration therapy,while the research group was given the tonifying the kidney and invigorating the blood recipe.Continuous treatment for 14 days.The clinical efficacy,amniotic fluid index(AFI),amniotic fluid volume(AFV),umbilical artery peak systolic/diastolic velocity(S/D),thromboelastography(TEG),D-dimer(D-D),pregnancy outcome,week of birth,mode of delivery,neonatal weight,and Apgar score of the newborn were compared between the two groups before and after treatment.Results After treatment,the total effective rate of the study group(85%)was higher than that of the control group(50%).There was a statistically significant difference in clinical efficacy between the two groups(P<0.05).Compared with before treatment,AFI and AFV in the two groups were increased,and the increase in the research group was more significant than that in the control group.The S/D,fibrinogen function Angle and D-dimer of the two groups were decreased compared with those before treatment,and the decrease in the research group was more significant than control group(P<0.05).The coagulation factor activity R in the research group was higher than that before treatment,and the research group is higher than the control group(P<0.05).There was no significant difference in fibrinogen function K and platelet function MA between the two groups before and after treatment(P>0.05).The cesarean section rate(20%),premature delivery rate(5%)and incidence rate of low birth weight(0%)in study group were lower than those in control group(55%、35%、30%),the gestational age of delivery was greater than that of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence rate of intrauterine distress,postpartum hemorrhage and neonatal Apgar score(P>0.05).Conclusion Tonifying the kidney and invigorating the blood recipe is effective in treating oligohydramnios.It can effectively improve amniotic fluid index,increase amniotic fluid volume,improve hypercoagulable state,reduce cesarean section rate,improve the incidence of premature delivery and low birth weight,and improve the clinical pregnancy outcome.It is worthy of being widely popularized in clinical application.