归芍寿胎方联合黄体酮、低分子肝素治疗复发性流产临床研究

Clinical Study on Guishao Shoutai Prescription Combined with Progesterone and Low Molecular Weight Heparin for Recurrent Spontaneous Abortion

目的:观察归芍寿胎方联合黄体酮、低分子肝素钙注射液治疗复发性流产的临床疗效及对妊娠结局的影响。方法:选取80例复发性流产患者为研究对象,随机分为对照组和试验组各40例。对照组采用黄体酮及低分子肝素钙注射液治疗,试验组在对照组基础上加用归芍寿胎方治疗。观察2组临床疗效,治疗前后中医证候积分、凝血功能[纤维蛋白原(Fib)、D-二聚体(D-D)]、性激素水平[雌二醇(E_(2))、孕酮(P)、人绒毛膜促性腺激素β亚基(β-HCG)]及妊娠结局。结果:试验组总有效率为95.00%,对照组为80.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候主、次症评分及总积分均较治疗前降低(P<0.05),且试验组上述各项评分均低于对照组(P<0.05)。治疗后,2组血浆Fib、D-D水平均较治疗前降低(P<0.05),且试验组Fib、D-D水平均低于对照组(P<0.05)。治疗后,2组血清E_(2)、P、β-HCG水平均较治疗前升高(P<0.05),且试验组E_(2)、P、β-HCG水平均高于对照组(P<0.05)。随访至妊娠结束,试验组足月生产率为82.50%,对照组为50.00%,2组比较,差异有统计学意义(P<0.05)。试验组流产率、早产率分别为5.00%、10.00%,对照组分别为20.00%、30.00%,2组比较,差异均有统计学意义(P<0.05)。结论:归芍寿胎方联合黄体酮、低分子肝素钙注射液治疗复发性流产疗效确切,能有效改善中医证候、凝血功能及性激素水平,且妊娠结局更好。

Objective:To observe the clinical effect of Guishao Shoutai Prescription combined with progesterone and low molecular weight heparin calcium injection for recurrent spontaneous abortion and its effect on pregnancy outcome.Methods:A total of 80 cases of patients with recurrent spontaneous abortion were selected as the study subjects and randomly divided into the control group and the trial group according to the random number table method,with 40 cases in each group.The control group was treated with progesterone and low molecular weight heparin calcium injection,and the trial group was additionally treated with Guishao Shoutai Prescription based on the treatment of the control group.The traditional Chinese medicine(TCM)syndrome scores,coagulation function[fibrinogen(Fib)and D-dimer(D-D)],and sex hormones levels[estrogen(E_(2)),progesterone(P)andβ-human chorionic gonadotropin(β-hCG)]before and after treatment,as well as clinical effects and pregnancy outcome were observed between the two groups.Results:The total effective rate was 95.00%in the trial group and 80.00%in the control group,the difference being significant(P<0.05).After treatment,the scores of main and secondary symptoms and the total scores in TCM syndromes in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the trial group were lower than those in the control group(P<0.05).After treatment,the levels of Fib and D-D in plasma in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of Fib and D-D in the trial group were lower than those in the control group(P<0.05).After treatment,the levels of E2,P andβ-HCG in serum in the two groups were increased when compared with those before treatment(P<0.05),and the levels of E2,P andβ-HCG in the trial group were higher than those in the control group(P<0.05).Following up until the end of pregnancy,the full-term productivity was 82.50%in the trial group,and 50.00%in the control group,the difference being significant(P<0.05).The abortion rate and premature delivery rate were 5.00%and 10.00%respectively in the trial group,and 20.00%and 30.00%respectively in the control group,differences being significant(P<0.05).Conclusion:Guishao Shoutai Prescription combined with progesterone and low molecular weight heparin calcium injection has a definite curative effect in treating recurrent spontaneous abortion,which can effectively improve TCM syndromes,coagulation function and sex hormones levels with better pregnancy outcome.