健脾益肾养血安胎方联合黄体酮治疗先兆流产脾肾两虚兼血弱证临床观察

Clinical efficacy of Jianpi Yishen Yangxue Antai Formula combined with Western medicine for threatened abortion of spleen-kidney deficiency and blood deficiency

目的观察健脾益肾养血安胎方联合黄体酮治疗先兆流产脾肾两虚兼血弱证的临床疗效。方法将120例先兆流产脾肾两虚兼血弱证患者按照随机数字表法分为2组,对照组60例予黄体酮注射液治疗,治疗组60例在对照组治疗基础上加健脾益肾养血安胎方治疗。2组均7天为1个疗程,治疗2个疗程。比较2组疗效;比较2组治疗前后中医症状评分变化;比较2组治疗前后性激素指标[β-绒毛膜促性腺激素(β-HCG)、孕酮(P)、雌二醇(E_(2))]、子宫动脉血流动力学指标[阻力指数(RI)、搏动指数(PI)、收缩期/舒张末期血流速峰值比(S/D)]变化;比较2组不良反应发生情况。结果治疗组总有效率93.33%(56/60),对照组总有效率73.33%(44/60),治疗组疗效优于对照组(P<0.05)。2组治疗后各项中医症状评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后β-HCG、P、E_(2)水平均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后RI、PI、S/D均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论健脾益肾养血安胎方联合黄体酮治疗先兆流产脾肾两虚兼血弱证临床疗效显著,可有效改善患者临床症状,调节性激素水平,改善子宫动脉血流动力学指标。

Objective To observe the clinical efficacy of Jianpi Yishen Yangxue Antai Formula combined with Western medicine for threatened abortion(TA)of spleen-kidney deficiency and blood deficiency.Methods A total of 120 TA patients(spleen-kidney deficiency and blood deficiency)were randomly assigned into the treatment group(n=60)and the control group(n=60).All patients were managed by progesterone injection,and those in the treatment group were additionally treated with Jianpi Yishen Yangxue Antai Formula.The treatment continued for 2 courses(1 course for 7 days),the aim was to compare traditional Chinese medicine(TCM)symptom score,sex hormone(β-chorionic gonadotropin[β-HCG],progesterone[P],estrogen[E_(2)]),uterine hemodynamic indexes(resistant index[RI],pulsatility index[PI],the ratio of peak systolic blood flow velocity to end-diastolic blood flow velocity[S/D]),adverse reactions.The curative effect was assessed.Results The overall effective rate in the treatment group was better than that in the control group(93.33%[56/60]vs 73.33%[44/60],[P<0.05],respectively).After treatment,TCM symptom scores in groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).β-HCG,P,E_(2)in groups were significantly increased(P<0.05),the increase in the treatment group was more prevalent compared with the control group(P<0.05).RI,PI,S/D in groups were significantly decreased(P<0.05),the decrease in the treatment group was more common than the control group(P<0.05).None of the incidence of adverse reactions differed significantly between groups(P>0.05).Conclusion For TA patients(spleen-kidney deficiency and blood deficiency),Jianpi Yishen Yangxue Antai Formula combined with Western medicine has significant clinical efficacy,which can effectively improve clinical symptoms,regulate sex hormone levels,and improve uterine artery hemodynamic parameters.