自拟清胞饮联合去氧孕烯炔雌醇片治疗流产后气滞血瘀型宫内组织残留的临床研究

Clinical Study on the Self-prescribed Qingbaoyin Combined with Desogestrel and Ethinylestradiol Tablets in the Treatment of Intrauterine Residual Tissue of Qi-stagnation and Blood-stasis Type after Miscarriage

目的:探究自拟清胞饮联合去氧孕烯炔雌醇片治疗流产后气滞血瘀型宫内组织残留的临床疗效。方法:将2021年7月—2023年3月三明市中西结合医院妇科门诊的80例各类流产后宫内组织残留且不愿意清宫患者,根据随机数字表法分为对照组40例与观察组40例。对照组采用去氧孕烯炔雌醇片治疗,观察组则在对照组的基础上加用自拟清胞饮进行治疗。比较两组的治疗效果、阴道出血时间、月经复潮时间、血人绒毛膜促性腺激素(hCG)恢复正常时间、宫内残留组织直径、炎症指标[血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)]及子宫血流指标(螺旋动脉血流参数、子宫底蜕膜血流信号)。结果:观察组的治疗总有效率显著高于对照组,阴道出血时间、月经复潮时间及血hCG恢复正常时间均显著短于对照组(P<0.05)。治疗前,两组的宫内残留组织直径、炎症反应及子宫血流指标比较,差异均无统计学意义(P>0.05);治疗后,观察组的宫内残留组织直径显著小于对照组,炎症反应指标及螺旋动脉峰值舒张期血流速度(PDV)均显著低于对照组,螺旋动脉阻力指数(RI)显著高于对照组,子宫底蜕膜血流信号显著优于对照组(P<0.05)。结论:自拟清胞饮联合去氧孕烯炔雌醇片治疗宫内组织残留临床疗效较好,可显著缩短阴道出血时间及血hCG恢复正常时间,更快促进月经来潮,对于炎症及子宫血流指标也有较好的改善作用。

Objective:To investigate the clinical effect of self-prescribed Qingbaoyin combined with Desogestrel and Ethinylestradiol Tablets in the treatment of intrauterine residual tissue of Qi-stagnation and bloodstasis type after miscarriage.Method:A total of 80 patients with intrauterine residual tissue after miscarriage and unwillingness to undergo curettage in Gynecology Clinic of Sanming Integrated Traditional Chinese and Western Medicine Hospital from July 2021 to March 2023 were divided into control group 40 cases and observation group 40 cases according to the random number table method.The control group was treated with Desogestrel and Ethinylestradiol Tablets,the observation group was treated with self-prescribed Qingbaoyin on the treatment of control group.The treatment effect,vaginal bleeding time,menstrual recovery time,time of blood human choionic gonadotophin(hCG)to return to normal,diameter of residual tissue in the uterus,inflammatory indicators[serum C reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)]and uterine blood flow indexes(spiral artery blood flow parameters and uterine decidua blood flow signals)of the two groups were compared.Result:The total effective rate of observation group was significantly higher than that of control group,the vaginal bleeding time,menstrual recovery time and time of blood hCG to return to normal were significantly shorter than those of control group(P<0.05).Before treatment,diameter of residual tissue in the uterus,inflammatory reaction and uterine blood flow indexes were compared between the two groups,the differences were not statistically significant(P>0.05);after treatment,the diameter of residual tissue in the uterus of observation group was significantly smaller than that of control group,the inflammatory reaction indexes and spiral artery peak diastolic velocity(PDV)were significantly lower than that of control group,the spiral artery resistance index(RI)was significantly higher than that of control group,the uterine decidua blood flow signals were significantly better than those of control group(P<0.05).Conclusion:The clinical effect of self-prescribed Qingbaoyin combined with Desogestrel and Ethinylestradiol Tablets in the treatment of intrauterine residual tissue is better,and it can significantly shorten the time for vaginal bleeding and the time for blood hCG to return to normal and promote menstruation more quickly,its improvement for inflammatory reaction and uterine blood flow indexes is better too.