中医辨识体质干预对胎动不安患者中医证候积分、激素水平及妊娠结局的影响

Effect ofTCM constitution identification intervention on TCM syndrome scores,hormone levels and pregnancy outcomes in patients with excessive fetal movement

目的:探讨中医辨识体质干预对胎动不安患者中医证候积分、激素水平及妊娠结局的影响。方法:将2020年2月~2023年8月期间安徽省六安市中医院妇产科收治的114例“胎动不安”孕妇随机分为对照组、实验组各57例,对照组口服地屈孕酮,实验组地屈孕酮联合中医辨识体质干预治疗,两组均持续治疗三个月。比较两组疗效、中医证候积分、激素水平,随访两组妊娠结局。结果:实验组总有效率明显高于对照组(P<0.05)。治疗后两组阴道出血、小腹坠痛、腰酸胀痛等评分明显降低,且实验组明显低于对照组(P<0.05)。治疗后两组β-人绒毛膜促性腺激素(β-HCG)、孕酮、雌二醇明显增高,实验组高于对照组(P<0.05)。实验组不良妊娠结局占比低于对照组(P<0.05)。结论:地屈孕酮结合中医辨识体质干预方法治疗胎动不安孕妇疗效明显,可有效改善激素水平并调整妇女体质的偏颇,或可作为早期胎动不安的有效预防途径。

Objective To investigate the effect of traditional Chinese medicine(TCM)constitution identification intervention on TCM syndrome scores,hormone levels and pregnancy outcomes in patients with excessive fetal movement.Methods 114pregnant women with excessive fetal movement who were admitted to the Department of of Gynecology and Obstetrics at Traditional Chinese Medicine Hospital of Lu’an in Anhui Province from February 2020to August 2023were randomly divided into control group(n=57)and experimental group(n=57).Pregnant women in the control group orally took dydrogesterone,and those in the experimental group were treated with dydrogesterone combined with TCM constitution identification intervention.Both groups were given 3month of continuous treatment.Therapeutic effects,TCM syndrome scores and hormone levels were compared between the groups.Pregnancy outcomes of the two groups were observed.Results The total effective rate in the experimental group was significantly higher(P<0.05).After treatment,the scores for vaginal bleeding,lower abdominal bearing-down pain,soreness and swelling pain of waist in both groups were significantly reduced,and above scores of the experimental group were significantly lower(P<0.05).After treatment,the levels ofβ-hCG,progesterone and estradiol in both groups were significantly increased,and the levels in the experimental group were significantly higher(P<0.05).The incidence of adverse pregnancy outcomes was significantly lower in the experimental group(P<0.05).Conclusion The combination of dydrogesterone and TCM constitution identification intervention can achieve significant therapeutic effect on pregnant women with excessive fetal movement,which can effectively improve their hormone levels and adjust their constitution.It may be an effective method for preventing excessive fetal movement in early stage.