桂枝茯苓胶囊联合补中益气丸治疗气虚血瘀型药物流产不全的效果研究

Therapeutic effect of Guizhi Fuling Capsules combined with Buzhong Yiqi Pills in the treatment of Qi deficiency and blood stasis type incomplete abortion

目的分析桂枝茯苓胶囊联合补中益气丸治疗气虚血瘀型药物流产不全的疗效。方法回顾分析2021年2月至2023年2月河北中医学院第二附属医院妇产科就诊的132例气虚血瘀型药流不全患者,根据治疗方法不同将其分为对照组和观察组,各66例,对照组给予米非司酮治疗,观察组在对照组基础上给予桂枝茯苓胶囊联合补中益气丸治疗,比较两组临床疗效、中医证候积分、血清生化指标、子宫复旧指标、清宫手术率、不良反应总发生率。结果观察组临床总有效率(96.97%)高于对照组(84.85%)(P<0.05)。相较于治疗前,治疗后两组恶露不止、小腹坠痛、面色恍白、神疲乏力积分和血清血管内皮生长因子(VEGF)、γ-干扰素(IFN-γ)水平均降低,且观察组低于对照组(P<0.05).血清可溶性FMS样酪氨酸激酶1(sFlt-1)、白细胞介素-2(IL-2)水平升高,且观察组高于对照组(P<0.05)。观察组恶露持续时间、血β-hCG复常时间均短于对照组(P<0.05)。观察组清宫手术率(4.55%)低于对照组(16.67%)(P<0.05)。观察组不良反应总发生率(4.55%)与对照组(7.58%)比较,差异无统计学意义(P>0.05)。结论桂枝茯苓胶囊联合补中益气丸可提高气虚血瘀型药流不全治疗效率,缓解阴道出血等症状,纠正血清VEGF、IFN-γ、sFlt-1、IL-2表达紊乱,降低清宫手术率,且治疗期间未引发严重不良反应,安全有效,值得应用。

Objective To analyze the effects of Guizhi Fuling Capsules combined with Buzhong Yiqi Pills in the treatment of Qi deficiency and blood stasis type incomplete abortion.Methods A retrospective analysis was performed on 132 patients with Qi deficiency and blood stasis type drug insufficiency treated in the Obstetrics and Gynecology Department of the Second Affiliated Hospital of Hebei College of Traditional Chinese Medicine from February 2021 to February 2023.According to different treatment methods,they were divided into control group and observation group,66 cases in each group.The control group was treated with mifepristone,and the observation group was treated with Guizhi Fuling Capsules combined with Buzhong Yiqi Pills on the basis of the control group.The clinical efficacy,Chinese medicine syndrome scores,serum biochemical index,uterine rejuvenation index,clearance operation rate and total incidence of adverse reactions were compared between the two groups.Results The total effective rate of observation group(96.97%)was higher than that of control group(84.85%)(P<0.05).After treatment,lochia continuance,lower abdominal pain,pale complexion,fatigue,the serum levels of vascular endothelial growth factor(VEGF)and gamma-interferon(IFN-γ)decreased in both groups,and the observation group were lower than the control group(P<0.05),the serum levels of soluble FMS-like tyrosine kinase 1(sFlt-1)and interleukin-2(IL-2)increased in both groups,and the observation group were higher than the control group(P<0.05).Lochia duration and bloodβ-hCG normalization time in observation group were shorter than those in control group(P<0.05).The rate of clearance operation in observation group(4.55%)was lower than that in control group(16.67%)(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the observation group(4.55%)and the control group(7.58%)(P>0.05).Conclusion Guizhe Fuling Capsules combined with Buzhong Yiqi Pills can improve the treatment efficiency of Qi deficiency and blood stasis type drug insufficiency,relieve symptoms such as vaginal bleeding,correct the expression disorders of serum VEGF,IFN-γ,sFlt-1 and IL-2,reduce the rate of uterine clearance surgery,and no serious adverse reactions are caused during treatment,so it has a certain safety.