益气养胎法治疗胎儿宫内发育迟缓的临床研究

Clinical study of Yiqiyangtai decoction on intrauterine growth retardation

目的 研究益气养胎中药对胎儿生长发育的影响 ,并检测孕妇氧自由基及有关指标。方法 选择胎儿宫内发育迟缓 (IUGR)的初产妇 4 7例 ,随机分为治疗组 2 8例 ,对照组 1 9例 ,另选择正常晚孕初产妇2 0例作为正常组 ,均在我院分娩。治疗组予益气养胎中药 ,每日 1剂 ,水煎服 ,并予复方丹参注射液及能量合剂静脉滴注。对照组予复方氨基酸注射液及能量合剂静脉滴注。 2组均 7日为 1个疗程 ,疗程间隔 3～ 5日 ,一般用 2～ 4个疗程。观测母体宫高、腹围、体重及新生儿出生体重 ;孕妇血清雌三醇 (E3)及胎盘泌乳素(hPL) ;孕妇血氧自由基 (OFR) ;孕妇血血栓素B2 (TXB2 )、6 酮 前列腺素1 α(6 keto PGF1 α)。结果 1 .治疗组临床有效率 85 .7% ,对照组临床有效率 73.7% ,2组比较有显著性差异 (P <0 .0 5 )。 2 .新生儿出生体重治疗组(30 1 8± 35 6 )g ,对照组 (2 86 1± 32 7)g ,2组比较有显著性差异 (P <0 .0 5 ) ;2组与正常组 (32 1 5± 386 )g比较均无显著性差异 (P >0 .0 5 )。 3.治疗组孕妇宫高、腹围、体重的每周平均增长速度高于对照组 (P <0 .0 5 ) ,并较正常组快 (P <0 .0 1 )。 4 .治疗前治疗组和对照组孕妇血清E3、hPL均较正常组低 (P <0 .0 5 ) ,治疗后治疗组虽仍低于正常组 ,但无显著性差异

Objective To study the effect Yiqiyangtai decoction on fetal growth and development and measure indexes of oxygen free radical of pregnant woman. Methods 47 premiparas with intrauterine growth retardation were randomly divided into control group (n=19) and treatment group (n=28). 20 premiparas with late term pregnancy were in normal group. 28 patients in treatment group were treated with combination of Yiqiyangtai decoction, compound injection of Salvia miltiorrhiza and routine western medicine. 19 patients in control group were treated with routine western medicine. A therapeutic course was 7 days in both groups. Measurement of height of the uterus, abdominal circumference and body weight of pregnancy and the neonates were carried on. Serum estriol, placental prolactin, oxygen free radical, TXB 2 and 6-keto-PGF 1α of pregnant were observed to evaluate effect of Yiqiyangtai decoction. Result The clinical effective rate in treatment group (85.7%) was higher than that in control group (73.7%,  P<0.05).  The birth weight of the neonates in treatment group (3 018 g±356) was higher than that in control group (2 861 g±327, P<0.05). E 3 and hPL in treatment group and control group before treatment was lower than those in normal group (P<0.05). E 3 and hPL in control group after treatment was still lower than those in normal group (P<0.05). But E 3 and hPL in treatment group after treatment was not obvious lower than those in normal group (P>0.05). Conclusion Yiqiyangtai decoction and compound injection of Salvia miltiorrhiza could improve activities of SOD?GSH Px of premiparas with intrauterine growth retardation, reduce level of LPO and inhibit synthesis of TXB 2. It could change function of placenta by resisting OFR, expanding blood vessel and inducing flow of blood.