逍遥散与归芍五子汤联合参芎葡萄糖注射液治疗子宫动脉血流阻力增高型复发性流产的临床效果
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摘要
目的探讨中医治疗子宫动脉血流阻力增高型复发性流产的临床疗效。方法采用随机数字表法将南宁市中医医院2016年1月—2017年6月间收治的80例子宫动脉血流阻力增高型复发性流产患者分为2组,每组40例。孕前对照组给予阿司匹林治疗,观察组给予中药逍遥散加减(月经期)、归芍五子汤加减(非月经期)联合参芎葡萄糖注射液治疗,2组均治疗3个疗程。治疗后,比较中医症候积分、双侧子宫动脉血流阻力指数(RI)与双侧子宫动脉收缩期峰值流速/舒张末期流速(S/D)比值之和,比较妊娠30 d及妊娠56 d血清绒毛膜促性腺激素(β-HCG)与孕酮(P)水平,比较妊娠后保胎成功率。结果治疗后,2组中医症候积分均明显降低(均P<0.05),且观察组显著低于对照组(均P<0.05)。治疗后,2组左侧RI、右侧RI及S/D比值之和水平均明显降低(均P<0.05),且观察组显著低于对照组(均P<0.05)。治疗后,观察组妊娠30 d及妊娠56 d血清β-HCG、P水平显著高于对照组(P<0.05)。治疗后,观察组保胎成功率为86.84%,显著高于对照组的67.56%(P<0.05)。结论逍遥散加减、归芍五子汤加减联合参芎葡萄糖注射液治疗子宫动脉血流阻力增高型复发性流产疗效显著,可明显改善患者临床症状,降低子宫动脉血流阻力,提高患者保胎成功率。
Objective To investigate the clinical effect of Xiaoyao san(menstrual period) and Guishao Wuzi decoction(non-menstrual) combined with Shenqi glucose injection on the treatment of uterine artery resistance increased recurrent abortion. Methods A total of 80 patients with uterine artery resistance increased recurrent abortion from January 2016 to June 2017 in our hospital were divided into two groups according to the random number method, with 40 in each group. Before the pregnancy, the control group was given aspirin, and the observation group was given Xiaoyao san(menstrual period) plus Guishao Wuzi decoction(non-menstrual) combined with Shenqi glucose injection. Two groups were treated for 3 courses. After treatment, the TCM syndrome score, the bilateral uterine artery blood flow resistance index(RI) and the bilateral uterine artery systolic peak flow rate/end diastolic flow rate(S/D) ratio of two groups, as well as serum chorionic gonadotropin(β-HCG) and progesterone(P) at Pregnancy 30 days and 56 days in two groups were compared, and the pregnancy success rate after pregnancy was accounted. Results After treatment, the TCM syndrome scores of the two groups were significantly lower(P<0.05), and the observation group was significantly lower than the control group(P<0.05). After treatment, the sum of the left RI, right RI and S/D ratios was significantly lower(P<0.05), and the observation group was significantly lower than the control group(P<0.05). The β-HCG and P levels of observation group at pregnancy 30 days and 56 days were significantly higher than that of control group(P<0.05). After treatment, the success rate of the fetus in the observation group was 86.84%, which was significantly higher than that of the control group(67.56%), P<0.05. Conclusion Xiaoyao San(menstrual period) plus Guishao Wuzi Decoction(non-menstrual period) combined with Shenqi glucose injection could effectively treat uterine artery resistance increased recurrent abortion, significantly improve the clinical symptoms and reduce uterine artery blood flow resistance, and improve the success rate of patients with abortion.
Objective To investigate the clinical effect of Xiaoyao san(menstrual period) and Guishao Wuzi decoction(non-menstrual) combined with Shenqi glucose injection on the treatment of uterine artery resistance increased recurrent abortion. Methods A total of 80 patients with uterine artery resistance increased recurrent abortion from January 2016 to June 2017 in our hospital were divided into two groups according to the random number method, with 40 in each group. Before the pregnancy, the control group was given aspirin, and the observation group was given Xiaoyao san(menstrual period) plus Guishao Wuzi decoction(non-menstrual) combined with Shenqi glucose injection. Two groups were treated for 3 courses. After treatment, the TCM syndrome score, the bilateral uterine artery blood flow resistance index(RI) and the bilateral uterine artery systolic peak flow rate/end diastolic flow rate(S/D) ratio of two groups, as well as serum chorionic gonadotropin(β-HCG) and progesterone(P) at Pregnancy 30 days and 56 days in two groups were compared, and the pregnancy success rate after pregnancy was accounted. Results After treatment, the TCM syndrome scores of the two groups were significantly lower(P<0.05), and the observation group was significantly lower than the control group(P<0.05). After treatment, the sum of the left RI, right RI and S/D ratios was significantly lower(P<0.05), and the observation group was significantly lower than the control group(P<0.05). The β-HCG and P levels of observation group at pregnancy 30 days and 56 days were significantly higher than that of control group(P<0.05). After treatment, the success rate of the fetus in the observation group was 86.84%, which was significantly higher than that of the control group(67.56%), P<0.05. Conclusion Xiaoyao San(menstrual period) plus Guishao Wuzi Decoction(non-menstrual period) combined with Shenqi glucose injection could effectively treat uterine artery resistance increased recurrent abortion, significantly improve the clinical symptoms and reduce uterine artery blood flow resistance, and improve the success rate of patients with abortion.
引文
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[7] 谢一红,赵美兰.中医综合疗法对子宫动脉血流异常导致的复发性流产临床疗效观察[J].浙江临床医学,2017,19(7):1287-1288.
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[9] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:254-256.
[10] MüLLER A,WAGNER J,HOD,et al.Genetic variation in leptin and leptin receptor genes is a risk factor for idiopathic recurrent spontaneous abortion[J].Croat Med J,2016,57(6):566-571.
[11] 武颖,刘雁峰,何军琴,等.不同证型复发性流产影响因素及血栓前状态的相关性分析[J].标记免疫分析与临床,2016,23(3):237-240.
[12] BLANCO P G,VERCELLINI R,RUBE A,et al.Evaluation of feline uterine and umbilical arteries blood flow in a pharmacologically induced abnormal gestation model[J].Theriogenology,2016,86(9):2323-2327.
[13] 李嘉音,李扬璐,阮祥燕,等.资癸女贞胶囊治疗复发性流产的疗效观察[J].首都医科大学学报,2016,37(5):688-692.
[14] 柴智,杜珊,樊慧杰,等.逍遥散及其加减治疗肝病的临床应用及现代研究进展[J].中华中医药杂志,2017,32(8):3631-3634.
[15] 贾红静.参芎葡萄糖注射液的安全性评价研究[D].长春:吉林大学,2015.
[16] LIU Y,LIU Y,LI X,et al.Predictive value of serum β-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion[J].Int J Gynecol Obstet,2016,135(1):16-21.
[17] 苏辉,左莉莉,孙海茹,等.血清HCG、孕酮水平与复发性流产女性早期妊娠流产的相关性[J].实用医学杂志,2016,32(4):595-597.
[2] 中华医学会妇产科学分会产科学组.复发性流产诊治的专家共识[J].中华妇产科杂志,2016,51(1):3-9.
[3] 李建薇,张倩莹.内科内分泌疾病与复发性流产[J].实用妇产科杂志,2016,32(2):89-92.
[4] MEKA A,REDDY B M.Recurrent spontaneous abortions: An overview of genetic and non-genetic backgrounds[J].Int J Hum Genet,2016,6(2):109-117.
[5] 付雪梅,王丹,郝鹏锴.阿司匹林联合低分子肝素治疗血栓前状态致复发性流产84例临床分析[J].中国妇幼保健,2016,31(8):1681-1683.
[6] XU G L,HU X F,HAN Y M,et al.Clinical efficacy of low molecular heparin on unexplained recurrent spontaneous abortion[J].Clin Lab,2018,64(6):1037-1040.
[7] 谢一红,赵美兰.中医综合疗法对子宫动脉血流异常导致的复发性流产临床疗效观察[J].浙江临床医学,2017,19(7):1287-1288.
[8] 谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:49.
[9] 郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:254-256.
[10] MüLLER A,WAGNER J,HOD,et al.Genetic variation in leptin and leptin receptor genes is a risk factor for idiopathic recurrent spontaneous abortion[J].Croat Med J,2016,57(6):566-571.
[11] 武颖,刘雁峰,何军琴,等.不同证型复发性流产影响因素及血栓前状态的相关性分析[J].标记免疫分析与临床,2016,23(3):237-240.
[12] BLANCO P G,VERCELLINI R,RUBE A,et al.Evaluation of feline uterine and umbilical arteries blood flow in a pharmacologically induced abnormal gestation model[J].Theriogenology,2016,86(9):2323-2327.
[13] 李嘉音,李扬璐,阮祥燕,等.资癸女贞胶囊治疗复发性流产的疗效观察[J].首都医科大学学报,2016,37(5):688-692.
[14] 柴智,杜珊,樊慧杰,等.逍遥散及其加减治疗肝病的临床应用及现代研究进展[J].中华中医药杂志,2017,32(8):3631-3634.
[15] 贾红静.参芎葡萄糖注射液的安全性评价研究[D].长春:吉林大学,2015.
[16] LIU Y,LIU Y,LI X,et al.Predictive value of serum β-hCG for early pregnancy outcomes among women with recurrent spontaneous abortion[J].Int J Gynecol Obstet,2016,135(1):16-21.
[17] 苏辉,左莉莉,孙海茹,等.血清HCG、孕酮水平与复发性流产女性早期妊娠流产的相关性[J].实用医学杂志,2016,32(4):595-597.