葆宫止血颗粒联合甲羟孕酮治疗药物流产后持续阴道出血的疗效观察
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摘要
目的探讨葆宫止血颗粒联合甲羟孕酮治疗药物流产后持续阴道出血的临床疗效。方法选取2017年1月—2018年6月新乡医学院第一附属医院收治的122例药物流产后持续阴道出血患者,随机分为对照组和治疗组,每组各61例。对照组口服醋酸甲羟孕酮片,10 mg/次,1次/d。治疗组在对照组治疗基础上口服葆宫止血颗粒,1袋/次,3次/d。两组均治疗7 d。观察两组的临床疗效,比较两组出血控制、月经恢复、宫腔组织残留情况。比较两组治疗前后子宫内膜厚度、孕酮(P)、人绒毛膜促性腺激素(HCG)的变化情况。结果治疗后,对照组和治疗组的总有效率分别是83.6%、95.1%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组阴道出血持续时间、月经复潮时间均显著短于对照组,且治疗组阴道出血量、月经复潮量均少于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组宫内组织残留率为8.2%显著低于对照组21.3%,两组比较差异具有统计学意义(P<0.05);治疗后,两组子宫内膜厚度均显著增加,血清P、HCG水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组子宫内膜厚度显著高于对照组,治疗组血清P、HCG水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组和治疗组的并发症发生率分别是19.7%、6.6%,两组比较差异具有统计学意义(P<0.05)。结论葆宫止血颗粒联合甲羟孕酮治疗药物流产后持续阴道出血具有较好的临床疗效,能有效控制出血,促进子宫内膜修复及宫内残留组织的排出,减少并发症,促进月经复潮,具有一定的临床推广应用价值。
Objective To investigate the clinical effect of Baogong Zhixue Granules combined with medroxyprogesterone in treatment of persistent vaginal bleeding after drug abortion. Methods 122 Patients with persistent vaginal bleeding after drug abortion in the First Affiliated Hospital of Xinxiang Medical University from January 2017 to June 2018 were randomly divided into control(61 cases) and treatment(61 cases) groups. Patients in the control group were po administered with Medroxyprogesterone Acetate Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Baogong Zhixue Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the situations of bleeding, menstrual recovery, uterine cavity tissue residue in two groups were compared. The changes of endometrial thickness, progesterone(P) and human chorionic gonadotropin(HCG) before and after treatment in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment group were 83.6% and 95.1%, and there were differences between two groups(P < 0.05). After treatment, the duration of vaginal bleeding and menstrual rehydration in the treatment group were significantly shorter than those in the control group, and the amount of vaginal bleeding and menstrual rehydration in the treatment group was less than that in the control group, and there were differences between two groups(P < 0.05). The intrauterine tissue residual rate of the treatment group was 8.2%, which was significantly lower than that of the control group(21.3%), and there were differences between two groups(P < 0.05). After treatment, endometrium thickness in two groups was significantly increased, but P and HCG were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, endometrium thickness in the treatment group was significantly higher than that of the control group, but P and HCG were significantly lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, the complication rate in the control and treatment group was 19.7% and 6.6%, and there were differences between two groups(P < 0.05).Conclusion Baogong Zhixue Granules combined with medroxyprogesterone has significant clinical effect in treatment of persistent vaginal bleeding after drug abortion, and can effectively control bleeding, also can promote endometrial repair and discharge of intrauterine residual tissue, and reduce complications, and promote menstruation, which has a certain clinical application value.
Objective To investigate the clinical effect of Baogong Zhixue Granules combined with medroxyprogesterone in treatment of persistent vaginal bleeding after drug abortion. Methods 122 Patients with persistent vaginal bleeding after drug abortion in the First Affiliated Hospital of Xinxiang Medical University from January 2017 to June 2018 were randomly divided into control(61 cases) and treatment(61 cases) groups. Patients in the control group were po administered with Medroxyprogesterone Acetate Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Baogong Zhixue Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the situations of bleeding, menstrual recovery, uterine cavity tissue residue in two groups were compared. The changes of endometrial thickness, progesterone(P) and human chorionic gonadotropin(HCG) before and after treatment in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment group were 83.6% and 95.1%, and there were differences between two groups(P < 0.05). After treatment, the duration of vaginal bleeding and menstrual rehydration in the treatment group were significantly shorter than those in the control group, and the amount of vaginal bleeding and menstrual rehydration in the treatment group was less than that in the control group, and there were differences between two groups(P < 0.05). The intrauterine tissue residual rate of the treatment group was 8.2%, which was significantly lower than that of the control group(21.3%), and there were differences between two groups(P < 0.05). After treatment, endometrium thickness in two groups was significantly increased, but P and HCG were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, endometrium thickness in the treatment group was significantly higher than that of the control group, but P and HCG were significantly lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, the complication rate in the control and treatment group was 19.7% and 6.6%, and there were differences between two groups(P < 0.05).Conclusion Baogong Zhixue Granules combined with medroxyprogesterone has significant clinical effect in treatment of persistent vaginal bleeding after drug abortion, and can effectively control bleeding, also can promote endometrial repair and discharge of intrauterine residual tissue, and reduce complications, and promote menstruation, which has a certain clinical application value.
引文
[1]卢春琦.药物流产的可接受性及影响因素[J].中外医学研究,2016,14(20):125-126.
[2]李飞.药物流产后阴道流血的治疗现状[J].右江医学,2002,30(4):330-331.
[3]叶思款,季波,吴佩兹,等.醋酸甲羟孕酮的药理作用与临床应用[J].中国药业,2010,19(1):63-64.
[4]国家药典委员会.国家食品药品监督管理局国家药品标准:新药转正标准(第69册)[M].北京:中国医药科技出版社,2008:55-58.
[5]戴慎,薛建国,岳沛平.中医病证诊疗标准与方剂选用[M].北京:人民卫生出版社,2001:425-429.
[6]刘忠艳,刘忠诚.药物流产存在的问题[J].医学信息,2011,24(6):3993-3994.
[7]朱慧玲,程利南.药物流产后阴道出血的原因分析和治疗现状[J].中国计划生育学杂志,2006,14(9):569-571.
[8]郑春霞.醋酸甲羟孕酮的药理作用与临床应用[J].世界最新医学信息文摘,2013,13(32):93.
[9]戴梅.药物流产后恶露不绝的病因病机及治法[J].山西中医学院学报,2006,7(2):27-28.
[10]国家基本药物临床应用指南和处方集编委会.国家基本药物临床应用指南:中成药(2012年版)[M].北京:人民卫生出版社,2013:172.
[11]梁秀秀.葆宫止血颗粒治疗药物流产后子宫出血疗效观察[J].中国中医药信息杂志,2014,21(7):108-109.
[12]张锋英,邵秀兰,王巧岭.E2、P、hCG水平对药流后异常子宫出血的临床意义[J].标记免疫分析与临床,2016,23(12):1424-1426.
[13]方旭霞.药流后异常子宫出血患者β-HCG水平变化及临床意义[J].中国卫生检验杂志,2013,23(4):231-232.
[2]李飞.药物流产后阴道流血的治疗现状[J].右江医学,2002,30(4):330-331.
[3]叶思款,季波,吴佩兹,等.醋酸甲羟孕酮的药理作用与临床应用[J].中国药业,2010,19(1):63-64.
[4]国家药典委员会.国家食品药品监督管理局国家药品标准:新药转正标准(第69册)[M].北京:中国医药科技出版社,2008:55-58.
[5]戴慎,薛建国,岳沛平.中医病证诊疗标准与方剂选用[M].北京:人民卫生出版社,2001:425-429.
[6]刘忠艳,刘忠诚.药物流产存在的问题[J].医学信息,2011,24(6):3993-3994.
[7]朱慧玲,程利南.药物流产后阴道出血的原因分析和治疗现状[J].中国计划生育学杂志,2006,14(9):569-571.
[8]郑春霞.醋酸甲羟孕酮的药理作用与临床应用[J].世界最新医学信息文摘,2013,13(32):93.
[9]戴梅.药物流产后恶露不绝的病因病机及治法[J].山西中医学院学报,2006,7(2):27-28.
[10]国家基本药物临床应用指南和处方集编委会.国家基本药物临床应用指南:中成药(2012年版)[M].北京:人民卫生出版社,2013:172.
[11]梁秀秀.葆宫止血颗粒治疗药物流产后子宫出血疗效观察[J].中国中医药信息杂志,2014,21(7):108-109.
[12]张锋英,邵秀兰,王巧岭.E2、P、hCG水平对药流后异常子宫出血的临床意义[J].标记免疫分析与临床,2016,23(12):1424-1426.
[13]方旭霞.药流后异常子宫出血患者β-HCG水平变化及临床意义[J].中国卫生检验杂志,2013,23(4):231-232.