中西医结合防治脾虚血瘀型子痫前期复发的临床疗效观察
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摘要
目的探讨加减补中益气汤联合低分子肝素钠防治脾虚血瘀型子痫前期复发的临床疗效。方法选择既往患子痫前期病史的孕妇245例,随机分为A组67例,予中药加减补中益气汤加味治疗,B组67例予中药+低分子肝素钠治疗,C组66例予低分子肝素钠治疗,D组45例空白组,不用中药+低分子肝素钠治疗。比较各组孕妇子痫复发率、发病孕周、早产平均孕周、早产儿平均体重;检测各组治疗前后胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)。结果子痫前期复发率:D组>A组和C组>B组,比较有显著性差异(P<0.05),A组和C组比较无差异。早产儿体重比较:B组>A组和C组>D组,比较有显著性差异,A组和C组比较无差异(P>0.05)。早产平均孕周B组比A组、C组、D组明显延长。TC、Tg,LDL治疗期升高值:D组>A组和C组>B组,比较有显著性差异(P<0.05),A组和C组比较无差异(P>0.05);HDL治疗期升高值:B组>A组和C组>D组,比较有显著性差异(P<0.05),A组和C组比较无差异(P>0.05)。结论防治子痫前期患者复发,加减补中益气汤加低分子肝素钠临床效果最佳。
Objective: To study the clinical effect of modified Buzhong Yiqi Decoction combined with low molecular weight heparin on prevention and treatment of pre-eclampsia recurrence patients with spleen asthenia and blood stasis syndrome. Methods: 245 pregnant women with a history of pre-eclampsia were randomly divided into group A( 67 cases),treated with traditional Chinese medicine plus Buzhong Yiqi Decoction,group B( 67 cases),treated with traditional Chinese medicine plus low molecular weight heparin,group C( 66cases),treated with low molecular weight heparin,and group D( 45 cases),treated only with low molecular weight heparin. The epilepsy recurrence rate,the incidence of gestational weeks,the average gestational age of premature birth and the average weight of premature children of each group were compared and their TC,TG,HDL and HDL were detected. Results: The pre-eclampsia recurrence rate: group D > group A and group C > group B. The comparison showed significant difference( P < 0. 05). There was no difference between Group A and group C. The body weight of premature infants: group B > group A and group C > group D. The comparison was significant difference. There was no significant difference between group A and group C( P > 0. 05). The average gestational age in preterm labor group B was significantly longer than that in group A,C and D. The levels of TC,TG and LDL in the treatment group were significantly higher than those in group A and C( P < 0. 05),but there was no significant difference between group A and group C( P > 0. 05). Conclusion: Modified Buzhong Yiqi Decoction plus low molecular weight heparin sodium has the best clinical effect on the prevention and treatment of pre-eclampsia recurrence patients.
Objective: To study the clinical effect of modified Buzhong Yiqi Decoction combined with low molecular weight heparin on prevention and treatment of pre-eclampsia recurrence patients with spleen asthenia and blood stasis syndrome. Methods: 245 pregnant women with a history of pre-eclampsia were randomly divided into group A( 67 cases),treated with traditional Chinese medicine plus Buzhong Yiqi Decoction,group B( 67 cases),treated with traditional Chinese medicine plus low molecular weight heparin,group C( 66cases),treated with low molecular weight heparin,and group D( 45 cases),treated only with low molecular weight heparin. The epilepsy recurrence rate,the incidence of gestational weeks,the average gestational age of premature birth and the average weight of premature children of each group were compared and their TC,TG,HDL and HDL were detected. Results: The pre-eclampsia recurrence rate: group D > group A and group C > group B. The comparison showed significant difference( P < 0. 05). There was no difference between Group A and group C. The body weight of premature infants: group B > group A and group C > group D. The comparison was significant difference. There was no significant difference between group A and group C( P > 0. 05). The average gestational age in preterm labor group B was significantly longer than that in group A,C and D. The levels of TC,TG and LDL in the treatment group were significantly higher than those in group A and C( P < 0. 05),but there was no significant difference between group A and group C( P > 0. 05). Conclusion: Modified Buzhong Yiqi Decoction plus low molecular weight heparin sodium has the best clinical effect on the prevention and treatment of pre-eclampsia recurrence patients.
引文
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[11]江燕.黄芪药理作用及在方剂配伍方面的应用.中国实用医药,2015,10(1):226-226.
[12]陈国英.黄芪的药理作用研究进展.北方药学,2013,10(10):53-54.
[13]张荣华.丹参注射液联合低分子量肝素治疗48例早发型子痫前期的疗效评价.2013,22(14):15-16.
[14]裴艳霞.川芎的药理作用及临床应用.中医中药.2011,9(34):197-199.
[15]施卿卿.黄春林教授妙用中药治疗蛋白尿血尿经验摭拾.中医药学刊,2002,20(2):157-159.
[16]黄兆胜.中药学[M].北京:人民卫生出版社,2010:414,239,451.
[2]Rosser ML,Katz NT.Preeclampsia:an obstetrician’s persp[J].Adv Chronic Kidney Dis,2013,20(3):287-296.
[3]乐杰.妇产科学[M].8版.北京:人民卫生出版社,2013:64-71.
[4]罗颂平.中医妇科学[M].第1版.上海:上海科学技术出版社,2007:161-166.
[5]张如星.妊娠期脂代谢与妊娠结局相关性探讨[J].现代中西医结合杂志.2015,24(35):3920-3922.
[6]熊薇,周容.子痫前期抗凝治疗安全性和有效性的循证评价.实用妇产科杂志,2010,26(9):662-664.
[7]李智芬,王芝敏.加味五等散治疗妊娠高血压综合征例209例[J].陕西中医,1993,12(2):534-534.
[8]王淑雯,姚天一,胡云霞.祖国医学对妊娠中毒症病因病机的探讨[M].天津医药,1986,14(3):168-169.
[9]张雅洁,潘明.活血化瘀为主治疗妊娠高血压综合征初步探讨[J].中医杂志,1984,25(5):38-39.
[10]刘宁,商辉,蔡志疆,等.硫酸镁和黄芪注射液预防妊娠晚期体重异常增加发生子痛前期的MP监测.新疆中医药,2007,25(4):29-31.
[11]江燕.黄芪药理作用及在方剂配伍方面的应用.中国实用医药,2015,10(1):226-226.
[12]陈国英.黄芪的药理作用研究进展.北方药学,2013,10(10):53-54.
[13]张荣华.丹参注射液联合低分子量肝素治疗48例早发型子痫前期的疗效评价.2013,22(14):15-16.
[14]裴艳霞.川芎的药理作用及临床应用.中医中药.2011,9(34):197-199.
[15]施卿卿.黄春林教授妙用中药治疗蛋白尿血尿经验摭拾.中医药学刊,2002,20(2):157-159.
[16]黄兆胜.中药学[M].北京:人民卫生出版社,2010:414,239,451.