固肾安胎汤联合黄体酮治疗肾虚型胎漏、胎动不安的临床研究
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摘要
目的观察自拟固肾安胎汤联合黄体酮注射液对肾虚型胎漏、胎动不安患者的临床疗效。方法纳入肾虚型胎漏、胎动不安患者74例,随机分为观察组和对照组,每组各37例,对照组予黄体酮注射液治疗(肌肉注射,一日2次,每次20 mg);观察组在对照组基础上,加用固肾安胎汤(口服,一日1剂,分2次服用),5~7 d为一疗程。在我院信息系统妇产科临床数据库中提取入选患者的一般资料(年龄、孕周、疗程、流产次数)、中医症状总积分、实验室指标[血清人绒毛膜促性腺激素(β-HCG)、孕酮(P)水平]及随访结局(顺产、流产及复发情况),分析比较两组治疗前后各指标。结果与治疗前相比,两组治疗后β-HCG及P水平均上升(P<0.05或P<0.01);且与对照组相比,观察组治疗后β-HCG及P水平更高(P<0.05)。与治疗前相比,两组治疗后中医症状总积分均下降,但仅观察组差异有统计学意义(P<0.01);与对照组相比,观察组治疗后中医症状总积分更低(P<0.05)。与对照组相比,观察组因胎漏、胎动不安复发、第二次复发、流产者均较少,顺产者较多(P<0.01)。结论自拟固肾安胎汤联合黄体酮注射液治疗肾虚型胎漏、胎动不安,可提高患者β-HCG及P水平,明显减少复发及流产的发生率,值得临床推广应用。
Objective To observe the clinical effect of the Gushen Antai decoction combined with progesterone injection on the patients with fetal leakage and fetal irritability with kidney deficiency. Methods Seventy-four patients with fetal leakage and fetal irritability with kidney deficiency were randomly divided into observation group and control group as 37 cases in each group. The control group was treated with progesterone injection(intramuscular injection, 20 mg each time, twice a day). On the basis of the control group, the observation group was additionally treated with Gushen Antai decoction(orally, one dose a day, twice a day), as 5~7 days a course. The general data(age, pregnancy week, course of treatment, frequency of abortion), total score of traditional Chinese Medicine(TCM) symptoms, laboratory indexes [serum human chorionic gonadotropin(β-HCG), progesterone level] and follow-up outcome(the condition of eutocia, abortion and recrudescence) before and after treatment were analyzed and compared between two groups. Results Compared with before treatment, the β-HCG and progesterone level after treatment in two groups were increased(P<0.05 or P<0.01). The β-HCG and progesterone level in observation group were higher than those in control group(P<0.05). Compared with before treatment, the total score of TCM symptoms after the treatment in two groups were decreased, but the differencewas statistically significant only in observation group(P<0.01). Compared with the control group, the total score of TCM symptoms of the observation group was lower(P<0.05). The patients with recrudescence, the second recrudescence, and abortion in observation group were less than those in control group, but the patients with eutocia were more(P<0.01). Conclusion Gushen Antai decoction combined with progesterone injection in the treatment of fetal leakage and fetal irritability with kidney deficiency can improve patients' β-HCG and progesterone level, and obviously reduce the recrudescence and abortion.
Objective To observe the clinical effect of the Gushen Antai decoction combined with progesterone injection on the patients with fetal leakage and fetal irritability with kidney deficiency. Methods Seventy-four patients with fetal leakage and fetal irritability with kidney deficiency were randomly divided into observation group and control group as 37 cases in each group. The control group was treated with progesterone injection(intramuscular injection, 20 mg each time, twice a day). On the basis of the control group, the observation group was additionally treated with Gushen Antai decoction(orally, one dose a day, twice a day), as 5~7 days a course. The general data(age, pregnancy week, course of treatment, frequency of abortion), total score of traditional Chinese Medicine(TCM) symptoms, laboratory indexes [serum human chorionic gonadotropin(β-HCG), progesterone level] and follow-up outcome(the condition of eutocia, abortion and recrudescence) before and after treatment were analyzed and compared between two groups. Results Compared with before treatment, the β-HCG and progesterone level after treatment in two groups were increased(P<0.05 or P<0.01). The β-HCG and progesterone level in observation group were higher than those in control group(P<0.05). Compared with before treatment, the total score of TCM symptoms after the treatment in two groups were decreased, but the differencewas statistically significant only in observation group(P<0.01). Compared with the control group, the total score of TCM symptoms of the observation group was lower(P<0.05). The patients with recrudescence, the second recrudescence, and abortion in observation group were less than those in control group, but the patients with eutocia were more(P<0.01). Conclusion Gushen Antai decoction combined with progesterone injection in the treatment of fetal leakage and fetal irritability with kidney deficiency can improve patients' β-HCG and progesterone level, and obviously reduce the recrudescence and abortion.
引文
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[2]邢艺璇.胎漏、胎动不安中医证型与体质的相关性研究[D].湖南中医药大学,2015:5-5.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:253-256.
[4]张玉珍.中医妇科学[M].北京:中国中医药出版社,2002:209-209.
[5]乐杰.妇产科学[M].第7版.北京:人民卫生出版社,2008:58-58.
[6]胡再萍,杨兴良,杨蔚.安胎饮治疗先兆流产63例[J].四川中医,2012,30(8):107-108.
[7]陈士铎.陈士铎医学全书[M].太原:山西科学技术出版社,2012:501-501.
[8]孟昱琼,翟婷婷.用补肾保胎助孕汤治疗肾虚型胎漏和胎动不安的效果观察[J].当代医药论丛,2016,14(9):23-24.
[9]龙菊.补肾安胎方佐以宁心安神中药治疗早期流产40例临床观察[J].湖南中医杂志,2016,32(10):76-77.