黄体酮联合地屈孕酮治疗黄体功能不足性先兆流产的临床效果
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摘要
目的:探讨黄体酮结合地屈孕酮治疗黄体功能不足性先兆流产的临床价值。方法:选取2016年2月-2018年2月本院收治的黄体功能不足性先兆流产患者94例,以随机数字表法分为对照组和观察组各47例,对照组应用黄体酮治疗,观察组在对照组基础上加用地屈孕酮,观察两组治疗效果、性激素水平变化及不良反应发生情况。结果:观察组治疗总有效率(91.5%)高于对照组(74.5%)(P<0.05);两组治疗前阴道出血量、疼痛程度差异无统计学意义(P>0.05),治疗2周后均有改善,观察组阴道出血量及疼痛视觉模拟法(VAS)评分低于对照组(P<0.05);两组治疗前性激素水平差异无统计学意义(P>0.05),治疗后均有改善,治疗2周后观察组血清雌二醇、人绒毛膜促性腺激素、孕酮水平高于对照组(P<0.05);观察组治疗期间不良反应发生率(14.9%)与对照组(10.6%)比较无差异(P>0.05)。结论:黄体酮与地屈孕酮结合治疗黄体功能不足性先兆流产,可有效改善患者症状,调节性激素水平,疗效确切,安全性较好。
Objective:To investigate the clinical value of progesterone combined with dydrogesterone for treating pregnant women with threatened abortion because of luteal insufficiency.Methods:94pregnant women with threatened abortion because of luteal insufficiency admitted to the second people's hospital of Jiangyou city from February 2016 to February 2018 were selected as subjects,and they were divided into control group and observation group randomly(47cases in each group).The pregnant women in control group were treated by progesterone,and the pregnant women in observation group were treated by progesterone combined with dydrogesterone.The treatment efficacy,the changes of sex hormone levels,visual analogue scale(VAS)score,and the incidence of adverse reaction of pregnant women in the two groups were observed.Results:The total efficacy rate of patients in observation group was 91.5%,which was significant higher than that(74.5%)of patients in control group(P<0.05).There was no significant different in the amount of vaginal bleeding and the degree of pain of pregnant women between the two groups before treatment(P>0.05),but the amount of vaginal bleeding and the degree of pain of all pregnant women had improved after 2weeks treatment.The amount of vaginal bleeding and VAS score of pregnant women in observation group were significant lower than those of pregnant women in control group(P<0.05).There was no significant difference in the sex hormone level of pregnant women between the two groups before treatment(P>0.05),but the sex hormone level of all pregnant women had improved after treatment.The levels of serum estradiol(E2),human chorionic gonadotropin(hCG)and progesterone(P)of pregnant women in observation group were significant higher than those of pregnant women in control group(P<0.05)after 2weeks treatment.There was no significant difference in the incidence of adverse reactions between observation group(14.9%)and control group(10.6%)(P>0.05).Conclusion:Progesterone combined with dydrogesterone for treating pregnant women with threatened abortion because of luteal insufficiency can effectively improve the symptoms of patients,regulate the level of sex hormones,which has better effective and safety,so it is worth clinical application.
Objective:To investigate the clinical value of progesterone combined with dydrogesterone for treating pregnant women with threatened abortion because of luteal insufficiency.Methods:94pregnant women with threatened abortion because of luteal insufficiency admitted to the second people's hospital of Jiangyou city from February 2016 to February 2018 were selected as subjects,and they were divided into control group and observation group randomly(47cases in each group).The pregnant women in control group were treated by progesterone,and the pregnant women in observation group were treated by progesterone combined with dydrogesterone.The treatment efficacy,the changes of sex hormone levels,visual analogue scale(VAS)score,and the incidence of adverse reaction of pregnant women in the two groups were observed.Results:The total efficacy rate of patients in observation group was 91.5%,which was significant higher than that(74.5%)of patients in control group(P<0.05).There was no significant different in the amount of vaginal bleeding and the degree of pain of pregnant women between the two groups before treatment(P>0.05),but the amount of vaginal bleeding and the degree of pain of all pregnant women had improved after 2weeks treatment.The amount of vaginal bleeding and VAS score of pregnant women in observation group were significant lower than those of pregnant women in control group(P<0.05).There was no significant difference in the sex hormone level of pregnant women between the two groups before treatment(P>0.05),but the sex hormone level of all pregnant women had improved after treatment.The levels of serum estradiol(E2),human chorionic gonadotropin(hCG)and progesterone(P)of pregnant women in observation group were significant higher than those of pregnant women in control group(P<0.05)after 2weeks treatment.There was no significant difference in the incidence of adverse reactions between observation group(14.9%)and control group(10.6%)(P>0.05).Conclusion:Progesterone combined with dydrogesterone for treating pregnant women with threatened abortion because of luteal insufficiency can effectively improve the symptoms of patients,regulate the level of sex hormones,which has better effective and safety,so it is worth clinical application.
引文
[1]许瑾平,王慧青,郭春兰等.先兆流产的影响因素分析及妊娠结局评估[J].中国药物与临床,2015,15(9):1317-1320.
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[3]谢幸,苟文丽.妇产科学.第8版[M].北京:人民卫生出版社,2013:89.
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[6]范丽丽,薛秀珍,张镛镛等.地屈孕酮与黄体酮单药或联用治疗黄体功能不全型先兆流产的临床研究[J].药物评价研究,2017,40(3):381-384.
[7]Krachudel J,Bondzio A,Einspanier R,et al.Luteal insufficiency in bitches as a consequence of an autoimmune response against progesterone?[J].Theriogenology,2013,79(9):1278-1283.
[8]Gy9rgy S.Siklasi,Ferenc G.Banhidy,Nandor cs.Fundamental role of folliculo-luteal function in recurrent miscarriage[J].Archives of Gynecology&Obstetrics,2012,286(5):1299-1305.
[9]张扬,俞美娟.地屈孕酮与黄体酮用于治疗先兆流产的临床效果比较[J].生殖医学杂志,2014,23(11):880-883.
[10]张华,张红英,袁宁霞等.探讨黄体酮对孕妇黄体功能不全所致的先兆流产的治疗效果[J].陕西医学杂志,2016,45(4):425-426.
[11]赵一芳,沈涟,王晓临等.地屈孕酮联合黄体酮治疗先兆流产疗效分析[J].河北医药,2013,35(21):3246-3247.
[12]吴金萍.地屈孕酮治疗先兆流产的临床效果[J].中国妇幼保健,2015,30(9):1424-1426.
[13]孙佳,高卫真.地屈孕酮与黄体酮治疗黄体功能不全型先兆流产的临床效果观察[J].中国妇幼保健,2015,30(28):4833-4835.
[14]俞奇,林霞,孙广范等.妊娠早期妇女的性激素水平与先兆流产的相关性分析[J].中国妇幼健康研究,2015,26(3):531-533.
[15]潘园园,张丽丽,郝志龙等.先兆流产与血清性激素水平关系的临床分析[J].世界中西医结合杂志,2016,11(12):1720-1723.
[2]骆小英.地屈孕酮与黄体酮治疗先兆流产的临床疗效分析[J].中国妇幼保健,2013,28(2):343-345.
[3]谢幸,苟文丽.妇产科学.第8版[M].北京:人民卫生出版社,2013:89.
[4]华克勤,丰有吉.实用妇产科学[M].北京:人民卫生出版社,2013:126-127.
[5]李继俊.妇产科内分泌治疗学.第3版[M].北京:人民军医出版社,2014:211.
[6]范丽丽,薛秀珍,张镛镛等.地屈孕酮与黄体酮单药或联用治疗黄体功能不全型先兆流产的临床研究[J].药物评价研究,2017,40(3):381-384.
[7]Krachudel J,Bondzio A,Einspanier R,et al.Luteal insufficiency in bitches as a consequence of an autoimmune response against progesterone?[J].Theriogenology,2013,79(9):1278-1283.
[8]Gy9rgy S.Siklasi,Ferenc G.Banhidy,Nandor cs.Fundamental role of folliculo-luteal function in recurrent miscarriage[J].Archives of Gynecology&Obstetrics,2012,286(5):1299-1305.
[9]张扬,俞美娟.地屈孕酮与黄体酮用于治疗先兆流产的临床效果比较[J].生殖医学杂志,2014,23(11):880-883.
[10]张华,张红英,袁宁霞等.探讨黄体酮对孕妇黄体功能不全所致的先兆流产的治疗效果[J].陕西医学杂志,2016,45(4):425-426.
[11]赵一芳,沈涟,王晓临等.地屈孕酮联合黄体酮治疗先兆流产疗效分析[J].河北医药,2013,35(21):3246-3247.
[12]吴金萍.地屈孕酮治疗先兆流产的临床效果[J].中国妇幼保健,2015,30(9):1424-1426.
[13]孙佳,高卫真.地屈孕酮与黄体酮治疗黄体功能不全型先兆流产的临床效果观察[J].中国妇幼保健,2015,30(28):4833-4835.
[14]俞奇,林霞,孙广范等.妊娠早期妇女的性激素水平与先兆流产的相关性分析[J].中国妇幼健康研究,2015,26(3):531-533.
[15]潘园园,张丽丽,郝志龙等.先兆流产与血清性激素水平关系的临床分析[J].世界中西医结合杂志,2016,11(12):1720-1723.