八珍汤配合静脉营养治疗胎儿宫内生长受限的临床研究
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摘要
研究背景
胎儿宫内生长受限(FGR)其发病的原因较多,是围生期主要并发症之一,我国发病率平均为6.39%,其围生儿病死率为正常儿的4～6倍。FGR不仅近期会影响胎儿宫内的生长发育,而且远期影响儿童和青春期的体能和智能发育,早期诊断及治疗,对减少围产儿死亡,促进优生优育,提高整体人口素质有着积极的意义。
研究目的
本研究通过随机对照临床试验研究方法,在中医理论的指导下,采取不同的干预措施,探讨中西医结合对治疗胎儿生长受限的效果,以及对相关实验室指标的影响,从临床角度出发,为中西医结合治疗胎儿宫内生长受限提供了科学、有效的理论依据。
研究方法
本研究采用随机-对照试验,将符合纳入标准的90例胎儿生长受限孕妇,随机分为中药组(30例)、西药组(30例)、中西医结合组(30例)进行对比。所有治疗组均采取左侧卧位,低流量吸氧30min,bid;高蛋白饮食。中药组采用口服八珍汤,日1剂,bid;西药组采用复方氨基酸250ml,ivdrip,qd;能量合剂500ml,ivdrip,qd;脂肪乳250ml ivdrip,qod;中西医结合组采用上述两组方法。所有治疗5天为一个疗程,中间间隔2天再进行下一疗程治疗,总共4疗程。经治疗后,将3组治疗组相应实验室检查指标及新生儿预后指标进行比较、观察。
研究结果
本研究表明,对于促进胎儿宫内生长发育和改善新生儿预后三组治疗组均产生治疗作用,中药组、西药组、中西医结合组治疗本病的有效率分别为60.7%、64.3%、89.7%;其中,中西医结合组与中药组、西药组疗效相比较差异有统计学意义(p＜0.05)。
总之,中药组和西药组对治疗胎儿宫内生长受限效果明确,若二者结合则作用更加显著。
研究结论
八珍汤具有益气养血育胎之功效,配合西药静脉营养,将其运用于临床上对于治疗气血虚弱型胎儿宫内生长受限有较好的疗效。
Background:There are many reasons lead to Fetal Growth Restriction,which is one of the major complications in Perinatal period.The average incidence rate in our country is 6.39%,which compare to normal infants the perinatal mortality rate is 4～6 times.FGR is not only affects the fetal growth and development recently,and affects the physical and mental development of child and adolescent in long-term.Early diagnosis and treatment can reduce the percents of perinatal deaths,also can advance the promotion of birth,improve the overall quality of the population,which has clinical significance.
Purpose:This research uses a series of clinical treatment,inquiring a related interfere method to the effects of fetal growth restriction and the influence of the lab test index.Set out in the clinical aspect,it provides the scientific and available theories base for the effects of fetal growth restriction after the combination of traditional Chinese Medicine and Western Medicine.
Methods:This research uses the radon and check methods to the experiment.It collect 90 cases who were the fetal growth restriction women,Derived them into 3 group:the Chinese herb medicine group(30 samples),the Western medicine group(30 samples),the combination of traditional Chinese Medicine and Western Medicine group(30 samples).All treatment groups are taken the left decubitus, High-protein diet,Low-flow oxygen,bid;The Chinese herb medicine group drinks the Ba-zhen Decoction,the Western medicine group uses compound amino acids 250ml,ivdrip,qd;energy mixture liquid 500ml,ivdrip,qd;fat milk through intravenous drips,250ml ivdrip,qod.The combination of traditional Chinese Medicine and Western Medicine group uses both of above.Sdays for a course,total of 4 course.After the therapy,compared the laboratory data of treatment groups.
Result:
This reseach express that three treatment groups all can promote the fetal growth and improve the prognosis of neonatal,fetal the efficient is 60.7%,64.3%,89.7%,The effect of The combination of traditional Chinese Medicine and Western Medicine group compared to the Chinese herb medicine group and the Western medicine group,it said that there is significantly different in Effects(p＜0.05).Anyway,the Chinese herb medicine or Western medicine can promote the fetal growth,if both of them combined appropriately,the effect of the treatment would be more Significant.
Conclusion:
Ba-zhen Decoction with parenteral nutrition,can promotethe fetal growth and improve the prognosis of neonatal more better.
胎儿宫内生长受限(FGR)其发病的原因较多,是围生期主要并发症之一,我国发病率平均为6.39%,其围生儿病死率为正常儿的4～6倍。FGR不仅近期会影响胎儿宫内的生长发育,而且远期影响儿童和青春期的体能和智能发育,早期诊断及治疗,对减少围产儿死亡,促进优生优育,提高整体人口素质有着积极的意义。
研究目的
本研究通过随机对照临床试验研究方法,在中医理论的指导下,采取不同的干预措施,探讨中西医结合对治疗胎儿生长受限的效果,以及对相关实验室指标的影响,从临床角度出发,为中西医结合治疗胎儿宫内生长受限提供了科学、有效的理论依据。
研究方法
本研究采用随机-对照试验,将符合纳入标准的90例胎儿生长受限孕妇,随机分为中药组(30例)、西药组(30例)、中西医结合组(30例)进行对比。所有治疗组均采取左侧卧位,低流量吸氧30min,bid;高蛋白饮食。中药组采用口服八珍汤,日1剂,bid;西药组采用复方氨基酸250ml,ivdrip,qd;能量合剂500ml,ivdrip,qd;脂肪乳250ml ivdrip,qod;中西医结合组采用上述两组方法。所有治疗5天为一个疗程,中间间隔2天再进行下一疗程治疗,总共4疗程。经治疗后,将3组治疗组相应实验室检查指标及新生儿预后指标进行比较、观察。
研究结果
本研究表明,对于促进胎儿宫内生长发育和改善新生儿预后三组治疗组均产生治疗作用,中药组、西药组、中西医结合组治疗本病的有效率分别为60.7%、64.3%、89.7%;其中,中西医结合组与中药组、西药组疗效相比较差异有统计学意义(p＜0.05)。
总之,中药组和西药组对治疗胎儿宫内生长受限效果明确,若二者结合则作用更加显著。
研究结论
八珍汤具有益气养血育胎之功效,配合西药静脉营养,将其运用于临床上对于治疗气血虚弱型胎儿宫内生长受限有较好的疗效。
Background:There are many reasons lead to Fetal Growth Restriction,which is one of the major complications in Perinatal period.The average incidence rate in our country is 6.39%,which compare to normal infants the perinatal mortality rate is 4～6 times.FGR is not only affects the fetal growth and development recently,and affects the physical and mental development of child and adolescent in long-term.Early diagnosis and treatment can reduce the percents of perinatal deaths,also can advance the promotion of birth,improve the overall quality of the population,which has clinical significance.
Purpose:This research uses a series of clinical treatment,inquiring a related interfere method to the effects of fetal growth restriction and the influence of the lab test index.Set out in the clinical aspect,it provides the scientific and available theories base for the effects of fetal growth restriction after the combination of traditional Chinese Medicine and Western Medicine.
Methods:This research uses the radon and check methods to the experiment.It collect 90 cases who were the fetal growth restriction women,Derived them into 3 group:the Chinese herb medicine group(30 samples),the Western medicine group(30 samples),the combination of traditional Chinese Medicine and Western Medicine group(30 samples).All treatment groups are taken the left decubitus, High-protein diet,Low-flow oxygen,bid;The Chinese herb medicine group drinks the Ba-zhen Decoction,the Western medicine group uses compound amino acids 250ml,ivdrip,qd;energy mixture liquid 500ml,ivdrip,qd;fat milk through intravenous drips,250ml ivdrip,qod.The combination of traditional Chinese Medicine and Western Medicine group uses both of above.Sdays for a course,total of 4 course.After the therapy,compared the laboratory data of treatment groups.
Result:
This reseach express that three treatment groups all can promote the fetal growth and improve the prognosis of neonatal,fetal the efficient is 60.7%,64.3%,89.7%,The effect of The combination of traditional Chinese Medicine and Western Medicine group compared to the Chinese herb medicine group and the Western medicine group,it said that there is significantly different in Effects(p＜0.05).Anyway,the Chinese herb medicine or Western medicine can promote the fetal growth,if both of them combined appropriately,the effect of the treatment would be more Significant.
Conclusion:
Ba-zhen Decoction with parenteral nutrition,can promotethe fetal growth and improve the prognosis of neonatal more better.
引文
[1]张惜阴主编.实用妇产科学[M].北京:人民卫生出版社,2007;第二版,250-254
[2]黄荷风主编.高危妊娠[M].北京:人民卫生出版社,2003;391-401
[3]乐杰主编.妇产科学[M].北京:人民卫生出版社,2008;第七版,130-132
[4]朱少莲,孙传聪等.脐动脉血流S/D值升高预测胎儿宫内生长受限[J].中国妇幼保健,2007;22:1630-1631
[5]KarowiczBilinska A,Suzin J,Sieroszewski P.Evalu2ation of oxidative stress indices during treatment in pregnant women with intrauterine growth retardation[J].Med SciMonit,2002;8:211-216.
[6]Van Eerden P./Wu X.-X/Chazotte C./Rand J.H.Annexin A5 levels in midtrimester amniotic fluid:Association with intrauterine growth restriction Obstetrics/Gynecology.2002;7:68
[7]门晓亮,刑爱耘.胰岛素样生长因子系统在胎儿生长受限中的作用[J].中华妇幼临床医学杂志,2006;2(4):231-232
[8]李帆,冯玲.血管内皮生长因子与胎儿生长受限的研究进展[J].中国优生与遗传杂志,2007;15(3):118-121
[9]Dablback B,Carlsson M,Svenson PJ,et al.Familiar thromophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein c:prediction of a cofactor to activated protein c[J].Proc Natl Acad Sci USA,2005;90:1004-8.
[10]Baker J,Liu JP,Robertson EJ,et al.Role of insulin-like growth factors in embryonic and postnatal growth.Cell,1993;75(1):73-82
[11]Wijnberger LD,Krediet TG,Egberts J,et al.Nitric oxide production during the early neonatal period in small-forgestational-age infants.Acta Paediatr,2001;90(5):569-572
[12]Masuzaki H,Ogawa Y,Sagawa N,et al.Nonadipose tissue production of leptin:Leptin as a novel placenta-derived hormone in humans.Nat Med,1997,3(9):1029-1033
[13]路妍妍,王自能,等.HGF在胎儿生长受限胎盘中的表达及其意义[J].中国优生与遗传杂志,2006;14(1)期:32-33
[14]国培,主编.中医妇产科学[M].第2版.北京:人民卫生出版社,2002;515-522
[15]王若光,尤昭玲.论胎萎不长与血瘀[J].湖南中医药导报 2002;(8):1
[16]王若光,尤昭玲.论胎萎不长与血瘀[J].湖南中医药导报 2002;(8):1
[17]Shen Y,Mani S,Donovan SL,et al.Growth associatedprotein-43 is required for commissural axon guidance in the developing vertebrate nervous system[J].Neurosc,2002;22(21);239-241.
[18]洪莹,王燕,张元珍,等.川芎嗪对宫内生长受限幼鼠生长发育及脑损伤GAP-43蛋白表达的影响[N].武汉大学学报医学版,2007;28(2):145-147
[19]李兰花,张延丽,等.表皮生长因子及其受体在胎儿生长受限时表达及川芎嗪注射液的作用[J].Chinese journal of interation medicine on cadio,2007;5(1):34-35
[20]雷世慧.云南灯盏花素注射液时效、量效及症效关系临床探讨[J].天津医科大学学报,2008;3:56
[21]李岩,孙晓波.葛根素治疗胎儿宫内生长受限的研究[J].黑龙江医学,2005;29(8):679-620
[22]朱文斯,等编.当归汤加味与能量合剂对照治疗胎儿宫内生长迟缓94例[J].上海中医药杂志,1998;(3):5
[23]胡先平,刘付强.丹参、肝素在治疗胎儿宫内生长受限中的作用[J].中国优生与遗传杂志,2006;14(1):71-72
[24]潘毓宁,潘洪平,石延书.八珍汤的化学成分、药理作用及临床应用研究进展[J].广西医学,1996;18(2):134-137
[25]谭允育,黄守雄,龙猛山,等.八珍汤对照射小鼠免疫功能影响的试验研究[J].中国免疫学杂志,1995;11(11):38-39.
[26]潘洪平.八珍汤的药理研究和临床应用[J].中成药,2003;11(25):2-4
[27]陈玉春,王碧英,高依卿.八珍汤对红细胞生成素影响的动物试验研究[J].中医研究,2000;13(2):22-24
[28]潘毓宁,潘洪平,石延书.八珍汤的化学成分、药理作用及临床应用研究进展[J].广西医学,1996;18(2):134-137
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[43]潘洪平.八珍汤的药理研究和临床应用[J].中成药,2003;11(25):2-4
[44]Shen Y,Mani S,Donovan SL,et al.Growth associatedprotein-43 is required for commissural axon guidance in the developing vertebrate nervous system[J].Neurosc,2002;22(21):239-241
[2]黄荷风主编.高危妊娠[M].北京:人民卫生出版社,2003;391-401
[3]乐杰主编.妇产科学[M].北京:人民卫生出版社,2008;第七版,130-132
[4]朱少莲,孙传聪等.脐动脉血流S/D值升高预测胎儿宫内生长受限[J].中国妇幼保健,2007;22:1630-1631
[5]KarowiczBilinska A,Suzin J,Sieroszewski P.Evalu2ation of oxidative stress indices during treatment in pregnant women with intrauterine growth retardation[J].Med SciMonit,2002;8:211-216.
[6]Van Eerden P./Wu X.-X/Chazotte C./Rand J.H.Annexin A5 levels in midtrimester amniotic fluid:Association with intrauterine growth restriction Obstetrics/Gynecology.2002;7:68
[7]门晓亮,刑爱耘.胰岛素样生长因子系统在胎儿生长受限中的作用[J].中华妇幼临床医学杂志,2006;2(4):231-232
[8]李帆,冯玲.血管内皮生长因子与胎儿生长受限的研究进展[J].中国优生与遗传杂志,2007;15(3):118-121
[9]Dablback B,Carlsson M,Svenson PJ,et al.Familiar thromophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein c:prediction of a cofactor to activated protein c[J].Proc Natl Acad Sci USA,2005;90:1004-8.
[10]Baker J,Liu JP,Robertson EJ,et al.Role of insulin-like growth factors in embryonic and postnatal growth.Cell,1993;75(1):73-82
[11]Wijnberger LD,Krediet TG,Egberts J,et al.Nitric oxide production during the early neonatal period in small-forgestational-age infants.Acta Paediatr,2001;90(5):569-572
[12]Masuzaki H,Ogawa Y,Sagawa N,et al.Nonadipose tissue production of leptin:Leptin as a novel placenta-derived hormone in humans.Nat Med,1997,3(9):1029-1033
[13]路妍妍,王自能,等.HGF在胎儿生长受限胎盘中的表达及其意义[J].中国优生与遗传杂志,2006;14(1)期:32-33
[14]国培,主编.中医妇产科学[M].第2版.北京:人民卫生出版社,2002;515-522
[15]王若光,尤昭玲.论胎萎不长与血瘀[J].湖南中医药导报 2002;(8):1
[16]王若光,尤昭玲.论胎萎不长与血瘀[J].湖南中医药导报 2002;(8):1
[17]Shen Y,Mani S,Donovan SL,et al.Growth associatedprotein-43 is required for commissural axon guidance in the developing vertebrate nervous system[J].Neurosc,2002;22(21);239-241.
[18]洪莹,王燕,张元珍,等.川芎嗪对宫内生长受限幼鼠生长发育及脑损伤GAP-43蛋白表达的影响[N].武汉大学学报医学版,2007;28(2):145-147
[19]李兰花,张延丽,等.表皮生长因子及其受体在胎儿生长受限时表达及川芎嗪注射液的作用[J].Chinese journal of interation medicine on cadio,2007;5(1):34-35
[20]雷世慧.云南灯盏花素注射液时效、量效及症效关系临床探讨[J].天津医科大学学报,2008;3:56
[21]李岩,孙晓波.葛根素治疗胎儿宫内生长受限的研究[J].黑龙江医学,2005;29(8):679-620
[22]朱文斯,等编.当归汤加味与能量合剂对照治疗胎儿宫内生长迟缓94例[J].上海中医药杂志,1998;(3):5
[23]胡先平,刘付强.丹参、肝素在治疗胎儿宫内生长受限中的作用[J].中国优生与遗传杂志,2006;14(1):71-72
[24]潘毓宁,潘洪平,石延书.八珍汤的化学成分、药理作用及临床应用研究进展[J].广西医学,1996;18(2):134-137
[25]谭允育,黄守雄,龙猛山,等.八珍汤对照射小鼠免疫功能影响的试验研究[J].中国免疫学杂志,1995;11(11):38-39.
[26]潘洪平.八珍汤的药理研究和临床应用[J].中成药,2003;11(25):2-4
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