参芪寿胎汤联合地屈孕酮治疗先兆流产合并绒毛膜下出血的临床研究(1)
摘 要：目的 观察运用自拟方参芪寿胎汤联合地屈孕酮治疗先兆流产合并绒毛膜下出血的临床疗效。方法 选择我院收治的脾肾两虚型先兆流产合并绒毛膜下出血患者104例，随机分为治疗组53例和对照组51例，对照组患者口服地屈孕酮治疗，治疗组在此基础上口服参芪寿胎汤治疗，比较两组患者阴道出血时间、停经时间及治疗有效率。结果 治疗组总有效率为76.92%，高于对照组的58.82%，差异有统计学意义(P<0.05);治疗组患者阴道流血天数为(9.11±2.83)d，对照组为(10.55±3.29)d，治疗组患者停经时间为(59.72±17.28)d，对照组为(60.25±17.62)d，组间比较，差异均无统计学意义(P>0.05)。结论 参芪寿胎汤合并地屈孕酮治疗脾肾两虚型先兆流产合并绒毛膜下出血临床效果好，可在一定程度改善患者阴道流血情况。
关键词：先兆流产;绒毛膜下出血;地屈孕酮
中图分类号：R714.21 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.035
, http://www.100md.com
文章编号：1006-1959(2018)24-0123-03
Abstract：Objective To observe the clinical efficacy of self-made Shenqi Shoutai Decoction combined with dydrogesterone in the treatment of threatened abortion with subchondral hemorrhage.Methods A total of 104 patients with spleen and kidney deficiency and threatened abortion and subchondral hemorrhage were enrolled in our hospital. They were randomly divided into treatment group (n=53) and control group (n=51). The control group received oral dydrogesterone treatment. On the treatment of oral Shenqi Shoutai Decoction， the vaginal bleeding time， menopause time and treatment efficiency were compared between the two groups.Results The total effective rate was 76.92% in the treatment group， which was higher than 58.82% in the control group，the difference was statistically significant (P<0.05). The vaginal bleeding days in the treatment group were (9.11±2.83) d， and the control group was (10.55±3.29) d， the menopause time of the treatment group was (59.72±17.28) d， and the control group was (60.25±17.62) d，there was no significant difference between the groups (P>0.05).Conclusion Shenqi Shoutai Decoction combined with dydrogesterone in the treatment of spleen and kidney deficiency type threatened abortion combined with submacular hemorrhage has a good clinical effect， which can improve the vaginal bleeding of patients to some extent.
, 百拇医药
Key words：Threatened abortion;Subchondral hemorrhage;Ddydrogesterone
先兆流產(threatened abortion)患者伴有阴道出血和或腹痛的，超声提示妊娠囊周围可见新月形、不规则形液性暗区，其致病机理尚不明确，李清[1]等在对孕早期绒毛膜下出血和同期先兆流产提示绒毛膜下出血者的妊娠结局荟萃分析中得出结论，绒毛膜下出血可增加自然流产的发生(OR=3.12，95%CI 2.18～4.73)。有研究显示先兆流产合并绒毛膜下出血易导致患者的不良妊娠结局，若暗区长时间存在，不能吸收，甚至扩大，伴有阴道流血时间长，甚至会增加胚停、流产的风险。目前临床上多采用地屈孕酮或黄体酮口服治疗，抑制宫缩，合并感染时，予以抗生素预防感染治疗，因妊娠早中期有妊娠呕吐反应，口服地屈孕酮及或黄体酮治疗，会加重妊娠呕吐反应，且疗程较长，患者症状及绒毛膜下出血改善效果不理想。中药在治疗先兆流产合并阴道出血方面，临床效果较好，保胎成功率高，为验证其效果，本研究选择先兆流产合并绒毛膜下出血辨证为脾肾亏虚的患者104例展开研究，现报道如下。, 百拇医药(樊艺 王亚飞)
关键词：先兆流产;绒毛膜下出血;地屈孕酮
中图分类号：R714.21 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.035
, http://www.100md.com
文章编号：1006-1959(2018)24-0123-03
Abstract：Objective To observe the clinical efficacy of self-made Shenqi Shoutai Decoction combined with dydrogesterone in the treatment of threatened abortion with subchondral hemorrhage.Methods A total of 104 patients with spleen and kidney deficiency and threatened abortion and subchondral hemorrhage were enrolled in our hospital. They were randomly divided into treatment group (n=53) and control group (n=51). The control group received oral dydrogesterone treatment. On the treatment of oral Shenqi Shoutai Decoction， the vaginal bleeding time， menopause time and treatment efficiency were compared between the two groups.Results The total effective rate was 76.92% in the treatment group， which was higher than 58.82% in the control group，the difference was statistically significant (P<0.05). The vaginal bleeding days in the treatment group were (9.11±2.83) d， and the control group was (10.55±3.29) d， the menopause time of the treatment group was (59.72±17.28) d， and the control group was (60.25±17.62) d，there was no significant difference between the groups (P>0.05).Conclusion Shenqi Shoutai Decoction combined with dydrogesterone in the treatment of spleen and kidney deficiency type threatened abortion combined with submacular hemorrhage has a good clinical effect， which can improve the vaginal bleeding of patients to some extent.
, 百拇医药
Key words：Threatened abortion;Subchondral hemorrhage;Ddydrogesterone
先兆流產(threatened abortion)患者伴有阴道出血和或腹痛的，超声提示妊娠囊周围可见新月形、不规则形液性暗区，其致病机理尚不明确，李清[1]等在对孕早期绒毛膜下出血和同期先兆流产提示绒毛膜下出血者的妊娠结局荟萃分析中得出结论，绒毛膜下出血可增加自然流产的发生(OR=3.12，95%CI 2.18～4.73)。有研究显示先兆流产合并绒毛膜下出血易导致患者的不良妊娠结局，若暗区长时间存在，不能吸收，甚至扩大，伴有阴道流血时间长，甚至会增加胚停、流产的风险。目前临床上多采用地屈孕酮或黄体酮口服治疗，抑制宫缩，合并感染时，予以抗生素预防感染治疗，因妊娠早中期有妊娠呕吐反应，口服地屈孕酮及或黄体酮治疗，会加重妊娠呕吐反应，且疗程较长，患者症状及绒毛膜下出血改善效果不理想。中药在治疗先兆流产合并阴道出血方面，临床效果较好，保胎成功率高，为验证其效果，本研究选择先兆流产合并绒毛膜下出血辨证为脾肾亏虚的患者104例展开研究，现报道如下。, 百拇医药(樊艺 王亚飞)