摘要
目的 探讨寿胎丸加味联合黄体酮及低分子肝素治疗复发性流产的临床疗效。方法 选取2020年1月—2021年6月期间河南省中医院、河南中医药大学第一附属医院妇产科收治的100例复发性流产患者,按照随机数字表法分为对照组和观察组,每组各50例。对照组采用黄体酮、低分子肝素治疗,观察组在对照组基础上应用寿胎丸加味治疗。治疗2周后,观察比较两组患者的子宫动脉血流阻力指数、血液流变学指标[全血高切黏度(The Whole Blood High-shear Viscosity, HS)、全血低切黏度(The Whole Blood Low-shear Viscosity, LS)、血浆黏度(Plasma Viscosity, PV)]、凝血功能指标[凝血酶时间(Thrombin Time, TT)、凝血酶原时间(Prothrombin Time, PT)、活化部分凝血活酶时间(Activated Partial Thromboplastin Time, APTT)]、性激素指标[雌二醇(Estradiol, E_(2))、孕酮(Progesterone, P)]、症状评分、保胎成功率、流产率、早产率、心理状态评分、不良反应发生率。结果 治疗后两组患者子宫动脉血流阻力指数、全血高切黏度、全血低切黏度、血浆黏度均较治疗前降低,差异有统计学意义(P<0.05);且观察组子宫动脉血流阻力指数、全血高切黏度、全血低切黏度、血浆黏度均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者凝血功能指标TT、PT、APTT均较治疗前延长,差异有统计学意义(P<0.05);且观察组TT、PT、APTT均长于对照组,差异有统计学意义(P<0.05)。治疗后两组患者性激素指标雌二醇、孕酮均较治疗前升高,差异有统计学意义(P<0.05);且观察组雌二醇、孕酮均高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者腰膝酸软、畏寒肢冷、头晕耳鸣等症状评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组各项症状(腰膝酸软、畏寒肢冷、头晕耳鸣)评分均低于对照组,差异有统计学意义(P<0.05)。治疗后观察组保胎成功率96.00%(48/50)高于对照组82.00%(41/50),观察组流产率4.00%(2/50)、早产率10.00%(5/50)低于对照组流产率18.00%(9/50)、早产率26.00%(13/50),差异有统计学意义(P<0.05)。治疗后两组患者心理状态焦虑评分、抑郁评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组心理状态焦虑评分、抑郁评分均低于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 寿胎丸加味与黄体酮、低分子肝素联合用于复发性流产治疗中,可有效改善子宫血液流变学,调整凝血功能及性激素水平,达到缓解症状、减少流产发生的保胎效果,有利于改善患者心理状态,还不会增加用药后的不良反应,安全性良好。
Objective To explore the clinical efficacy of modified Shoutai Pills combined with progesterone and low-molecular-weight heparin(LMWH)on recurrent abortion.Methods A total of 100 patients with recurrent abortion treated in the Department of Obstetrics and Gynecology of Henan Province Hospital of Traditional Chinese Medicine,The First Affiliated Hospital of Henan University of Chinese Medicine from January 2020 to June 2021 were enrolled and randomly divided into a control group and an observation group with 50 cases in each group according to the random number table method.All patients were treated with progesterone and LMWH,while those in the observation group received additional modified Shoutai Pills.Two weeks after treatment,the uterine artery blood flow resistance index,hemorheological indicators[whole blood high-shear viscosity(HS),whole blood low-shear viscosity(LS),and plasma viscosity(PV)],coagulation function indicators[thrombin time(TT),prothrombin time(PT),and activated partial thromboplastin time(APTT)],sex hormone indicators[estradiol(E_(2))and progesterone(P)],symptom score,the success rate of fetal protection,abortion rate,premature delivery rate,psychological state score,and incidence of adverse reactions of the two groups were compared.Re-sults After treatment,the uterine artery blood flow resistance index,HS,LS,and PV of the two groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the coagulation function indicators TT,PT,and APTT of the two groups were prolonged compared with those before treat-ment(P<0.05),and the observation group was longer than the control group(P<0.05).After treatment,the sex hormone indicators of E_(2) and P in both groups increased compared with those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).After treatment,the scores of symptoms such as soreness in the waist and knees,aversion to cold,cold limbs,dizziness,and tinnitus in both groups decreased compared with those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,the success rate of fe-tal protection in the observation group was 96.00%(48/50),higher than 82.00%(41/50)in the control group(P<0.05).The abortion rate and premature birth rate in the observation group were 4.00%(2/50)and 10.00%(5/50),lower than 18.00%(9/50)and 26.00%(13/50)in the control group(P<0.05).After treatment,the anxiety score and depres-sion score of the two groups decreased compared with those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reac-tions between the two groups(P>0.05).Conclusion Modified Shoutai Pills combined with progesterone and LMWH in the treatment of recurrent abortion can effectively improve uterine hemorheology,adjust blood coagulation function and sex hormone levels to relieve symptoms and reduce abortion,which helps to improve the psychological state of patients without increasing adverse reactions after medication,with good safety.
作者
夏如意
李艳青
宋艳丽
XIA Ru-yi;LI Yan-qing;SONG Yan-li(Henan Province Hospital of Traditional Chinese Medicine,the Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450000;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450000)
出处
《世界中西医结合杂志》
2023年第4期796-800,805,共6页
World Journal of Integrated Traditional and Western Medicine
基金
河南省中医药科学研究专项课题(2019ZY2049)。
关键词
寿胎丸
黄体酮
低分子肝素
复发性流产
Shoutai Pills
Progesterone
Low-molecular-weight Heparin
Recurrent Abortion
