生化汤加味对于米非司酮配伍米索前列醇药物流产患者的应用效果  

Application Effects of Modified Shenghua Decoction on Mifepristone Combined with Misoprostol Medical Abortion Patients

作　　者：马萌 仝腊娟 赵虹 MA Meng;TONG Lajuan;ZHAO Hong(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China)

机构地区：[1]陕西中医药大学第二附属医院妇产科,陕西咸阳712000

出　　处：《中国医药导刊》2023年第6期601-606,共6页Chinese Journal of Medicinal Guide

摘　　要：目的:观察生化汤加味对于米非司酮配伍米索前列醇药物流产患者的应用效果。方法:选择2020年12月至2021年12月于我院进行药物流产的患者200例,按照随机数字表法分为探究组和参照组,每组各100例。探究组患者米非司酮配伍米索前列醇给药后给予生化汤加味治疗,参照组患者仅采用米非司酮配伍米索前列醇给药。药流前、药流后检测两组患者血清孕酮(P)、雌激素(E 2)、卵泡刺激素(FSH)、人绒毛膜促性腺激素(HCG)、血管内皮生长因子(VEGF)、可溶性fms样酪氨酸激酶1(sFlt-1)、Th1细胞因子γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)及Th2细胞因子白细胞介素4(IL-4)水平;记录两组患者孕囊排出时间、阴道出血时间、腹痛时间、月经恢复时间、出血量;治疗3 d后给予患者疼痛数字评分法(NRS)评价;复查时,检测两组患者子宫动脉血流参数[阻力指数(RI)、收缩期峰值流速(PSV)、博动指数(PI)]水平及子宫内膜厚度、左右卵巢体积;记录两组患者完全流产率,比较两组患者临床疗效及不良反应发生率。结果:药流后,探究组患者性激素相关指标P、FSH水平低于参照组(P<0.05),E 2水平高于参照组(P<0.05);血清HCG、VEGF水平低于参照组(P<0.05),sFlt-1水平高于参照组(P<0.05);炎症因子IFN-γ、TNF-α水平低于参照组(P<0.05),IL-4水平高于参照组(P<0.05)。探究组患者孕囊排出、阴道出血、腹痛、月经恢复时间短于参照组(P<0.05),出血量少于参照组(P<0.05)。探究组患者NRS评分低于参照组(P<0.05);药流后PSV水平高于参照组(P<0.05),RI、PI水平低于参照组(P<0.05);子宫内膜厚度、左右卵巢体积大于参照组(P<0.05)。探究组患者治疗总有效率、完全流产率高于参照组(P<0.05),不良反应发生率低于参照组(P<0.05)。结论:对于米非司酮配伍米索前列醇药物流产患者,生化汤加味治疗可调节机体性激素水平,调节HCG、VEGF、sFlt-1水平,抑制机Objective:To observe the application effect of modified shenghua decoction on mifepristone combined with misoprostol medical abortion patients.Methods:A total of 200 patients undergoing medical abortion in our hospital from December 2020 to December 2021 were selected and divided into the research group and the reference group according to random number table method,with 100 cases in each group.Patients in the research group were given modified shenghua decoction after mifepristone combined with misoprostol medical abortion,while patients in the reference group were only given mifepristone combined with misoprostol for abortion.Before and after medical abortion,the serum levels of progesterone(P),estrogen(E 2),follicle stimulating hormone(FSH),human chorionic gonadotropin(HCG),vascular endothelial growth factor(VEGF),soluble fms-like tyrosine kinase 1(sFlt),Th1 cytokineγinterferon(IFN-γ),tumor necrosis factorα(TNF-α)and Th2 cytokine interleukin 4(IL-4)of patients in the two groups were detected.The gestational sac discharge time,vaginal bleeding time,abdominal pain time,menstrual recovery time,and blood loss of the patients were recorded.After 3 days of treatment,pain numerical rating scale(NRS)were evaluated in the patients during re-examination,the uterine artery blood flow parameters[resistance index(RI),peak systolic flow velocity(PSV),and pulsatile index(PI)],endometrial thickness,left and right ovarian volume of the patients were detected.The complete abortion rate of the two groups was recorded,and the clinical efficacy and incidence of adverse reactions of the two groups of patients were compared.Results:After medical abortion,the levels of sex hormone related indexes P and FSH of patients in the research group were lower than those of the reference group(P<0.05),and the level of E 2 was higher than that of the reference group(P<0.05).The serum HCG and VEGF levels of patients in the research group were lower than those of the reference group(P<0.05),and the sFlt-1 level was higher than that of the ref

关 键 词：药物流产 生化汤加味 米非司酮 米索前列醇 子宫流血 完全流产率 

分 类 号：R71[医药卫生—妇产科学]