自拟补肾健脾汤联合地屈孕酮治疗妊娠早期脾肾两虚型先兆流产的效果  

Self-prepared Bushen Jianpi Decoction Combined with Dydrogesterone Treats Threatened Abortion in Patients with Syndrome of Both Spleen and Kidney Deficiency in Early Pregnancy

作　　者：曲昌华 吕妍 QU Changhua;LV Yan(Department of Obstetrics,Weihai Maternal and Child Health Hospital,Weihai 264200,China)

机构地区：[1]威海市妇幼保健院产二科,山东威海264200

出　　处：《基层中医药》2023年第7期40-45,共6页Basic Traditional Chinese Medicine

摘　　要：目的 探讨妊娠早期脾肾两虚型先兆流产患者在应用地屈孕酮治疗的同时口服补肾健脾汤的临床疗效及对妊娠结局的影响。方法 选择160例在2020年1月—2022年1月于威海市妇幼保健院临床诊断为妊娠早期脾肾两虚型先兆流产的患者展开研究。以随机数字表法分组,每组纳入80例,对照组口服地屈孕酮治疗,研究组口服自拟补肾健脾汤联合地屈孕酮治疗。两组均治疗4周,比较不同用药方案的临床疗效。结果 研究组治疗总有效率(95.00%)高于对照组(83.75%,P <0.05)。治疗后,两组中医证候评分均较治疗前降低(P <0.05),且研究组低于对照组(P <0.01);两组β-HCG、孕酮水平均较治疗前升高(P <0.05),且研究组均高于对照组(P <0.01);研究组足月妊娠率(87.50%)高于对照组(70.00%,P <0.01),早产率(10.00%)低于对照组(25.00%,P <0.05),两组流产率比较,差异无统计学意义(P> 0.05)。两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 妊娠早期脾肾两虚型先兆流产患者采用自拟补肾健脾汤联合地屈孕酮治疗可提高临床疗效,改善孕激素水平及临床症状,获得理想的妊娠结局,同时联合用药有着较好的安全性。Objective To study the clinical efficacy of Bushen Jianpi Decoction combined with dydrogesterone in treating the patients with threatened abortion(syndrome of both spleen and kidney deficiency)in early pregnancy and the effect of this therapy on pregnancy outcomes.Methods A total of 160 patients who were clinically diagnosed as threatened abortion with the syndrome of both spleen and kidney deficiency in early pregnancy in Weihai Maternal and Child Health Hospital from January 2020 to January 2022 were selected for this study.The patients were assigned into a control group(n=80)and an observation group(n=80)by the random number table method.The control group was treated by oral administration of dydrogesterone,and the observation group by oral administration of self-prepared Bushen Jianpi Decoction combined with dydrogesterone.Both groups were treated for 4 weeks,and the clinical efficacy was compared between the two groups.Results The observation group had higher total response rate than the control group(95.00%vs.83.75%,P<0.05).After treatment,the TCM syndrome scores of both groups decreased(P<0.05),and the observation group had lower score than the control group(P<0.01).The levels of beta-human chorionic gonadotropin(β-HCG)and progesterone in both groups elevated after treatment(P<0.05)and were higher in the observation group than in the control group(P<0.01).The observation group had higher full-term pregnancy rate(87.50%vs.70.00%,P<0.01)and lower preterm birth rate(10.00%vs.25.00%,P<0.05)than the control group.There was no statistically significant difference in the abortion rate or the incidence of adverse reactions between the two groups(P>0.05).Conclusion Bushen Jianpi Decoction combined with dydrogesterone can elevate the progesterone levels,alleviate the clinical symptoms,and improve the pregnancy outcomes in treating threatened abortion in the patients with the syndrome of both spleen and kidney deficiency in early pregnancy.Moreover,the combined drug has good clinical safety.

关 键 词：妊娠早期 先兆流产 脾肾两虚 地屈孕酮 补肾健脾汤 

分 类 号：R71[医药卫生—妇产科学]