温阳化浊方对不明原因复发性流产患者妊娠结局的影响  

Effect of Wenyang Huazhuo recipe on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion

作　　者：邱韵桓 马赛花 马甜甜 陈怡然 王宝娟[1] 董融 李晓洲[2] 琚端[2] 夏天[1] Qiu Yunhuan;Ma Saihua;Ma Tiantian;Chen Yiran;Wang Baojuan;Dong Rong;Li Xiaozhou;Ju Duan;Xia Tian(Reproductive Center,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300193,China;Department of Gynaecology and Obstetrics,General Hospital of Tianjin Medial University,Tianjin 300052,China)

机构地区：[1]天津中医药大学第一附属医院生殖中心国家中医针灸临床医学研究中心,天津300193 [2]天津医科大学总医院妇产科,天津300052

出　　处：《中华生殖与避孕杂志》2024年第4期347-352,共6页Chinese Journal of Reproduction and Contraception

基　　金：天津市教委科研计划项目(2022KJ164)。

摘　　要：目的探讨温阳化浊方对不明原因复发性流产(unexplained recurrent spontaneous abortion,URSA)患者妊娠结局的影响。方法采用回顾性队列研究方法,收集2018年11月至2022年3月期间就诊于天津中医药大学第一附属医院生殖中心和天津医科大学总医院妇产科240例再次妊娠的脾肾阳虚证URSA患者的临床资料,按照是否于孕前3个月至孕后8~12周规律口服温阳化浊方治疗,分为中药组(120例)及对照组(120例)。比较两组妊娠结局、围产期结局及产科并发症。多因素logistic回归分析温阳化浊方对妊娠结局的影响。结果中药组活产率[86.67%(104/120)]、持续妊娠率[90.00%(108/120)]均高于对照组[71.67%(86/120),P=0.004;75.00%(90/120),P=0.002],早期流产率[10.08%(12/119)]低于对照组[25.86%(30/116),P=0.002],差异均有统计学意义。两组间围产期结局及产科并发症发病率差异均无统计学意义(均P>0.05)。多因素logistic回归分析显示,应用温阳化浊方能显著改善URSA患者的活产率(OR=8.818,95%CI:3.556~21.871,P<0.001)和持续妊娠率(OR=11.261,95%CI:4.262~29.751,P<0.001)。结论孕前及孕期使用温阳化浊方治疗可显著提高脾肾阳虚证URSA患者的活产率及持续妊娠率,改善URSA患者的妊娠结局。Objective To observe the effect of Wenyang Huazhuo recipe(WYHZ)on pregnancy outcomes in patients with unexplained recurrent spontaneous abortion(URSA).Methods A retrospective cohort study was used and 240 cases of pregnancy URSA patients with spleen kidney yang deficiency syndrome at the Reproductive Center,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Department of Gynaecology and Obstetrics,General Hospital of Tianjin Medial University from November 2018 to March 2022 were recruited.The patients were assigned to WYHZ group(120 cases)and control group(120 cases)based on whether accepting oral WYHZ from 3 months before pregnancy to 8-12 weeks after pregnancy regularly.Pregnancy outcomes,perinatal period outcomes and obstetric complications were compared between the two groups.Multivariate logistic regression were used to analyze the effect of WYHZ on pregnancy outcome.Results The live birth rate and the clinical pregnancy rate in WYHZ group[86.67%(104/120),90.00%(108/120)]were higher than those in control group[71.67%(86/120),P=0.004;75.00%(90/120),P=0.002].The early abortion rate in WYHZ group[10.08%(12/119)]was lower than that in control group[25.86%(30/116),P=0.002],the differences were statistically significant.There were no significant differences in perinatal outcome and incidence rate of obstetric complications between the two groups(all P>0.05).Multivariate logistic regression analysis showed that the application of WYHZ significantly improved the live birth rate(OR=8.818,95%CI:3.556-21.871,P<0.001)and sustained pregnancy rate(OR=11.261,95%CI:4.262-29.751,P<0.001)in URSA patients.Conclusion WYHZ using before and during pregnancy can significantly improve the live birth rate and the clinical pregnancy rate of URSA patients with syndrome of yang deficiency of spleen and kidney,and improve their pregnancy outcomes.

关 键 词：妊娠结局 中医学 温阳化浊方 不明原因复发性流产 活产率 

分 类 号：R271[医药卫生—中医妇科学]