健脾固胎方联合常规疗法治疗胎儿生长受限临床研究  

Clinical Study on Jianpi Gutai Prescription Combined with Conventional Therapy for Fetal Growth Restriction

作　　者：邱二娟 葛玲燕 李苍宁 陈娟[1] QIU Erjuan;GE Lingyan;LI Cangning;CHEN Juan(Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Hangzhou Zhejiang 310007,China)

机构地区：[1]浙江中医药大学附属杭州市中医院,浙江杭州310007

出　　处：《新中医》2024年第10期96-101,共6页New Chinese Medicine

基　　金：2022年度浙江省中医药科技计划项目(2022ZA106)。

摘　　要：目的:观察健脾固胎方联合常规疗法治疗胎儿生长受限(FGR)的疗效。方法:选取产前检查诊断为脾肾不足型FGR的100例孕妇作为研究对象,随机分为治疗组和对照组各50例。2组均予常规疗法治疗,治疗组加予健脾固胎方治疗。治疗2周。统计孕妇的子宫高度增加幅度、腹围增加幅度、脐动脉收缩压与舒张压的比值(S/D)与胎儿的腹围增加幅度、股骨长增加幅度、双顶径增加幅度,评定中医证候评分,检测血管生成素1(Ang-Ⅰ)、血管生成素2(Ang-Ⅱ)、酪氨酸激酶受体2(Tie2)。比较2组的临床疗效。统计2组的妊娠结局,计算发生率。结果:治疗2周后,治疗组总有效率高于对照组(P<0.05)。2组中医证候积分均较治疗前降低(P<0.05),治疗组中医证候积分低于对照组(P<0.05)。治疗组子宫高度增加幅度、腹围增加幅度均大于对照组(P<0.05)。2组脐动脉S/D值低于治疗前(P<0.05);治疗组脐动脉S/D值低于对照组(P<0.05)。治疗组胎儿腹围增加幅度、股骨长增加幅度、双顶径增加幅度均大于对照组(P<0.05)。2组Ang-Ⅰ、Ang-Ⅱ、Tie2水平均较治疗前升高(P<0.05)。治疗组Ang-Ⅰ、Ang-Ⅱ、Tie2水平均高于对照组(P<0.05)。治疗组剖宫产、产后出血、新生儿出生1 min内阿普加(Apgar)评分≤7分的发生率均低于对照组(P<0.05)。结论:在常规疗法基础上加用健脾固胎方治疗脾肾不足型FGR疗效显著,不但能有效缓解孕妇脾肾不足证相关证候,增加胎盘灌注,同时使胎儿的生长速度大幅提升。Objective:To observe the therapeutic effect of the therapy of Jianpi Gutai Prescription combined with conventional therapy on fetal growth restriction(FGR).Methods:A total of 100 pregnant women diagnosed with FGR through prenatal examinations were selected as study objects,and randomly divided into the treatment group and the control group,with 50 cases in each group.The two groups were treated with conventional therapy,and the treatment group was additionally given Jianpi Gutai Prescription.Both groups were treated for 2 weeks.The traditional Chinese medicine(TCM)scores evaluated,uterine height increase,abdominal circumference increase,the ratio of umbilical artery systolic blood pressure to diastolic blood pressure(S/D)and fetal abdominal circumference increase,femur length increase,double parietral diameter increase were statistically analyzed.The levels of Angoietin 1(Ang-Ⅰ),Angoietin 2(Ang-Ⅱ)and tyrosine kinase receptor 2(Tie2)were detected.The clinical effects in the two groups were also compared.The pregnancy outcome and the incidence rates were calculated.Results:After 2 weeks of treatment,the total effective rate in the treatment group was higher than that in the control group(P<0.05).The TCM scores in the two groups were decreased when compared with those before treatment(P<0.05);the TCM scores in the treatment group was lower than that in the control group(P<0.05).The ratio of umbilical artery S/D was lower than that before treatment,differences being significant(P<0.05).The increase of uterine height and abdominal circumference in the treatment group was greater than that in the control group,and the ratio of umbilical artery S/D was lower than that in the control group,differences being significant(P<0.05).The growth rates of fetal abdominal circumference,femur length and double parietal diameter in the two groups were increased when compared with those before treatment,differences being significant(P<0.05);the above indexes in the treatment group were higher than those in the control group,diffe

关 键 词：胎儿生长受限 脾肾不足证 健脾固胎方 血管生成素 酪氨酸激酶受体 阿普加评分 

分 类 号：R714.5[医药卫生—妇产科学]