桂枝汤内服联合半夏茯苓汤穴位贴敷治疗太阴证型妊娠恶阻的临床研究  

Clinical Study on Oral Administration of Guizhi Decoction Combined with Acupoint Application of Banxia Fuling Decoction in Treating Hyperemesis Gravidarum of Taiyin Syndrome Type

作　　者：周辉[1,2] 吴凡伟 林子琦 ZHOU Hui;WU Fan-Wei;LIN Zi-Qi(The Seventh Clinical Medical School,Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China;Bao’an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China)

机构地区：[1]广州中医药大学第七临床医学院,广东深圳518000 [2]广州中医药大学附属宝安中医院,广东深圳518000

出　　处：《广州中医药大学学报》2024年第8期2047-2054,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20182129);深圳市科创委资助项目(编号:JCYJ20180302144457509)。

摘　　要：【目的】评价桂枝汤内服联合半夏茯苓汤穴位贴敷治疗太阴证型妊娠恶阻(妊娠期恶心呕吐)的临床疗效。【方法】将60例太阴证型妊娠恶阻患者按1∶1比例随机分为治疗组和对照组,每组各30例。对照组给予半夏茯苓汤穴位贴敷(取穴:中脘、双侧内关、双侧足三里、双侧阴陵泉),治疗组在对照组的基础上加用桂枝汤内服,共治疗2周。观察2组患者治疗前后孕期呕吐和恶心专用量表(PUQE)评分、孕期妊娠恶心呕吐生活质量量表(NVPPQOL)评分和中医证候积分的变化情况,并对2组患者治疗前PUQE评分的影响因素进行多元线性回归分析,同时比较2组患者的愈显率以及妊娠焦虑转阴率、尿酮体转阴率。【结果】(1)疗效方面,治疗2周后,治疗组的愈显率为86.67%(26/30),对照组为56.67%(17/30),组间比较,治疗组的愈显率明显优于对照组(P<0.05)。(2)量表评分方面,治疗后,2组患者的PUQE评分、NVPPQOL评分和中医证候积分均较治疗前明显降低(P<0.05),且治疗组对PUQE评分、NVPPQOL评分和中医证候积分的降低程度均明显优于对照组(P<0.05)。(3)PUQE评分的影响因素方面,Pearson相关性分析结果显示,PUQE评分与患者妊娠年龄呈负相关(P<0.05),与妊娠周数、焦虑评分无相关性(P>0.05)。(4)妊娠焦虑转阴率方面,治疗后,治疗组的妊娠焦虑转阴率为16.67%(5/30),对照组为6.67%(2/30),组间比较,差异无统计学意义(P>0.05)。(5)尿酮体转阴率方面,治疗后,治疗组的尿酮体转阴率为53.33%(16/30),对照组为13.33%(4/30),组间比较,治疗组的尿酮体转阴率明显高于对照组(P<0.01)。(6)安全性方面,治疗过程中,2组患者均无明显不良反应和不良事件发生,患者的血、尿常规和肝肾功能等安全性指标均无异常变化,具有较高的安全性。【结论】桂枝汤内服联合半夏茯苓汤穴位贴敷可有效缓解太阴证型妊娠恶阻患者的恶心、呕吐症状,改善患者生活质�Objective To evaluate the clinical efficacy of oral administration of Guizhi Decoction combined with acupoint application of Banxia Fuling Decoction in the treatment of hyperemesis gravidarum(nausea and vomiting during pregnancy)of taiyin syndrome.Methods Sixty patients with hyperemesis gravidarum of taiyin syndrome were randomly divided into the treatment group and thecontrol group at the ratio of 1∶1,with 30 cases in each group.The control group was given acupoint application of Banxia Fuling Decoction on the acupoints of Zhongwan(CV12),bilateral Neiguan(PC6),bilateral Zusanli(ST36),and bilateral Yinlingquan(SP9).The treatment group was treated with Guizhi Decoction orally on the basis of treatment for the control group.Both groups were treated for 2 weeks.The changes of Pregnancy-Unique Quantification of Emesis(PUQE)score,Nausea and Vomiting of Pregnancy Specific Quality of Life Questionnaire(NVPPQOL)score and traditional Chinese medicine(TCM)syndrome score in the two groups were observed before and after treatment.Multiple linear regression analysis was performed for the exploration of the influencing factors of PUQE score in the two groups before treatment.After treatment,the cured and markedly effective rate,negative conversion rate of pregnancy anxiety and negative conversion rate of urinary ketone bodies were compared between the two groups.Results(1)After 2 weeks of treatment,the cured and markedly effective rate of the treatment group was 86.67%(26/30),and that of the control group was 56.67%(17/30).The intergroup comparison showed that the cured and markedly effective rate of the treatment group was significantly superior to that of the control group(P<0.05).(2)After treatment,the PUQE score,NVPPQOL score and TCM syndrome score of the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease of PUQE score,NVPPQOL score and TCM syndrome score in the treatment group was significantly superior to that in the control group(P<0.05).(3)Pearson correlation analysi

关 键 词：妊娠期恶心呕吐 妊娠恶阻 桂枝汤 半夏茯苓汤 穴位贴敷 临床疗效 生活质量 尿酮体转阴率 

分 类 号：R271.9[医药卫生—中西医结合]