长内膜方联合屈螺酮炔雌醇片治疗复发性流产术后临床研究  

Clinical Study on Zhangneimo Prescription Combined with Drospirenone Ethinylestra⁃diol Tablets for Recurrent Miscarriage Patients After Surgery

作　　者：全蕊 张红转 姚娅丹 QUAN Rui;ZHANG Hongzhuan;YAO Yadan(Department of Gynecology,Jiashan Hospital of Traditional Chinese Medicine,Jiashan Zhejiang 314100,China;Department of Gynecology,Jiaxing Hospital of Traditional Chinese Medicine,Jiaxing Zhejiang 314000,China)

机构地区：[1]嘉善县中医医院妇科,浙江嘉善314100 [2]嘉兴市中医院妇科,浙江嘉兴314000

出　　处：《新中医》2025年第4期41-45,共5页New Chinese Medicine

摘　　要：目的:观察长内膜方联合屈螺酮炔雌醇片治疗肾虚血瘀型复发性流产术后患者的临床疗效。方法:选择2018年1月—2022年12月在嘉善县中医医院行刮宫术的82例肾虚血瘀型复发性流产患者作为研究对象,依据随机数字表法分为对照组40例和观察组42例。对照组应用屈螺酮炔雌醇片治疗,观察组应用长内膜方联合屈螺酮炔雌醇片治疗。2组均连续治疗3个疗程。观察并记录患者术后月经复潮时间、月经量、经期持续时间。于治疗前和第3个疗程结束,评定中医证候评分,测量子宫内膜厚度,检测子宫内膜血流动力学指标[子宫动脉收缩期血流速度(PSV)与阻力指数(RI)]及性激素指标[血清孕酮(P)、促卵泡生成激素(FSH)和雌二醇(E_(2))]。比较2组的临床疗效与不良反应发生率。结果:治疗后,2组中医证候积分均较治疗前下降,观察组中医证候积分低于对照组,差异均有统计学意义(P<0.05)。观察组术后复潮时间早于对照组,月经量少于对照组,经期短于对照组,差异均有统计学意义(P<0.05)。2组子宫内膜厚度均较治疗前增加,观察组子宫内膜厚度值大于对照组,差异均有统计学意义(P<0.05)。2组PSV、RI值均较治疗前降低,观察组PSV、RI值均低于对照组,差异均有统计学意义(P<0.05)。2组P、FSH、E_(2)水平均较治疗前升高,观察组P、FSH、E_(2)水平均高于对照组,差异均有统计学意义(P<0.05)。观察组总有效率95.24%(40/42)、不良反应发生率4.76%(2/42),对照组总有效率72.50%(29/40)、不良反应发生率22.50%(9/40),2组总有效率、不良反应发生率比较,差异均有统计学意义(P<0.05)。结论:采用长内膜方联合屈螺酮炔雌醇片治疗肾虚血瘀型复发性流产术后患者疗效显著,不仅能缓解临床症状,促进术后月经恢复,还能加快子宫内膜生长,改善子宫供血及调节性激素分泌,且安全性高。Objective:To observe the clinical effect of Zhangneimo Prescription combined with Drospirenone Ethinylestradiol Tablets on patients with recurrent miscarriage of kidney deficiency and blood stasis type after surgery.Methods:A prospective study was conducted on 82 patients with recurrent miscarriage of kidney deficiency and blood stasis type who underwent dilation and curettage(D&C)in Jiashan Hospital of Traditional Chinese Medicine from January 2018 to December 2022.The patients were divided into the control group(40 cases)and the observation group(42 cases)by random number table method.The control group was treated with Drospirenone Ethinylestradiol Tablets,and the observation group was treated with Zhangneimo Prescription and Drospirenone Ethinylestradiol Tablets.After three courses of treatment,the recovery time,volume and duration of menstruation were observed and recorded after D&C.Before treatment and at the end of the third course of treatment,the traditional Chinese medicine(TCM)syndrome scores were assessed;the endometrial thickness was measured;the endometrial hemodynamic indexes[uterine arterial peak systolic velocity(PSV)and resistance index(RI)]and sex hormone indexes[serum progesterone(P),follicle stimulating hormone(FSH)and estradiol(E_(2))]were detected.The clinical effects and incidence of adverse reactions were compared between the two groups.Results:After treatment,the TCM syndrome scores in both groups were decreased when compared with those before treatment,the TCM syndrome score in the observation group was lower than that in the control group,differentces being significant(P<0.05).The observation group had earlier postoperative menstruation recovery time than the control group,less menstrual volume,and shorter menstrual duration than the control group,differences being significant(P<0.05).The endometrial thickness in both groups were respectively increased when compared with those before treatment,and the endometrial thickness in the observation group was thicker than that in the control gr

关 键 词：复发性流产 刮宫术 肾虚血瘀证 长内膜方 屈螺酮炔雌醇片 血流动力学 性激素 

分 类 号：R714.21[医药卫生—妇产科学]