自拟清肝退黄汤预防母婴血型不合的疗效的临床研究  

Clinical Study on the Effect of Qinggan Tuihuang Decoction on Preventing Maternal-Fetal Blood Type Incompatibility

作　　者：冯玉 鞠婷婷 

机构地区：[1]义乌市妇幼保健院,浙江 义乌

出　　处：《中医学》2022年第5期993-999,共7页Traditional Chinese Medicine

摘　　要：目的:探究自拟清肝退黄汤预防母婴血型不合的疗效。方法:选择100例血型为O型Rh(D)阳性,丈夫为非O型Rh(D)阳性的孕妇,随机分为对照组和研究组,对照组采用维生素C + 维生素E治疗,研究组采用自拟清肝退黄汤治疗,直至分娩,观察患者的抗体效价、中医症候在治疗前后的变化及妊娠合并症、新生儿病理性黄疸的发生率等情况。结果:1) 对照组患者治愈5例,有效24例,无效21例,总有效率58%;研究组患者治愈8例,有效36例,无效6例,总有效率88%,明显高于对照组,有统计学差异(P < 0.05)。2) 治疗后研究组患者中医症候积分明显低于对照组,有统计学差异(P < 0.05)。3) 治疗后研究组患者抗体效价明显低于对照组,有统计学差异(P < 0.05)。4) 对照组5名患者发生妊娠时限异常,3名患者出现胎儿宫内发育迟缓,2名患者出现胎儿宫内窘迫,妊娠合并症总发生率20%;研究组1名患者发生妊娠时限异常,无胎儿宫内发育迟缓或宫内窘迫,妊娠合并症总发生率2%,显著低于对照组,有统计学差异(P < 0.05)。5) 治疗结束,对照组最终48名新生儿出生,其中病理性黄疸有15例,占31.25%;研究组最终49名新生儿出生,其中病理性黄疸有4例,占8.16%,显著低于对照组,有统计学差异(P < 0.05)。结论:自拟清肝退黄汤可有效改善母婴血型不合孕妇的中医症候,降低抗体效价,预防妊娠合并症,明显降低了新生儿病理性黄疸的发生率,其疗效明显优于西药组。Objective: To explore the effect of Qinggan Tuihuang decoction on preventing maternal-fetal blood type incompatibility. Methods: A total of 100 pregnant women with positive blood type O Rh(D) and their husbands non-O Rh(D) positive were randomly divided into control group and study group. The control group was treated with vitamin C + vitamin E, while the study group was treated with self-designed Qinggan Tuihuang decoction until delivery. The changes of antibody titer and TCM symptoms were observed before and after treatment, and the incidence of pregnancy complications with neonatal pathological jaundice were counted after treatment. Results: 1) In the control group, 5 cases were cured, 24 cases were effective, 21 cases were ineffective, and the total effective rate was 58%;In the study group, 8 cases were cured, 36 cases were effective, and 6 cases were ineffective, with a total effective rate of 88%, which was significantly higher than that of the control group with statistical difference (P < 0.05). 2) After treatment, the TCM symptom scores of the study group were significantly lower than those in the control group, with statistical difference (P < 0.05). 3) After treatment, the antibody titer in the study group was significantly lower than that in the control group, with statistical difference (P < 0.05). 4) In the control group, 5 patients had abnormal pregnancy duration, 3 patients had intrauterine growth retardation, 2 patients had intrauterine fetal distress, and the total incidence of pregnancy complications was 20%. In the study group, one patient had abnormal pregnancy duration, no intrauterine growth retardation or intrauterine distress, and the total incidence of pregnancy complications was 2%, which was significantly lower than that in the control group with statistical difference (P < 0.05). 5) At the end of the treatment, 48 neonates in the control group were finally born, of which 15 cases were pathological jaundice, accounting for 31.25%;49 neonates in the study group were finally born, of wh

关 键 词：母婴血型不合 清肝退黄 抗体效价 新生儿黄疸 胎黄病 

分 类 号：R714[医药卫生—妇产科学]