中西医结合治疗辅助生殖技术后先兆流产的疗效观察

发布时间：2018-02-10 17:36

本文关键词： 先兆流产脾肾两虚型中西医结合治疗　出处：《云南中医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:固化、总结国家级名老中医张良英教授经验方“保胎饮”结合黄体酮的治疗效果,为临床治疗辅助生殖技术后先兆流产提供一种疗效好、易于推广应用的方法。方法:搜集60例辅助生殖技术后先兆流产脾肾两虚型患者,随机分为两组,每组30例。治疗组口服国家级名老中医张良英经验方“保胎饮”,每日一剂,一天三次,配合黄体酮注射液肌注;对照组单独给予肌肉注射黄体酮注射液,连续治疗4个疗程。治疗前、后进行观察,观察的主要疗效指标为:主要证候:阴道出血时间、出血量、出血色质以及小腹坠等;全身证候:腰酸胀痛,两膝酸软,头晕耳鸣,夜尿频多,神疲乏力,少气懒言等;性激素指标改善情况:雌激素(E2)、孕激素(P)水平、人绒毛膜促性腺激素(β-HCG)的变化。结果:两组治疗前、后自身对照,总证候积分、主要证候积分、全身证候积分、孕激素值相比,P0.01,差异显著,具有统计学意义;治疗组总疗效为90%,对照组总疗效为86.67%。各检查指标:E2、P、β-HCG水平,较治疗前改善明显;具有统计学意义。两组治疗后组间对照,总疗效及全身证候积分比较P0.05,两组无明显差异;主要证候积分:P0.01,治疗组优于对照组。治疗后两组主要证候积分比较,P0.05,差异显著;治疗后两组全身证候积分,P0.05,无统计学意义;各检查指标:β-HCG、P水平,P0.05,无统计学意义;E2水平改善情况治疗组明显高于对照组。观察中治疗组有1例患者用药初期观察到腹胀,便质稀等轻微胃肠反应,持续3天后症状缓解;对照组未观察到不良反应。结论:国家级名老中医张良英教授验方“保胎饮”联合黄体酮肌注治疗辅助生殖技术后先兆流产有肯定的疗效,其总疗效与单纯使用黄体酮组相当;治疗组可改善辅助生殖技术后先兆流产患者的脾肾两虚的全身证候,特别是在改善腰酸胀痛、头晕耳鸣、少气懒言方面,疗效显著;治疗组可明显改善辅助生殖技术后先兆流产患者的主要证候,如缩短阴道流血时间,改善小腹痛或坠方面疗效显著;治疗组可显著提升HCG、E2、P水平。国家级名老中医张良英教授验方“保胎饮”联合黄体酮肌注治疗辅助生殖技术后先兆流产安全可靠,是一种值得临床推广的有效治疗方法。
[Abstract]:Objective: to solidify and summarize the therapeutic effect of "Baotai Yin" combined with progesterone, Professor Zhang Liangying, professor of national famous Chinese medicine, in order to provide a good therapeutic effect for threatened abortion after clinical treatment of assisted reproductive technology. Methods: 60 cases of threatened abortion with deficiency of spleen and kidney after assisted reproductive technique were randomly divided into two groups, 30 cases in each group. Three times a day, combined with intramuscular injection of progesterone injection, while the control group was given intramuscular injection of progesterone injection for 4 consecutive courses of treatment. Before and after treatment, the main therapeutic effects were observed as follows: main syndromes: vaginal bleeding time, Blood loss, hemochromator, lower abdomen drop, etc.; systemic syndrome: pain in the waist, sore knees, dizziness and tinnitus, frequent urination at night, fatigue, lack of breath, and so on; improvement of sex hormone indexes: estrogen, E2P, progesterone (P), etc. Changes of human chorionic gonadotropin (尾 -HCG). Results: before and after treatment, the total syndromes integral, main syndromes integral, systemic syndrome score and progesterone value were significantly different between the two groups (P 0.01). The total curative effect of the treatment group was 90 and the total curative effect of the control group was 86.67.The levels of 尾 -HCG and 尾 -HCG were significantly improved compared with those before treatment. There was no significant difference between the two groups in the total curative effect and the integral score of systemic syndrome after treatment (P 0.05). The main syndromes score P0.01 was better in the treatment group than in the control group. After treatment, there was a significant difference in the main syndrome score between the two groups, but there was no significant difference between the two groups in the whole body syndrome score (P0.05) after treatment. The level of 尾 -HCGN P was 0.05, and the improvement of E2 level in the treatment group was significantly higher than that in the control group. In the treatment group, there was a slight gastrointestinal reaction, such as abdominal distension and dilute feces, which were observed at the beginning of the treatment period, and the symptoms were relieved after 3 days. Conclusion: "Baotai Yin" combined with progesterone intramuscular injection has positive curative effect on threatened abortion after assisted reproductive technique, and the total curative effect is equal to that of only using progesterone group. The treatment group can improve the syndrome of deficiency of spleen and kidney in the patients with threatened abortion after assisted reproductive technology, especially in improving the pain of waist and acid, dizziness and tinnitus, less breath and lazy speech, the curative effect is remarkable. The treatment group can obviously improve the main syndromes of the patients with threatened abortion after assisted reproductive technology, such as shortening the time of vaginal bleeding and improving the effect of abdominal pain or falling. The treatment group can significantly improve the level of HCGN E2P. Professor Zhang Liangying, a national famous Chinese medicine, is a safe and reliable method for the treatment of threatened abortion after assisted reproductive technology by combining Baofeiyin with progesterone, which is an effective treatment method worthy of clinical popularization.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.21

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