易黄汤加减联合抗生素预防未足月胎膜早破感染的临床观察

发布时间：2018-03-18 03:15

本文选题：未足月胎膜早破　切入点：易黄汤加减　出处：《山西中医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的探求易黄汤加减联合抗生素对妊娠期生殖道感染进行预防的效果,及其针对湿热型未足月胎膜早破预防感染的疗效。为临床中预防治疗胎膜早破提供经验,进一步做好围产期保健,提高妊娠质量,促进母儿健康。方法:收集年龄在19岁~40岁孕周为28W~34W的在我院治疗的中医辨证均属湿热型的未足月胎膜早破患者60例,随机分成对照组和治疗组,均予患者绝对卧床休息,抬高臀部并保持外阴清洁,抑制宫缩,促胎肺成熟,补充微量元素。对照组A组为抗生素(选用注射用头孢呋辛钠),治疗组B组为易黄汤加减联合抗生素,通过对治疗后患者的体温、母婴心率、白细胞计数、血压、外阴瘙痒、口苦口腻、胸闷纳呆等症状统计分析,观察易黄汤加减联合抗生素的治疗效果。结果:1.对照组、治疗组预防感染的有效率分别为93.33%和96.55%,经卡方检验分析,两组在预防感染方面无统计学差异(P0.05)。在用药24小时、36小时、48小时、60小时、72小时后,两组心率、血压、体温、胎心率比较无明显差异(P0.05),与入院时心率、血压、体温、胎心率相比无统计学差异(P0.05)。以上结果说明,易黄汤加减联合抗生素在对PPROM预防感染的应用上疗效与单纯使用抗生素相当。2.两组用药24小时后,对照组白细胞数值降低,与入院时白细胞数值相比无统计学意义(P0.05);治疗组白细胞数值降低,与入院时白细胞数值相比有统计学意义((P0.05);两组间比较,对照组、治疗组白细胞数值有统计学差异(P0.05)。用药48小时、72小时后,两组间比较,对照组、治疗组白细胞数值无统计学差异(P0.05),与入院时白细胞数值相比有统计学差异(P0.05)。以上结果说明,易黄汤加减联合抗生素在降低PPROM发生感染的风险性的时间上,较单纯应用抗生素具有一定优势。3.对照组、治疗组的中医证候有效率分别为83.33%和96.55%,经卡方检验分析,两组在中医症候疗效方面有统计学差异(P0.05),治疗后治疗组中的中医证候积分与对照组比较有明显差异(P0.05),说明易黄汤加减联合抗生素在对PPROM自身症状的改善较单纯应用抗生素,有一定疗效。结论:本课题通过对60例中医辨证属湿热型未足月胎膜早破患者随机分为两组治疗后的疗效观察,易黄汤加减方联合抗生素在对PPROM预防感染的应用上疗效与单纯使用抗生素相当,但在降低PPROM发生感染的风险性的时间上较单纯应用抗生素具有一定优势。在用药过程中,易黄汤加减方联合抗生素与单纯使用抗生素相比较,对外阴瘙痒、胸闷纳差、口苦口粘等症状方面具有明显改善作用。单纯应用抗生素是目前临床上对妊娠期患者预防感染采取的主要治疗方式,易黄汤加减方联合抗生素在对PPROM患者的治疗上,不仅能有效的预防感染以达到延长孕龄促进胎儿进一步成熟的效果,还可以消除患者身体上其他方面的不适症状。
[Abstract]:Objective to explore the effect of Yihuang decoction combined with antibiotics on the prevention of pregnancy genital tract infection, and the effect of preventing infection with premature rupture of unmatured membranes of damp and heat type, so as to provide experience for clinical prevention and treatment of premature rupture of membranes. Further better perinatal health care, improve the quality of pregnancy, and promote maternal and infant health. Methods: 60 cases of premature rupture of unmatured membranes, which were treated in our hospital at the age of 19 years and 40 years old and gestational weeks of 28 W / 34 W, were all damp-heat type. They were randomly divided into control group and treatment group. The patients were given absolute bed rest, raised buttocks and kept vulva clean, inhibited uterine contraction, and promoted fetal lung maturation. Supplementation of trace elements. Control group A for antibiotics (selected for injection of cefuroxime sodium, treatment group B for Yi Huang decoction combined with antibiotics, through the treatment of patients' body temperature, maternal and child heart rate, white blood cell count, blood pressure, pruritus vulva, To observe the therapeutic effect of Yihuang decoction combined with antibiotics. Results: in control group, the effective rates of preventing infection in treatment group were 93.33% and 96.55, respectively. There was no significant difference in the prevention of infection between the two groups (P 0.05). There was no significant difference in heart rate, blood pressure, body temperature and fetal heart rate between the two groups after 24 hours, 36 hours, 48 hours, 60 hours and 72 hours, and there was no significant difference between the two groups in heart rate, blood pressure, body temperature at admission. There was no significant difference in fetal heart rate (FHR) between the two groups (P 0.05). The above results indicated that the efficacy of Yi Huang decoction combined with antibiotics in preventing PPROM infection was equivalent to that of antibiotics alone. Twenty-four hours after treatment, the white blood cells in the control group were decreased. There was no significant difference between WBC and WBC at admission (P 0.05); in the treatment group, leukocyte was decreased, and compared with WBC at admission (P 0.05); in the control group, there was no significant difference between the two groups, while in the control group, there was no significant difference between the two groups. After 48 hours and 72 hours of medication, there was no significant difference in white blood cell value between the two groups in the control group and the treatment group (P 0.05), and there was a significant difference in the white blood cell value between the two groups compared with the white blood cell value at admission (P 0.05). Yi-Huang decoction combined with antibiotics has some advantages over using antibiotics alone in reducing the risk of PPROM infection. The effective rates of TCM syndromes in the treatment group are 83.33% and 96.55, respectively. The chi-square test shows that the effective rates of TCM syndromes in the treatment group are 83.33% and 96.55, respectively. There was a significant difference in the curative effect of TCM symptoms between the two groups (P 0.05). The scores of TCM syndromes in the treatment group were significantly different from those in the control group (P 0.05), which indicated that Yi-Huang decoction combined with antibiotics was more effective in improving the symptoms of PPROM than in the simple use of antibiotics. Conclusion: 60 cases of premature rupture of unmatured membranes in traditional Chinese medicine were randomly divided into two groups after treatment. The efficacy of Yihuang decoction combined with antibiotics in preventing PPROM infection is similar to that of using antibiotics alone, but it has some advantages in reducing the risk of infection of PPROM. Compared with antibiotics alone, Yi Huang Tang Xianfang combined with antibiotics itched vulva, and had poor chest boredom. The simple use of antibiotics is the main treatment method to prevent infection in pregnancy patients. The combination of Yi Huang decoction and antibiotics is the main treatment for PPROM patients. Not only can effectively prevent infection to prolong gestational age to promote further maturation of the fetus, but also can eliminate other physical symptoms of patients.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R714.433

【参考文献】