中医辨证论治缩短药物流产后阴道流血时间的疗效研究

发布时间：2018-06-28 18:22

本文选题：药物流产 + 阴道流血　；参考：《西南医科大学》2017年硕士论文

【摘要】：目的:通过文献研究,探讨和总结药物流产后阴道流血的中医辨证论治方案,并进行临床验证。方法:收集近25年来药物流产后阴道流血中医辨证论治的文献,探讨总结出该疾病常见证型、辨证要点、治法、方药。临床收集病例120例,进行中医辨证后,随机分为对照组、实验A组、实验B组。三组均采用基本治疗:米非司酮+米索前列醇口服药物流产,孕囊排除后,立即肌肉注射缩宫素,口服头孢呋辛酯片。对照组:基本治疗+缩宫素鼻喷雾剂;实验A组:基本治疗+口服生化汤;实验B组:基本治疗+参照常见中医证型进行辨证论治。7天后仍阴道流血者再次进行中医辨证,阴道流血停止或行清宫术则结束治疗。对三组阴道流血时间、阴道流血量、清宫率、孕酮、HCG下降程度、月经复潮等进行比较,使用excel 2007进行数据统计、spss19.0进行数据分析。结果:1、药物流产后阴道流血的常见中医证型瘀阻胞宫型、气虚血瘀型、湿热瘀阻型、阴虚血热型、寒凝血瘀型。2、各证型可选用以下治法方药,并临证加减。瘀阻胞宫型,治宜活血化瘀止血,方可用生化汤加减;气虚血瘀型,治宜益气活血止血,方可选八珍汤和生化汤加减;湿热瘀阻型,治宜清利湿热,活血止血,可选用大黄牡丹皮汤合五味消毒饮加减;阴虚血热型,治宜滋阴清热止血,方可选用用两地汤合生化汤加减;寒凝血瘀型,治宜温经活血,化瘀止血,方可选用生化汤加上肉桂、乌药、艾叶。3、药物流产后阴道流血使用中医辨证论治,能有效缩短阴道流血时间、减少阴道流血量、减少7天后仍阴道流血的人数、降低清宫率、降低孕酮及血HCG、促进月经复潮。结论:药物流产后阴道流血中医常见证型包括瘀阻胞宫型、气虚血瘀型、湿热瘀阻型、阴虚血热型、寒凝血瘀型。中医辨证论治能缩短药物流产后阴道流血时间,对药物流产后阴道流血具有重要意义。
[Abstract]:Objective: to discuss and summarize the treatment scheme of vaginal bleeding after drug abortion based on literature study. Methods: to collect the literature on syndrome differentiation and treatment of vaginal bleeding after drug abortion in recent 25 years, and discuss and summarize the common syndrome types, main points of syndrome differentiation, treatment methods and prescriptions of this disease. 120 cases were randomly divided into control group, experimental group A and experimental group B after TCM syndrome differentiation. Three groups were treated with basic treatment: mifepristone misoprostol oral abortion, pregnancy sac removed, immediately intramuscular injection of oxytocin, oral cefuroxime octyl ester tablets. Control group: basic treatment of oxytocin nasal spray; experimental group A: basic treatment of oral biochemical decoction; experimental group B: basic treatment with reference to the common TCM syndrome differentiation treatment 7. 7 days after still vaginal bleeding, Vaginal bleeding stops or the removal of the uterus ends the treatment. The vaginal bleeding time, vaginal bleeding volume, uterine clearance rate, decrease degree of progesterone HCG and menstrual dysphagia were compared among the three groups. Excel 2007 was used to analyze the data. Results 1. The common TCM syndrome types of vaginal bleeding after drug abortion were ecchymosis, qi deficiency and blood stasis, dampness and heat stasis, yin deficiency and blood heat, cold coagulation and blood stasis. Blood stasis should be treated with activating blood circulation to remove blood stasis and hemostasis; Qi deficiency and blood stasis should be treated with Qi deficiency and blood stasis to stop bleeding; only Bazhen decoction and biochemical decoction can be selected to reduce blood stasis; dampness and heat stasis should be treated to clear away dampness and heat and activate blood circulation to stop bleeding. You can choose rhubarb peony skin decoction to add or subtract five kinds of disinfectant drink; Yin deficiency and blood heat type, which should be treated with nourishing yin and clearing away heat to stop bleeding, then you can choose to use both two kinds of decoction combined with biochemical decoction to reduce; cold coagulation and blood stasis type, it is good to warm the channels to promote blood circulation, and to remove blood stasis to stop bleeding, Can you choose biochemical soup plus cinnamon, black medicine, Ai Ye. 3. The vaginal bleeding after drug abortion can be treated with TCM syndrome differentiation. It can effectively shorten the vaginal bleeding time, reduce the amount of vaginal bleeding, reduce the number of vagina bleeding after 7 days, and reduce the rate of clearing the palace. Reduce progesterone and blood HCG, promote menstrual resuscitation. Conclusion: the common syndrome types of vaginal bleeding after drug abortion include ecchymosis, qi deficiency and blood stasis, dampness and heat stasis, yin deficiency and blood heat, and cold coagulation and blood stasis. TCM treatment based on syndrome differentiation can shorten the time of vaginal bleeding after drug abortion, which is of great significance to vaginal bleeding after drug abortion.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R169.42

【参考文献】