中药干预对复发性流产染色体多态性患者妊娠结局影响的临床研究

发布时间：2018-05-05 03:18

本文选题：复发性流产 + 脾肾亏虚　；参考：《北京中医药大学》2017年硕士论文

【摘要】：研究目的:研究探索中药干预对复发性流产染色体多态性患者妊娠结局的影响。研究方法:选取2012年2月至2016年9月期间就诊于中国中医科学院广安门医院妇科门诊的符合纳入标准及排除标准的脾肾亏虚型RSA患者共97例,经染色体核型分析分析,将染色体核型分析结果为染色体多态性的患者共50例作为多态组,染色体核型分析结果为染色体正常核型的患者47例作为对照组。予两组患者以自拟补脾益肾助孕方进行连续干预三个月经周期后解除避孕。观察指标:(1)两组患者既往自然流产史次数对比;(2)服药前两组患者的病情程度分级;(3)服药前两组患者的早卵泡激素:包括血清卵泡生成素(FSH)、血清黄体生成素(LH)、血清雌二醇(E2)、LH/FSH水平对比;(4)两组患者的中医证候疗效指数对比;(5)各组间服药前后的中医症状积分对比;(6)两组患者自解除避孕后至再次妊娠间隔时长并对比;(7)两组患者再次妊娠首诊时停经天数并对比;(8)两组患者再次妊娠首诊时人绒毛膜促性腺激素(hCG)、雌二醇(E2)、孕酮(P)水平并对比;(9)两组患者早期妊娠成功率并对比;(10)随访至晚期妊娠,统计活产率、畸形率等。研究结果:(1)多态组与对照组既往自然流产史次数比较无差异(P0.05)。(2)多态组与对照组服药前的病情分级比较无差异(P0.05)。(3)多态组与对照组服药前早卵泡激素FSH、LH、E2、LH/FSH水平比较无差异(P0.05)。(4)两组比较中医证候疗效指数,多态组:痊愈8.00%,显效66.00%,有效26.00%%,无效0%,总有效率为100%;对照组:痊愈4.26%,显效57.45%,有效36.17%,无效2.13%,总有效率为97.87%,两组总有效率比较无差异(P0.05)。(5)多态组、对照组经过补脾益肾助孕方干预后,组间服药前后相比,中医症状积分有显著性差异(P0.01)。(6)多态组与对照组自解除避孕后至再次妊娠间隔时长(≤6月),两组相比(84.00%vs 78.72%)无差异(P0.05)。(7)多态组与对照组再次妊娠首诊时停经天数比较无差异(P0.05)。(8)多态组与对照组再次妊娠首诊时人绒毛膜促性腺激素(hCG)、雌二醇(E2)、孕酮(P)对比均无差异(P0.05)。(9)多态组与对照组早期妊娠结局相比较,两组的成功率相比(96.00%vs 93.62%)无差异(P0.05)。(10)多态组与对照组晚期妊娠结局相比较,两组的活产率(96.00%vs 93.62%)、畸形率(均为0%)相比无差异(P0.05)。结论:(1)染色体多态性与自然流产史次数可能没有相关性。(2)说明染色体多态性对脾肾亏虚型的病情轻重程度无影响。(3)染色体多态性对女性早卵泡激素水平可能无影响。(4)补脾益肾助孕方可以有效改善脾肾亏虚型患者的中医临床症状。(5)经中药干预后,染色体多态性患者解除避孕半年内的受孕率与染色体对照患者无差别。(6)经中药干预后,染色体多态性患者再次受孕后首诊时停经天数与染色体对照患者无差别。(7)经中药干预后,染色体多态性患者再次妊娠时血清hCG、E2、P与染色体对照患者无差别。(8)经中药干预后,染色体多态性患者早期妊娠成功率与染色体对照患者无差别。(9)经中药干预后,染色体多态性患者活产率、畸形率均与染色体对照患者无差别。
[Abstract]:Objective: To explore the effect of traditional Chinese medicine intervention on pregnancy outcome of recurrent abortion chromosome polymorphisms. Methods: 97 cases of spleen kidney deficiency type RSA patients were selected from February 2012 to September 2016 in the gynecological clinic of the hospital of Guanganmen Hospital of Chinese Academy of traditional Chinese medicine (Chinese Academy of Chinese Medicine). A total of 50 patients with chromosome karyotype analysis were analyzed as polymorphic group, and 47 cases of normal karyotype of chromosome karyotype were used as control group. Two groups of patients were treated with self-made invigorating kidney benefiting kidney to relieve contraception after three months of menstrual cycle. The observation index: (1) two groups Comparison of the number of past natural abortion history; (2) grade of the two groups before taking the medicine; (3) the early follicle hormone in the two groups before taking the medicine: including serum follicular hormone (FSH), serum luteinizing hormone (LH), serum estradiol (E2), LH/FSH level to ratio; (4) two groups of patients with TCM syndrome effect index comparison; (5) before taking medicine between each group before taking medicine (6) two groups of patients from the release of contraception to the interval of pregnancy longer and compared; (7) the two group of patients with first pregnancy to stop the number of days and comparison; (8) the two group of first pregnancy first diagnosis of human chorionic gonadotropin (hCG), estradiol (E2), progesterone (P) level and contrast; (9) two groups of patients early pregnancy into Power and contrast; (10) follow up to late pregnancy, statistical live yield, deformity rate and so on. (1) there was no difference in the history of spontaneous abortion between the polymorphic group and the control group (P0.05). (2) there was no difference between the polymorphic group and the control group before taking the medicine (P0.05). (3) the level of early follicle hormone FSH, LH, E2, LH/FSH in the control group and the control group. There was no difference (P0.05). (4) the two groups compared the TCM syndrome curative effect index, polymorphic group: recovery 8%, effective 66%, effective 26.00%%, invalid 0%, the total effective rate was 100%; control group: cured 4.26%, 57.45%, effective 36.17%, 2.13%, total effective rate of 97.87%, total effective rate of two group was no difference (P0.05). (5) polymorphism group, the control group passes the spleen There was significant difference in TCM symptom score (P0.01). (6) there was no difference between the polymorphic group and the control group from the relief of contraception to the second pregnancy (less than June) and the two groups (84.00%vs 78.72%). (7) there was no difference in the number of days of menopause between the multiple group and the control group in the first pregnancy (P0.05). (8) there was no difference in the comparison of human chorionic gonadotropin (hCG), estradiol (E2) and progesterone (P) between the polymorphic group and the control group (P0.05). (9) there was no difference in the success rate between the two groups (96.00%vs 93.62%) compared with the control group (P0.05). (10) the polymorphism group was compared with the control group in the late pregnancy outcome, and the two group was compared. There was no difference in the rate of survival (96.00%vs 93.62%) and the rate of malformation (0%). Conclusion: (1) there is no correlation between chromosome polymorphism and the frequency of spontaneous abortion. (2) there is no effect on the severity of spleen and kidney deficiency syndrome. (3) the polymorphism of chromophore may have no effect on the level of female early follicle hormone. (4) supplementing the spleen. Renal assisted pregnancy can effectively improve the clinical symptoms of spleen and kidney deficiency patients. (5) there is no difference between chromosome polymorphism patients and chromosomal control patients in half a year after the prognosis of Chinese herbal medicine. (6) after the prognosis of Chinese medicine, the number of chromosomal polymorphisms in the first pregnancy after the first diagnosis is not poor with the chromosome control patients. (7) after the prognosis of Chinese medicine, the serum hCG, E2, P and chromosome control patients have no difference. (8) there is no difference between the early pregnancy success rate of the chromosome polymorphism patients and the chromosome control patients. (9) the survival rate and the malformation rate of the chromosome polymorphic patients are all with the chromosome pairs after the prognosis of the Chinese medicine. There is no difference in the patient.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

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