先兆流产的中医文献研究及91例先兆流产患者的回顾性研究

发布时间：2018-05-29 23:06

本文选题：先兆流产 + 回顾性分析　；参考：《北京中医药大学》2017年硕士论文

【摘要】：[目的]通过回顾性分析91例先兆流产患者病因、中医证型、治疗方式和临床疗效等,总结先兆流产的发病特点并提出有效而合理的治疗方法和预防措施。[方法]通过对北京中医药大学附属医院东直门医院妇科2014年6月到2017年1月三年间收治的91例先兆流产患者的一般资料、临床症状、既往月经情况、孕产史、距上次妊娠时间、中医证型、并发疾病、既往腹部相关手术史、妊娠结局等10个观察指标进行归纳分析,采用统计学处理。[结果]1.91例先兆流产患者的发病年龄主要集中在30岁到34岁之间,平均发病年龄32.91岁;2.91例先兆流产患者的临床表现为腰酸、下腹痛、小腹下坠、阴道出血,但多数患者有2种以上的症状表现,有39人,占42.86%;3.91例患者中有18人既往月经异常,其中月经后错的有13人,占14.29%;4.91例先兆流产患者中仅有10人有过分娩史,其余81人中有33人至少有过一次妊娠。91例患者有56人有过不良孕产史,其中胎停育患者人数最多,有33人,占36.36%;5.91例患者中距上次妊娠时间13-24个月的人数最多,为26人,占34.21%;6.中医证型方面先兆流产患者中主要以肾虚证居多,有59人,占64.84%;7.91例先兆流产病患中,2例伴发甲减、1例伴发哮喘病、1例伴发浅表性胃炎;8.91例先兆流产病患中有24人有过腹部手术史,占26.37%;9.91例先兆流产患者中治愈的有42人,占51.85%、显效的有14人,占17.28%、有效的10人,占12.35%、无效的15人,占18.52%。[结论]1.先兆流产的主要致病因素有高龄、劳累、多产等,且情志不畅也会对保胎治疗造成不良影响,在保胎治疗过程中应注意避免劳累、调畅情志;2.肾虚是先兆流产发生的主要病机,对治疗先兆流产主要以补肾安胎为主,治疗方以寿胎丸为基本方;3.采用中西医结合治疗先兆流产疗效确切,且对子代的安全性无不良影响,所以临床可遵循此治疗方法。
[Abstract]:[objective] to analyze retrospectively the etiology, syndrome type, treatment method and clinical efficacy of 91 patients with threatened abortion, and to summarize the characteristics of threatened abortion and to put forward effective and reasonable treatment methods and preventive measures. [methods] General data, clinical symptoms, past menstruation and pregnancy history of 91 patients with threatened abortion admitted from June 2014 to January 2017 in Dongzhimen Hospital, affiliated Hospital of Beijing University of traditional Chinese Medicine, were analyzed. From the last pregnancy time, TCM syndromes, complicated diseases, previous abdominal surgery history, pregnancy outcome and other 10 observation indicators were summarized and analyzed by statistical analysis. [results] 1.The age of onset of 91 threatened abortion patients was mainly between 30 and 34 years old. The average age of onset was 32.91 years old and 2.91 cases of threatened abortion patients showed lumbar acid, lower abdominal pain, lower abdomen fall, vaginal hemorrhage. But most of the patients had more than two symptoms, 39 of them (42.86 / 3.91) had abnormal menstruation, 13 of them were misdiagnosed after menorrhagia, and only 10 out of 14.2991 patients with threatened abortion had a history of delivery. Among the other 81 patients, 33 had at least one pregnancy. 56 of them had a history of bad pregnancy. Among them, the number of patients with fetal arrest was the most, 33, accounting for 36.3636 and 5.91 patients, the most from the last pregnancy time 13-24 months, 26, accounting for 34.21 and 6. Among the patients with threatened abortion in TCM syndromes, 59 were mainly kidney deficiency. Of the 791 patients with threatened abortion, 2 were diagnosed with hypothyroidism and 1 with asthma. Out of 8.91 threatened abortion patients with superficial gastritis, 24 had a history of abdominal surgery and 42 were cured out of 26.37g / 9.91 threatened abortion, the study showed that: (1) 2 cases with hypothyroidism and 1 case with asthma, 1 case with superficial gastritis and 8. 91 cases with threatened abortion, 24 cases had a history of abdominal surgery, accounting for 26. 37% of 9. 91 cases of threatened abortion. Accounting for 51.85, there are 14 people with remarkable effect, accounting for 17.28, 10 effective, 12.35 and 15 invalid, accounting for 18.52. [conclusion] 1. The main pathogenetic factors of threatened abortion are old age, tiredness, labor, and so on, and the unobstructed emotion will also have a bad effect on the treatment of fetal preservation. We should pay attention to avoid tiredness in the course of the treatment of fetal preservation and adjust the unobstructed feeling. 2. Kidney deficiency is the main pathogenesis of threatened abortion. The combination of traditional Chinese and western medicine is effective in treating threatened abortion and has no adverse effect on the safety of offspring.
【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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