安子合剂治疗复发性流产的临床疗效及对血清同型半胱氨酸水平的影响

发布时间：2018-06-02 15:53

本文选题：复发性流产 + 肾虚血瘀　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:通过观察安子合剂治疗肾虚血瘀型的复发性流产患者临床症状的变化、血清妊娠激素(E2、P、β-HCG)、同型半胱氨酸(Hcy)水平以及盆腔B超监测胚胎发育等情况,探讨安子合剂治疗复发性流产的临床疗效,以及安胎疗效与血清同型半胱氨酸相关性的作用机理。方法:临床收集2016年3月至2017年1月在江苏省中医院妇科门诊就诊及病房住院的肾虚血瘀型复发性流产患者60例,用简单随机分组方法分为治疗组(30例)和对照组(30例)。治疗组给予安子合剂+地屈孕酮片+复合维生素片(爱乐维)口服;对照组给予地屈孕酮片+复合维生素片(爱乐维)口服。4周为一观察周期。分别观察治疗前后两组患者证候积分变化、血清E2、P、β-HCG、同型半胱氨酸水平、盆腔B超监测胚胎发育情况。通过SPSS23.0统计软件进行数据处理,判断临床疗效,分析作用机理。结果:(1)临床证候积分:两组患者治疗后积分均较治疗前显著降低(P0.05);治疗组总积分降低幅度较对照组大(P0.05);中医证候疗效比较:治疗组总有效率93.3%,显著优于对照组总有效率66.7%(P0.05)。(2)血清妊娠激素水平:通过折线图走势发现,治疗后两组患者血清E2、P、β-HCG水平均呈上升趋势;通过折线图比较发现,治疗组上升幅度明显高于对照组(p0005)。(3)血清同型半胱氨酸水平:两组患者治疗后Hcy水平均较治疗前显著下降(P0.05);且治疗组下降幅度明显优于对照组(P0.05)。(4)盆腔B超监测胚胎发育情况:治疗组B超监测胎心良好且胚胎发育成形共28例(93.3%);对照组监测胎心良好且胚胎发育成形共21例(70.0%),治疗组胎儿成活率显著高于对照组(P0.05)。(5)综合疗效:治疗组痊愈率16.7%,显效率66.7%,有效率10%,总有效率93.3%;对照组痊愈率3.3%,显效率26.7%,有效率36.7%,总有效率66.7%。两组总有效率比较,治疗组明显优于对照组(P0.05)。结论:安子合剂治疗肾虚血瘀型复发性流产临床疗效确切,不仅能显著改善患者的临床症状,降低证候积分,提高妊娠激素水平,还能显著降低血清同型半胱氨酸水平,改善胞宫微循环,提高安胎成功率。
[Abstract]:Objective: to observe the changes of clinical symptoms of recurrent abortion patients with kidney deficiency and blood stasis type treated by Anzi mixture, the levels of serum pregnancy hormone E2P, 尾 -HCG, homocysteine Hcyine, and the monitoring of embryo development by pelvic B-ultrasound. To explore the clinical effect of Anzi mixture in the treatment of recurrent abortion and the mechanism of the correlation between the therapeutic effect and serum homocysteine. Methods: from March 2016 to January 2017, 60 cases of recurrent abortion with kidney deficiency and blood stasis type were collected from gynecological outpatient and ward of Jiangsu traditional Chinese Medicine Hospital. They were divided into treatment group (n = 30) and control group (n = 30). The treatment group was given diproprogesterone multivitamin tablets (Alovir) and the control group was given diproprogesterone multivitamin tablets (Alovir) for a period of 4 weeks. The changes of syndromes integral, serum E _ 2P, 尾 -HCG, homocysteine levels and pelvic B ultrasound were observed before and after treatment. The data were processed by SPSS23.0 software to judge the clinical effect and analyze the mechanism. Results (1) Clinical syndrome score: after treatment, the scores in both groups were significantly lower than those before treatment, the total score in the treatment group was lower than that in the control group, and the curative effect of TCM syndrome: the total effective rate of the treatment group was 93.3%, which was significantly better than that of the control group. The effective rate of 66.7%) serum pregnancy hormone level: through the trend of broken line, After treatment, the serum levels of E2P, 尾 -HCG in both groups showed an upward trend. The serum homocysteine level in the treatment group was significantly higher than that in the control group (P _ (0005). The serum homocysteine level in the treatment group was significantly lower than that in the pre-treatment group (P 0.05), and the decrease in the treatment group was significantly higher than that in the control group (P _ (0.05) P _ (0.05). Development: in the treatment group, the fetal heart was good and the embryo was formed in 28 cases, while in the control group, the fetal heart was good and the embryo was formed in 21 cases. The survival rate of the fetus in the treatment group was significantly higher than that in the control group. In the control group, the recovery rate was 3.3%, the markedly effective rate was 26.7%, the effective rate was 36.7%, and the total effective rate was 66.7%. The total effective rate of the two groups was significantly better than that of the control group (P 0.05). Conclusion: Anzi mixture is effective in the treatment of recurrent abortion with kidney deficiency and blood stasis. It can not only significantly improve the clinical symptoms of the patients, reduce the syndrome score, increase the level of pregnancy hormones, but also significantly reduce the level of serum homocysteine. Improve the uterine microcirculation and increase the success rate of fetus.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

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