寿胎丸加减治疗肾虚型早期先兆流产的临床观察

发布时间：2018-07-01 10:32

本文选题：中医药 + 寿胎丸　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：目的先兆流产(Threatened abortion)是指在怀孕的过程中(28周)发生的阴道出血,量较少,颜色为淡红色、黯红色或呈茶水样的褐色,随后出现轻微腹痛和(或)腰骶部坠胀痛,不伴有胎物组织排出的一种妇产科常见的疾病。先兆流产可以分为早期和晚期。早期先兆流产特指出现在妊娠12周末之前的流产征兆。随着现代社会压力的增加、环境污染及其它各种因素的影响,本病的发病率呈日益上升的趋势,若治疗及时、得当,则可以继续妊娠。若治疗不及时、不恰当,症状严重,则会演变成为难免流产,不能继续怀孕。先兆流产常常给孕妇及其家属造成很大的心理恐慌,由此伴随而来的不良后果常常会给很多家庭沉重的打击,影响家庭和谐。因此,研究本病的治疗有着很大的临床意义。本研究是关于寿胎丸加减治疗肾虚型早期先兆流产的临床研究,了解补肾安胎法治疗肾虚型早期先兆流产的临床效果,与西医治疗相对比,从而为补肾安胎法治疗先兆流产提供一定的指导依据。法1.收集资料:共62位病人,均为2012年10月——2015年10月在我院(十堰市中医医院)中医妇科门诊就诊的病人,都符合纳入早期先兆流产(中医证型为肾虚型)的相关标准。根据实验要求,将病人随机分成2组,命名为中医组、西医组,其中中医组31位患者,西医组31位患者。2.治疗方法:中医组给予汤剂寿胎丸加减服用(药物成分:菟丝子30g、阿胶10g(烊化)、续断12g、桑寄生20g、白术12g、党参15g、杜仲12g),同时再根据患者的各自症状的不同进行方药加减;西医组按普通治疗给以口服地屈孕酮片治疗,10mg每次,每8小时1次,初次剂量为40 mg[1],要求两组患者卧床休息、勿劳累[2]。每组治疗都以1星期为1个疗程,共研究2个疗程。观察患者在治疗前后阴道出血量、腹痛情况及相关临床结果的变化,以了解疗效情况。用SPSS19.0软件对结果统计分析:等级资料用秩和检验,计数资料采用卡方χ2检验,计量资料采用t检验,以双侧检验为标准,若P0.05为认为有统计学意义。结果1.在观察过程中,中医组及西医组分别剔除治疗过程中擅自停药者1例。2.综合临床疗效比较:经过2个疗程的处理后,对2组实验者的临床疗效进行综合评估,痊愈:中医组25例,西医组19例;显效:中医组3例,西医组4例;有效:中医组1例,西医组4例;无效:中医组1例,西医组3例。故总有效率为:中医组93.33%,西医组90%。治疗前后,2组均存在显著差异(P0.05);将治疗后的结果进行比较,中医组与西医组存在显著差异(P0.05),提示中医组疗效高于西医组。3.从临床症状开始缓解所需的平均时间上进行比较,中医组3.32天,西医组6.08天,具有可比性(P0.05),中医组效果优于西医组。4.根据B超检查孕囊发育情况判定,孕囊发育程度为:中医组西医组。5.依据患者血清β-HCG增长变化情况评估,2个疗程后2组患者血清β-HCG均比治疗前增高,且P0.05,具有差异性。2种治疗方案均有较为有效的保胎作用。但将各组患者治疗后的血清β-HCG进行统计学计算,P0.05。故可认为2组的疗效从高到低排列为:中医组西医组。6.根据治疗前后P、E2的变化情况来看,治疗后2组血清P、E2值均比治疗前上升,且升高幅度为中医组西医组。经统计计算,差异有显著意义(P0.05)。结论寿胎丸加减能有效的改善以肾虚为主的早期先兆流产的相关临床症状,可有效的改善阴道出血症状,促进血清β-HCG、P、E2值的增长,有利于孕囊成长。寿胎丸加减治疗肾虚型先兆流产疗效明确。
[Abstract]:Objective threatened abortion (Threatened abortion) refers to vaginal bleeding in the course of pregnancy (28 weeks), with less volume, light red, dark red or brown in tea water, followed by mild abdominal pain and (or) lumbosacral distention and pain, and a common obstetrics and gynecology disease without fetal tissue. Threatened abortion can be divided into early stages. Early and late stage. Early Threatened Abortion refers to the symptoms of abortion before the 12 week of pregnancy. With the increase of modern social pressure, environmental pollution and other factors, the incidence of this disease is increasing. If the treatment is timely and appropriate, it can continue pregnancy. If the treatment is not timely, inappropriate, and the symptoms are serious, the meeting will be performed. It is difficult to miscarry and cannot continue to conceive. Threatened abortion often causes great psychological panic to pregnant women and their families. The adverse consequences associated with them often give many families a heavy blow and affect family harmony. Therefore, the study of the treatment of this disease is of great significance. This study is about the treatment of kidney with Shou fetal pill. The clinical study of the Early Threatened Abortion of the deficiency type, to understand the clinical effect of the treatment of the Early Threatened Abortion of kidney deficiency type by the method of invigorating kidney and fetus, and comparing with the treatment of Western medicine, so as to provide certain guidance for the treatment of threatened abortion by the method of invigorating kidney and fetus. 1. the data of 62 patients were all in October 2012 - in our hospital (Shiyan traditional Chinese Medicine) in October 2015 According to the experimental requirements, the patients were randomly divided into 2 groups, named as traditional Chinese medicine group and Western medicine group, including 31 patients in traditional Chinese medicine group and 31 patients in western medicine group with.2. treatment methods: Chinese medicine group was given Decoction Shou Tai pill plus or minus (Medicine). Ingredients: dodder 30g, gelatin 10g (closing), continuous 12g, parasitic 20g, Atractylodes macrocephala 12g, Codonopsis 15g, Eucommia 12g), and then according to the different symptoms of the patients to carry out prescriptions and subtraction; the western medicine group is given oral Dydrogesterone Tablets treatment according to ordinary treatment, 10mg every 8 hours 1 times, the initial dose is 40 mg[1], two groups of patients rest in bed, Do not tired [2]. for each group of treatment for 1 weeks as 1 courses, a total of 2 courses of treatment. Observe the amount of vaginal bleeding, abdominal pain and changes in clinical results before and after treatment, to understand the effect. The results are statistically analyzed with SPSS19.0 software: rank sum test, chi square 2 test for counting data, measurement data adopted T test, with bilateral test as the standard, if P0.05 is considered to have statistical significance. Results 1. in the observation process, the Chinese medicine group and the western medicine group eliminated the treatment process in the treatment process, 1 cases of.2. comprehensive clinical efficacy comparison: after 2 courses of treatment, the clinical efficacy of the 2 groups of subjects were comprehensively evaluated, cured: 25 cases of traditional Chinese medicine, western medicine. Group 19 cases: 3 cases in Chinese medicine group and 4 cases in western medicine group, effective: 1 cases in traditional Chinese medicine group and 4 cases in western medicine group; 1 cases in traditional Chinese medicine group and 3 cases in western medicine group, so the total effective rate is 93.33% in traditional Chinese medicine group, and there are significant differences between the 2 groups before and after 90%. treatment in western medicine group (P0.05); there are significant differences between the Chinese medicine group and the western medicine group (P0.05). The curative effect of the medical group was higher than the average time required by the western medicine group.3. from the clinical symptoms to remission. 3.32 days in the traditional Chinese medicine group and 6.08 days in the western medicine group were comparable (P0.05). The effect of the traditional Chinese medicine group was superior to the western medicine group.4. according to the B ultrasonic examination of the development of the pregnancy sac. The development degree of the gestation sac was based on the serum beta -HCG growth of the patients in the western medicine group of the Chinese medicine group. After 2 courses of treatment, the serum beta -HCG in the 2 groups was higher than that before the treatment, and P0.05, and the difference.2 treatment scheme had a more effective protective effect. But the serum beta -HCG after the treatment of each group was calculated, and P0.05. could be considered as the treatment of the 2 groups from high to low: the western medicine group of the traditional Chinese medicine group was treated according to the treatment of.6.. The changes of P and E2 before and after treatment showed that the serum P and E2 values in the 2 groups were all higher than that before the treatment, and the increase was in the western medicine group of the traditional Chinese medicine group. The difference was significant (P0.05) by statistical calculation. Conclusion Shou fetal pill can effectively improve the related clinical symptoms of Early Threatened Abortion with kidney deficiency, which can effectively improve the symptoms of vaginal bleeding. Promoting the growth of serum -HCG, P and E2 is beneficial to the growth of gestational sac. Shou Tai pill is effective in the treatment of threatened abortion with kidney deficiency.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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