益气补肾活血方联合米非司酮及米索前列醇治疗稽留流产的临床研究
|
摘要
目的探讨益气补肾活血方联合米非司酮以及米索前列醇治疗稽留流产的临床疗效,进一步评价其有效性及安全性。方法 180例稽留流产患者,根据患者意愿及不同的临床用药治疗方式分为对照组和研究组,每组90例。对照组采用米非司酮联合米索前列醇治疗,如患者流产失败或不完全流产,则采取常规清宫术治疗,研究组给予患者口服米非司酮、米索前列醇联合补肾益气活血方治疗,如患者出现流产失败现象则给予常规清宫术治疗,观察2组患者妊娠物排出时间、腹痛持续时间、阴道不规则出血量,并对2组患者的完全流产率、不完全流产率以及流产失败率和不良反应发生率比较,进行统计分析。结果治疗前2组患者的性别、年龄及孕周经比较,差异无统计学意义(P> 0. 05)。治疗后研究组妊娠物排除时间、腹痛持续时间、阴道不规则出血量、完全流产率均明显优于对照组(P <0. 05),研究组的不完全流产率、流产失败率及不良反应发生率明显低于对照组(P <0. 05)。结论采用益气补肾活血方联合米非司醇、米索前列醇治疗稽留流产患者的临床有效率高,可加速妊娠物的排出,减少患者的出血量及腹痛持续时间,提高完全流产率,降低患者的不完全流产率、流产失败率及不良反应发生率,对患者的远期预后佳,可有效减轻稽留流产对患者自身造成的伤害,安全系数较高,值得临床进一步推广应用。
Objective To investigate the therapeutic effects of Yiqibushenhuoxue prescription combined with mifepristone and misoprostol on missed abortion,and to evaluate its efficacy and safety. Methods A total of 180 patients with missed abortion who were admitted and treated in our hospital from January 2016 to July 2017 were enrolled in the study.According to the different medication methods these patients were divided into control group and research group. The patients in control group were treated by mifepristone combined with misoprostol,if the patients were underwent abortion failure or incomplete abortion,they were trated by curettage,however,the patients in research group were treated by Yiqibushenhuoxue prescription combined with mifepristone and misoprostol,if the patients underwent abortion failure or incomplete abortion,they were trated by curettage. The discharging time of pregnancy matters,duration of abdominal pain,vaginal irregular blood loss,complete abortion rate,incomplete abortion rate,abortion failure rate and incidence of adverse reactions were observed and compared between the two groups. Results Before treatment there were no significant differences in patient's gender,age and gestational weeks between the two groups( P > 0. 05). After treatment discharging time of pregnancy matters,duration of abdominal pain,vaginal irregular blood loss,complete abortion rate in research group were superior to those in control group( P < 0. 05),moreover,the incomplete abortion rate,abortion failure rate and incidence of adverse reactions in research group were significantly lower than those in control group( P < 0. 05). Conclusion The therapeutic effects of Yiqibushenhuoxue prescription combined with mifepristone and misoprostol on missed abortionare quite significant,which can can accelerate the discharging of pregnancy matters,reduce the bleeding volume and duration of abdominal pain,increase complete abortion rate,lower incomplete abortion rate,abortion failure rate and incidence of adverse reactions,with good safety,therefor,it is worthy of further clinical application and promotion.
Objective To investigate the therapeutic effects of Yiqibushenhuoxue prescription combined with mifepristone and misoprostol on missed abortion,and to evaluate its efficacy and safety. Methods A total of 180 patients with missed abortion who were admitted and treated in our hospital from January 2016 to July 2017 were enrolled in the study.According to the different medication methods these patients were divided into control group and research group. The patients in control group were treated by mifepristone combined with misoprostol,if the patients were underwent abortion failure or incomplete abortion,they were trated by curettage,however,the patients in research group were treated by Yiqibushenhuoxue prescription combined with mifepristone and misoprostol,if the patients underwent abortion failure or incomplete abortion,they were trated by curettage. The discharging time of pregnancy matters,duration of abdominal pain,vaginal irregular blood loss,complete abortion rate,incomplete abortion rate,abortion failure rate and incidence of adverse reactions were observed and compared between the two groups. Results Before treatment there were no significant differences in patient's gender,age and gestational weeks between the two groups( P > 0. 05). After treatment discharging time of pregnancy matters,duration of abdominal pain,vaginal irregular blood loss,complete abortion rate in research group were superior to those in control group( P < 0. 05),moreover,the incomplete abortion rate,abortion failure rate and incidence of adverse reactions in research group were significantly lower than those in control group( P < 0. 05). Conclusion The therapeutic effects of Yiqibushenhuoxue prescription combined with mifepristone and misoprostol on missed abortionare quite significant,which can can accelerate the discharging of pregnancy matters,reduce the bleeding volume and duration of abdominal pain,increase complete abortion rate,lower incomplete abortion rate,abortion failure rate and incidence of adverse reactions,with good safety,therefor,it is worthy of further clinical application and promotion.
引文
1谢幸,苟文丽主编.妇产科学.第8版.北京:人民卫生出版社,2013.49-50.
2陈彩霞,李国芸,赵孟君,等.稽留流产病因分析及临床意义.中国误诊学杂志,2005,5:1629-1630.
3 Jukovic D,Overton C,Bender-Atik R.Diagnosis and management of first trimester miscarriage.BMJ,2013,346:f3676.
4 Lurie S,Feinstein M,Mamet Y,Disseminated intravascular coagulopathy in pregnancy:thorough comprehension of etiology and management reduces obstetricians’stress.Arch Gynecol Obstet,2000,263:126-130.
5张华坤,罗福微,耿茜.252例稽留流产者绒毛细胞遗传学分析与环境因素探讨.中华医学遗传学杂志,2011,28:575-589.
6冯春翠.中西医结合治疗稽留流产临床研究.中医学报,2015,7:1030-1031.
7 Salamanca A,Fernandez-Salmeron P,Beltran E,et al.Early em-bryonic morphology sonographically assessed andits correlation with yolk sacin missed abortion.Archives of gynecology and obstetrics,2013,287:245-246.
8傅山主编.傅青主女科.第1版.上海:上海科学技术出版社,1991.79.
9王彩霞,李大剑.中西医治疗稽留流产研究概况.中医药临床杂志,2016,28:1483-1485.
10乐杰主编.妇产科学.第7版.北京:人民卫生出版社,2008.83-86.
11韩学杰,刘孟宇,连智华,等.中医内科常见病诊疗指南临床应用评价研究.中国中药杂志,2017,42:3233-3237.
12罗丽丽.戊酸雌二醇配伍抗早孕药物在稽留流产中的应用价值.中国现代药物应用,2015,9:28-29.
13白力伟,陈秀媛.中西医结合治疗稽留流产30例.河北中医,1996,18:46.
14康美花,田春芳.稽留流产发病因素的研究进展与分析.医学综述,2011,17:1006-2084.
15文云霞,祁连芳,姜改丽.稽留流产的原因分析以及早期诊断.中国性科学,2015,24:66-69.
16顾华芬,衣欢,赵海红,等.1945例稽留流产的流行病学及高危因素分析.生殖与避孕,2016,36:195-200.
17杜晶,张兆奉,徐建华.遗传及相关因素与稽留流产关系的研究进展.生殖与避孕,2013,33:552-556.
18韩晶秀,曹兆进,刘欣燕,等.怀孕早期电磁辐射暴露对胚胎停育影响研究.卫生研究,2010,39:349-352.
19张雪茹.中医辩证治疗利凡诺引产致胎死不下13例.陕西中医,2005,26:408-409.
20王月华,杨军平,骆雨.中医治疗引产失败后胎死不下临床分析.中国医学理论与实践,2005,15:1087-1088.
21潘丽贞,王英.稽留流产30例中西医结合干预治疗结果观察.福建医药杂志,2009,31:139-140.
22李燕.联用米非司酮、米索前列醇与雌激素治疗稽留流产的效果研究.当代医药论丛,2017,15:99-100.
2陈彩霞,李国芸,赵孟君,等.稽留流产病因分析及临床意义.中国误诊学杂志,2005,5:1629-1630.
3 Jukovic D,Overton C,Bender-Atik R.Diagnosis and management of first trimester miscarriage.BMJ,2013,346:f3676.
4 Lurie S,Feinstein M,Mamet Y,Disseminated intravascular coagulopathy in pregnancy:thorough comprehension of etiology and management reduces obstetricians’stress.Arch Gynecol Obstet,2000,263:126-130.
5张华坤,罗福微,耿茜.252例稽留流产者绒毛细胞遗传学分析与环境因素探讨.中华医学遗传学杂志,2011,28:575-589.
6冯春翠.中西医结合治疗稽留流产临床研究.中医学报,2015,7:1030-1031.
7 Salamanca A,Fernandez-Salmeron P,Beltran E,et al.Early em-bryonic morphology sonographically assessed andits correlation with yolk sacin missed abortion.Archives of gynecology and obstetrics,2013,287:245-246.
8傅山主编.傅青主女科.第1版.上海:上海科学技术出版社,1991.79.
9王彩霞,李大剑.中西医治疗稽留流产研究概况.中医药临床杂志,2016,28:1483-1485.
10乐杰主编.妇产科学.第7版.北京:人民卫生出版社,2008.83-86.
11韩学杰,刘孟宇,连智华,等.中医内科常见病诊疗指南临床应用评价研究.中国中药杂志,2017,42:3233-3237.
12罗丽丽.戊酸雌二醇配伍抗早孕药物在稽留流产中的应用价值.中国现代药物应用,2015,9:28-29.
13白力伟,陈秀媛.中西医结合治疗稽留流产30例.河北中医,1996,18:46.
14康美花,田春芳.稽留流产发病因素的研究进展与分析.医学综述,2011,17:1006-2084.
15文云霞,祁连芳,姜改丽.稽留流产的原因分析以及早期诊断.中国性科学,2015,24:66-69.
16顾华芬,衣欢,赵海红,等.1945例稽留流产的流行病学及高危因素分析.生殖与避孕,2016,36:195-200.
17杜晶,张兆奉,徐建华.遗传及相关因素与稽留流产关系的研究进展.生殖与避孕,2013,33:552-556.
18韩晶秀,曹兆进,刘欣燕,等.怀孕早期电磁辐射暴露对胚胎停育影响研究.卫生研究,2010,39:349-352.
19张雪茹.中医辩证治疗利凡诺引产致胎死不下13例.陕西中医,2005,26:408-409.
20王月华,杨军平,骆雨.中医治疗引产失败后胎死不下临床分析.中国医学理论与实践,2005,15:1087-1088.
21潘丽贞,王英.稽留流产30例中西医结合干预治疗结果观察.福建医药杂志,2009,31:139-140.
22李燕.联用米非司酮、米索前列醇与雌激素治疗稽留流产的效果研究.当代医药论丛,2017,15:99-100.