益肾祛瘀方辅助西药治疗先兆流产伴宫腔积血的疗效及对超声指标的影响

钱艳清; 孙云

doi:10.16766/j.cnki.issn.1674-4152.002505

益肾祛瘀方辅助西药治疗先兆流产伴宫腔积血的疗效及对超声指标的影响

doi: 10.16766/j.cnki.issn.1674-4152.002505

钱艳清^,,
孙云

温州市中医院妇科，浙江温州 325000

基金项目:

浙江省中医药科技计划项目 2019ZB121

详细信息

通讯作者:
钱艳清, E-mail: qyf18257619270@163.com

中图分类号: R714.21 R289.53
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- 被引次数: 0
出版历程
- 收稿日期: 2021-11-30
- 网络出版日期: 2022-09-21

Effect of Yishen Quyu Decoction combined with Western medicine in the treatment of threatened abortion with uterine haematocele and its influence on ultrasound indexes

QIAN Yan-qing^,,
SUN Yun

Department of Gynecology, Wenzhou Traditional Chinese Medicine Hospital, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的研究益肾祛瘀方治疗先兆流产伴宫腔积血的疗效, 为临床治疗提供依据。方法选择2019年1月-2020年6月在温州市中医院治疗的先兆流产伴宫腔积血患者126例, 采用随机数表法分为西医组(63例)和联合组(63例)。西医组患者给予低分子肝素联合地屈孕酮治疗, 联合组患者加用益肾祛瘀方治疗。比较2组患者的中医证候积分、超声指标、妊娠结局、性激素、糖类抗原125及炎性因子水平。结果治疗后2组患者的主症积分和次症积分均明显下降, 联合组低于西医组(均P < 0.05)。治疗后2组患者的超声指标均明显改善, 联合组患者的子宫螺旋动脉舒张末期血流速度和收缩期峰值血流速度水平高于西医组, 阻力指数低于西医组(均P < 0.05)。治疗后2组患者的血清性激素和糖类抗原125水平均明显改善, 联合组患者的孕酮、雌二醇和人绒毛膜促性腺激素水平高于西医组, 糖类抗原125水平低于西医组(均P < 0.05)。治疗后2组患者的炎性因子水平均明显改善, 联合组患者白细胞介素-4、白细胞介素-10、干扰素-γ和白细胞介素-2水平低于西医组(均P < 0.05)。联合组保胎成功率为93.65%, 西医组仅为80.95%(P < 0.05)。结论益肾祛瘀方辅助西药治疗可以明显改善先兆流产伴宫腔积血患者的临床症状, 调节血清性激素和Th1/Th2细胞因子水平, 改善子宫动脉供血, 降低糖类抗原125水平, 保胎成功率更高。
- 益肾祛瘀方 /
- 先兆流产 /
- 宫腔积血 /
- 超声指标 /
- 炎性因子
Abstract: Objective To study the effect of Yishen Quyu Decoction on threatened abortion with uterine haematocele, so as to provide basis for clinical treatment. Methods From January 2019 to June 2020, 126 patients with threatened abortion and intrauterine haematocele admitted in Wenzhou Traditional Chinese Medicine Hospital were selected and randomly divided into the Western medicine group (63 cases) and combined group (63 cases).The Western medicine group was treated with low-molecular-weight heparin combined with didroxyprogesterone, and the combined group was treated with Yishen Quyu Decoction and Western medicine.The traditional Chinese medicine (TCM) syndrome score, ultrasound index, pregnancy outcome, sex hormone, carbohydrate antigen 125(CA125) and inflammatory factor levels of the two groups were compared. Results After treatment, the main symptom and secondary symptom scores of the two groups were significantly decreased, and the scores of the combined group were lower than those of the Western medicine group (all P < 0.05).After treatment, the ultrasound indexes of the two groups were significantly improved.The end diastolic blood flow velocity (EDV) and peak systolic blood flow velocity (PSV) levels of the combined group were higher than those of the Western medicine group, and resistance index (RI) was lower than that of the Western Medicine group (all P < 0.05).After treatment, the levels of serum sex hormone and CA125 in the two groups were significantly improved.The levels of progesterone (P), estradiol (E₂) and human chorionic gonadotropin (HCG) in the combined group were significantly higher than those in the control group, and the CA125 level in the combined group was lower than that in Western medicine group (all P < 0.05).After treatment, the levels of inflammatory factors in both groups were significantly improved.The levels of IL-4, IL-10, INF-γ and IL-2 in the combined group were lower than those in the Western medicine group (all P < 0.05).The success rate of foetus preservation in the combined group was 93.65%, which was only 80.95% in the Western medicine group (P < 0.05). Conclusion Yishen Quyu Decoction combined with Western medicine can significantly improve the clinical symptoms of threatened abortion patients with uterine haematocele, regulate the levels of serum sex hormones and Th1/Th2 cytokines, improve the blood supply of the uterine artery and reduce the CA125 level, and has a higher success rate of foetal protection.
- Yishen Quyu Decoction /
- Threatened abortion /
- Uterine haematocele /
- Ultrasonic index /
- Inflammatory factors

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表 1 2组先兆流产伴宫腔积血患者基线资料比较(x ±s)

Table 1. Comparison of baseline data between two groups of patients with threatened abortion and intrauterine hemorrhage(x ±s)

组别	例数	年龄(岁)	孕周(周)	出血时间(d)
西医组	63	28.94±4.16	8.26±1.49	3.82±0.58
联合组	63	29.15±4.09	8.34±1.42	4.01±0.53
t值		0.286	0.309	1.919
P值		0.775	0.758	0.063

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表 2 2组先兆流产伴宫腔积血患者中医证候积分比较(x ±s，分)

Table 2. Comparison of TCM syndrome scores between two groups of patients with threatened abortion and intrauterine hemorrhage (x ±s, points)

组别	例数	主症积分		次症积分
组别	例数	治疗前	治疗后	治疗前	治疗后
西医组	63	19.58±2.13	8.37±1.62^a	10.53±1.94	4.61±0.83^a
联合组	63	19.36±2.19	5.82±1.04^a	10.62±1.89	2.27±0.38^a
t值		0.572	10.514	0.264	20.346
P值		0.568	< 0.001	0.792	< 0.001
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组先兆流产伴宫腔积血患者超声指标比较(x ±s)

Table 3. Comparison of ultrasound indicators between two groups of patients with threatened abortion and intrauterine hemorrhage (x ±s)

组别	例数	EDV(cm/s)		PSV(cm/s)		RI
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
西医组	63	10.94±1.63	13.16±2.14^a	21.47±3.72	24.86±4.95^a	0.76±0.15	0.53±0.11^a
联合组	63	10.87±1.59	15.96±3.38^a	21.54±3.63	28.16±6.39^a	0.79±0.13	0.35±0.08^a
t值		0.244	5.555	0.107	3.241	1.200	10.504
P值		0.808	< 0.001	0.915	< 0.001	0.516	< 0.001
注：与同组治疗前比较，^aP＜0.05。

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表 4 2组先兆流产伴宫腔积血患者血清性激素和CA125水平比较(x ±s)

Table 4. Comparison of serum sex hormone and CA125 levels between two groups of patients with threatened abortion and intrauterine hemorrhage (x ±s)

组别	例数	P(nmol/L)		E₂(pmol/L)		HCG(mIU/mL)		CA125(U/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
西医组	63	50.15±7.14	97.26±13.95^a	2 285.37±315.94	7 427.25±528.76^a	8 429.47±264.91	149 376.15±1 538.73^a	49.62±9.37	34.17±7.59^a
联合组	63	48.93±7.05	131.58±18.61^a	2 307.16±309.27	8 614.28±753.49^a	8 395.46±275.82	195 738.42±2 016.39^a	50.02±9.45	25.13±4.82^a
t值		0.965	11.712	0.391	10.235	0.706	145.081	0.239	7.980
P值		0.335	< 0.001	0.696	< 0.001	0.481	< 0.001	0.812	< 0.001
注：与同组治疗前比较，^aP＜0.05。

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表 5 2组先兆流产伴宫腔积血患者炎性因子水平比较(x ±s，pg/mL)

Table 5. Comparison of inflammatory factors between two groups of patients with threatened abortion and intrauterine hemorrhage (x±s, pg/mL)

组别	例数	INF-γ		IL-2		IL-4		IL-10
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
西医组	63	38.49±6.85	27.27±4.37^a	7.38±1.74	5.37±1.06^a	6.98±1.46	4.53±0.94^a	8.51±1.87	6.43±1.39^a
联合组	63	38.16±7.05	15.28±2.52^a	7.32±1.71	3.16±0.75^a	7.05±1.42	2.76±0.51^a	8.46±1.91	3.72±0.87^a
t值		0.267	18.866	0.195	13.509	0.273	13.137	0.149	13.117
P值		0.790	< 0.001	0.845	< 0.001	0.785	< 0.001	0.882	< 0.001
注：与同组治疗前比较，^aP＜0.05。

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表 6 2组先兆流产伴宫腔积血患者妊娠结局比较[例(%)]

Table 6. Comparison of pregnancy outcomes between two groups of patients with threatened abortion and intrauterine hemorrhage [cases (%)]

组别	例数	足月妊娠	早产	流产	保胎成功
西医组	63	37(58.73)	14(22.22)	12(19.05)	51(80.95)
联合组	63	48(76.19)	11(17.46)	4(6.35)	59(93.65)
注：2组患者保胎成功率比较，χ²=5.582，P=0.032。

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