何氏益气养血束胞饮调节脾肾气虚型胎盘前置状态的疗效

田蕾; 黄月颖; 桑晓庆; 陈忠菊

doi:10.16766/j.cnki.issn.1674-4152.003594

何氏益气养血束胞饮调节脾肾气虚型胎盘前置状态的疗效

doi: 10.16766/j.cnki.issn.1674-4152.003594

宁波大学附属妇女儿童医院中医科，浙江宁波 315000

基金项目:

浙江省中医药科技计划青年人才基金项目 2021ZQ081

宁波市卫生健康青年技术骨干人才培养专项项目甬卫发[2021]106号

浙江省中医药传承与创新“十百千”人才工程(杏林工程)项目浙中医药〔2022〕7号

详细信息

通讯作者:
黄月颖，E-mail：34234119@qq.com

中图分类号: R714.56 R242
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出版历程
- 收稿日期: 2023-12-05
- 网络出版日期: 2024-09-05

Observation on the efficacy of He's Yiqi Yangxue Decoction in regulating the placenta previa state of spleen and kidney qi deficiency

Department of Traditional Chinese Medicine, Women and Children ' s Hospital Affiliated to Ningbo University, Ningbo, Zhejiang 315000, China

摘要

摘要: 目的探讨何氏益气养血束胞饮不同使用方法对脾肾气虚型胎盘前置状态的临床疗效。方法收集2020年1月—2022年12月在宁波市妇女儿童医院中医科就诊的脾肾气虚型胎盘前置状态患者90例，按随机数字表法分为治疗组A、治疗组B、对照组，每组30例。对照组予期待疗法，治疗组A予何氏益气养血束胞饮内服，治疗组B予何氏益气养血束胞饮联合穴位贴敷治疗。比较3组患者的综合疗效、中医证候评分、28周时胎盘位置情况与妊娠、新生儿结局。结果 (1) 综合疗效：治疗1个疗程后, 治疗组B总有效率为86.67%(26/30)，与治疗组A(53.33%，16/30)和对照组(36.67%，11/30)比较，差异有统计学意义(P＜0.017)；治疗2个疗程后, 治疗组B总有效率为96.67%(29/30)，治疗组A为93.33%(28/30)，2组比较差异无统计学意义(P>0.017)。(2)中医症候积分：治疗2个疗程后，治疗组A和治疗组B中医症候积分均低于对照组(P＜0.01)。(3)28周胎盘位置情况：治疗组A和治疗组B有效率均为96.67%(29/30)，与对照组(66.67%，20/30)比较，差异有统计学意义(P＜0.017)。(4)妊娠与新生儿结局：治疗组A和治疗组B产后24 h出血量低于对照组，新生儿体质量、新生儿1 min Apgar评分均高于对照组(P＜0.05)。结论何氏益气养血束胞饮可有效改善脾肾气虚型孕妇的胎盘前置状态，提升胎盘位置，改善临床症状，改善妊娠结局与新生儿结局，且联合穴位贴敷疗效更优，并能加快治疗进程，值得临床推广应用。
- 胎盘前置状态 /
- 何氏益气养血束胞饮 /
- 脾肾气虚 /
- 穴位贴敷
Abstract: Objective To explore the clinical effects of different methods using He's Yiqi Yangxue Decoction on placenta previa in spleen and kidney qi deficiency. Methods A total of 90 patients diagnosed with placenta previa due to spleen and kidney qi deficiency in Department of Traditional Chinese Medicine, Ningbo Women and Children ' s Hospital from January 2020 and December 2022. These patients were randomly assigned into three distinct groups: treatment group A, treatment group B, and a control group, each containing 30 individuals. Those in the control group received conservative management therapy. The treatment group A was given He's Yiqi Yangxue Decoction. On the basis of treatment group A, acupoint application was applied to treatment group B. The comprehensive curative effect, TCM symptom score, placental position at 28 weeks, pregnancy and neonatal outcomes were observed in the three groups. Results (1) Comprehensive curative effect: After completing one period of treatment, the number of treatment group B was 86.67% (26/30) in terms of cure rate, which was statistically significant compared with 53.33% (16/30) of treatment group A and 36.67% (11/30) of control group (P < 0.017). After two treatment cycles, the total effective rate was 96.67% (29/30) in treatment group B and 93.33% (28/30) in treatment group A, and none distinction in statistics was between them (P>0.017). (2) TCM symptom score: After two treatment cycles, among treatment group A, treatment group B and control group, the distinction in statistics was significative (P < 0.01). (3) The effective rate of treatment group A and treatment group B was 96.67% (29/30), compared with the control group [66.67% (20/30)], the distinction in statistics was significative (P < 0.017). (4) Regarding pregnancy and neonatal outcomes: Pregnant women ' s postpartum hemorrhage in 24 hours who were assigned to these two treatment groups were both less than those who were assigned to the control group, and their neonatal body mass and neonatal 1min Apgar score were exceed than those who were assigned to the control group (P < 0.05). Conclusion He's Yiqi Yangxue Decoction can effectively improve the placental previa, improve the position of the placenta, treat clinical symptoms, and improve pregnancy outcomes and neonatal outcomes in pregnant women with spleen and kidney qi deficiency.
- Placenta previa /
- He's Yiqi Yangxue Decoction /
- Spleen and kidney qi deficiency /
- Acupoint application

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表 1 3组脾肾气虚型胎盘前置状态患者一般资料比较[M(P₂₅, P₇₅)]

Table 1. Comparison of general data for patiens with placental previa and spleen-kidney qi deficiency across three groups [M(P₂₅, P₇₅)]

组别	例数	年龄(岁)	孕周(周)	流刮次数(次)	剖宫产次数(次)	病程(d)
治疗组A	30	30.50(27.00, 34.00)	15.50(14.75, 17.00)	0(0, 1.00)	0(0, 0)	8.50(7.00, 15.00)
治疗组B	30	29.50(27.00, 33.50)	16.00(14.00, 18.00)	0(0, 0.25)	0(0, 0)	8.50(7.00, 15.25)
对照组	30	31.00(26.75, 33.25)	15.00(14.00, 17.00)	0(0, 0)	0(0, 0)	7.50(6.00, 15.25)
H值		0.723	1.524	0.658	0.692	0.591
P值		0.697	0.467	0.720	0.707	0.744

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表 2 3组脾肾气虚型胎盘前置状态患者治疗前后中医证候评分比较[M(P₂₅, P₇₅), 分]

Table 2. Comparison of TCM symptom scores before and after treatment among three groups of patients with placental previa and spleen-kidney qi deficiency[M(P₂₅, P₇₅), points]

组别	例数	治疗前	治疗1个疗程	治疗2个疗程
治疗组A	30	24.00(17.75, 32.00)	10.00(5.75, 15.50)	1.00(1.00, 6.00)^a
治疗组B	30	26.00(18.50, 29.75)	1.00(1.00, 9.00)^ab	0.00(1.00, 1.00)^a
对照组	30	26.00(17.75, 32.00)	12.50(8.00, 26.25)	6.50(2.75, 23.25)
注：与对照组比较，^aP＜0.01；与治疗组A比较，^bP＜0.05。

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表 3 3组脾肾气虚型胎盘前置状态患者治疗后综合疗效比较

Table 3. Comparison of comprehensive curative effect of three groups in patients with placental previa and spleen-kidney qi deficiency

组别	例数	治疗1个疗程					治疗2个疗程
组别	例数	治愈[例(%)]	显效[例(%)]	有效[例(%)]	无效[例(%)]	总有效率(%)	治愈[例(%)]	显效[例(%)]	有效[例(%)]	无效[例(%)]	总有效率(%)
治疗组A	30	3(10.00)	9(30.00)	4(13.33)	14(46.67)	53.33	17(56.67)^a	7(23.33)	4(13.33)	2(6.67)	93.33^a
治疗组B	30	16(53.34)^ab	7(23.33)	3(10.00)	4(13.33)	86.67^ab	26(86.67)^a	2(6.67)	1(3.33)	1(3.33)	96.67^a
对照组	30	1(3.34)	4(13.33)	6(20.00)	19(63.33)	36.67	4(13.33)	8(26.67)	5(16.67)	13(43.33)	56.67
统计量			22.993^c			16.063^d		34.792^c			20.220^d
P值			＜0.001			＜0.001		＜0.001			＜0.001
注：与对照组比较，^aP＜0.017；与治疗组A比较，^bP＜0.017。^c为H值，^d为χ²值。

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表 4 3组脾肾气虚型胎盘前置状态患者治疗后28周时胎盘位置变化情况比较

Table 4. Changes in placental position among three groups of patients with placental previa and spleen-kidney qi deficiency at 28 weeks post-treatment

组别	例数	痊愈[例(%)]	有效[例(%)]	无效[例(%)]	有效率(%)
治疗组A	30	16(53.34)	13(43.33)	1(3.33)	96.67^b
治疗组B	30	25(83.34)	4(13.33)	1(3.33)	96.67^b
对照组	30	6(20.00)	14(46.67)	10(33.33)	66.67
统计量			3.084^a		13.383^c
P值			0.002		0.001
注：与对照组比较，^bP＜0.017。^a为H值，^c为χ²值。

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表 5 3组脾肾气虚型胎盘前置状态患者治疗后妊娠与新生儿结局比较

Table 5. Comparison of pregnancy and newborn outcomes among three groups of patients with placental previa and spleen-kidney qi deficiency post-treatment

组别	例数	产后24 h出血量[M(P₂₅, P₇₅), mL]	分娩时孕周[M(P₂₅, P₇₅), 周]	新生儿体质量(x±s, kg)	新生儿1 min Apgar评分[M(P₂₅, P₇₅), 分]
治疗组A	30	500(500, 600)^a	38(37, 39)	3.28±0.19^a	9(9, 10)^a
治疗组B	30	500(500, 600)^a	38(37, 39)	3.31±0.21^a	9(9, 10)^a
对照组	30	600(500, 800)	37(35, 38)	3.12±0.21	9(8, 9)
统计量		12.328^b	4.580^b	7.192^c	10.289^b
P值		0.002	0.101	0.001	0.006
注：与对照组比较，^aP＜0.05。^b为H值，^c为F值。

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