本文關(guān)鍵詞： 先兆流產(chǎn) 脾腎兩虛型 中西醫(yī)結(jié)合治療　出處：《云南中醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:固化、總結(jié)國家級名老中醫(yī)張良英教授經(jīng)驗方“保胎飲”結(jié)合黃體酮的治療效果,為臨床治療輔助生殖技術(shù)后先兆流產(chǎn)提供一種療效好、易于推廣應(yīng)用的方法。方法:搜集60例輔助生殖技術(shù)后先兆流產(chǎn)脾腎兩虛型患者,隨機分為兩組,每組30例。治療組口服國家級名老中醫(yī)張良英經(jīng)驗方“保胎飲”,每日一劑,一天三次,配合黃體酮注射液肌注;對照組單獨給予肌肉注射黃體酮注射液,連續(xù)治療4個療程。治療前、后進行觀察,觀察的主要療效指標(biāo)為:主要證候:陰道出血時間、出血量、出血色質(zhì)以及小腹墜等;全身證候:腰酸脹痛,兩膝酸軟,頭暈耳鳴,夜尿頻多,神疲乏力,少氣懶言等;性激素指標(biāo)改善情況:雌激素(E2)、孕激素(P)水平、人絨毛膜促性腺激素(β-HCG)的變化。結(jié)果:兩組治療前、后自身對照,總證候積分、主要證候積分、全身證候積分、孕激素值相比,P0.01,差異顯著,具有統(tǒng)計學(xué)意義;治療組總療效為90%,對照組總療效為86.67%。各檢查指標(biāo):E2、P、β-HCG水平,較治療前改善明顯;具有統(tǒng)計學(xué)意義。兩組治療后組間對照,總療效及全身證候積分比較P0.05,兩組無明顯差異;主要證候積分:P0.01,治療組優(yōu)于對照組。治療后兩組主要證候積分比較,P0.05,差異顯著;治療后兩組全身證候積分,P0.05,無統(tǒng)計學(xué)意義;各檢查指標(biāo):β-HCG、P水平,P0.05,無統(tǒng)計學(xué)意義;E2水平改善情況治療組明顯高于對照組。觀察中治療組有1例患者用藥初期觀察到腹脹,便質(zhì)稀等輕微胃腸反應(yīng),持續(xù)3天后癥狀緩解;對照組未觀察到不良反應(yīng)。結(jié)論:國家級名老中醫(yī)張良英教授驗方“保胎飲”聯(lián)合黃體酮肌注治療輔助生殖技術(shù)后先兆流產(chǎn)有肯定的療效,其總療效與單純使用黃體酮組相當(dāng);治療組可改善輔助生殖技術(shù)后先兆流產(chǎn)患者的脾腎兩虛的全身證候,特別是在改善腰酸脹痛、頭暈耳鳴、少氣懶言方面,療效顯著;治療組可明顯改善輔助生殖技術(shù)后先兆流產(chǎn)患者的主要證候,如縮短陰道流血時間,改善小腹痛或墜方面療效顯著;治療組可顯著提升HCG、E2、P水平。國家級名老中醫(yī)張良英教授驗方“保胎飲”聯(lián)合黃體酮肌注治療輔助生殖技術(shù)后先兆流產(chǎn)安全可靠,是一種值得臨床推廣的有效治療方法。
[Abstract]:Objective: to solidify and summarize the therapeutic effect of "Baotai Yin" combined with progesterone, Professor Zhang Liangying, professor of national famous Chinese medicine, in order to provide a good therapeutic effect for threatened abortion after clinical treatment of assisted reproductive technology. Methods: 60 cases of threatened abortion with deficiency of spleen and kidney after assisted reproductive technique were randomly divided into two groups, 30 cases in each group. Three times a day, combined with intramuscular injection of progesterone injection, while the control group was given intramuscular injection of progesterone injection for 4 consecutive courses of treatment. Before and after treatment, the main therapeutic effects were observed as follows: main syndromes: vaginal bleeding time, Blood loss, hemochromator, lower abdomen drop, etc.; systemic syndrome: pain in the waist, sore knees, dizziness and tinnitus, frequent urination at night, fatigue, lack of breath, and so on; improvement of sex hormone indexes: estrogen, E2P, progesterone (P), etc. Changes of human chorionic gonadotropin (尾 -HCG). Results: before and after treatment, the total syndromes integral, main syndromes integral, systemic syndrome score and progesterone value were significantly different between the two groups (P 0.01). The total curative effect of the treatment group was 90 and the total curative effect of the control group was 86.67.The levels of 尾 -HCG and 尾 -HCG were significantly improved compared with those before treatment. There was no significant difference between the two groups in the total curative effect and the integral score of systemic syndrome after treatment (P 0.05). The main syndromes score P0.01 was better in the treatment group than in the control group. After treatment, there was a significant difference in the main syndrome score between the two groups, but there was no significant difference between the two groups in the whole body syndrome score (P0.05) after treatment. The level of 尾 -HCGN P was 0.05, and the improvement of E2 level in the treatment group was significantly higher than that in the control group. In the treatment group, there was a slight gastrointestinal reaction, such as abdominal distension and dilute feces, which were observed at the beginning of the treatment period, and the symptoms were relieved after 3 days. Conclusion: "Baotai Yin" combined with progesterone intramuscular injection has positive curative effect on threatened abortion after assisted reproductive technique, and the total curative effect is equal to that of only using progesterone group. The treatment group can improve the syndrome of deficiency of spleen and kidney in the patients with threatened abortion after assisted reproductive technology, especially in improving the pain of waist and acid, dizziness and tinnitus, less breath and lazy speech, the curative effect is remarkable. The treatment group can obviously improve the main syndromes of the patients with threatened abortion after assisted reproductive technology, such as shortening the time of vaginal bleeding and improving the effect of abdominal pain or falling. The treatment group can significantly improve the level of HCGN E2P. Professor Zhang Liangying, a national famous Chinese medicine, is a safe and reliable method for the treatment of threatened abortion after assisted reproductive technology by combining Baofeiyin with progesterone, which is an effective treatment method worthy of clinical popularization.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.21

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