本文選題：復(fù)發(fā)性流產(chǎn)　切入點(diǎn)：腎虛　出處：《南京中醫(yī)藥大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過觀察安子合劑治療腎虛型復(fù)發(fā)性流產(chǎn)患者治療前后臨床癥狀、血清妊娠激素、B超胚胎發(fā)育等情況,探討安子合劑治療腎虛型復(fù)發(fā)性流產(chǎn)的臨床療效,并通過檢測(cè)治療前后血清白細(xì)胞介素-6(IL-6)水平探討其安胎機(jī)理。 方法：臨床收集腎虛型復(fù)發(fā)性流產(chǎn)患者60例,隨機(jī)分為2組：治療組30例,給予安子合劑口服,加肌注黃體酮注射液和／或絨毛膜促性腺激素；對(duì)照組30例,肌注黃體酮注射液和／或絨毛膜促性腺激素。5周為一療程。觀察2組患者治療前后臨床癥候積分、血清妊娠激素(E2、P、β-HCG)水平、IL-6濃度及B超胚胎發(fā)育情況。 結(jié)果： ①癥候積分 兩組治療前后各癥候積分比較,數(shù)值明顯小于治療前,有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組組間比較發(fā)現(xiàn),治療后兩組的癥狀總積分亦有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組中醫(yī)癥狀改善的總有效率90.00%；對(duì)照組為76.67%,治療組顯著優(yōu)于對(duì)照組(P0.05)。 ②血清妊娠激素 兩組治療后血清E2、P、β-HCG水平均較治療前提高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；且激素水平均隨孕周的增加而增長,通過折線圖即可以看出治療組上升水平優(yōu)于對(duì)照組。 ③血清IL-6的濃度 兩組治療后血清IL-6濃度均上升,治療前后比較,有統(tǒng)計(jì)學(xué)意義(P0.05)；兩組組間比較,差異亦具顯著性(P0.05)。 ④B超監(jiān)測(cè)胚胎發(fā)育 治療組B超成形27例,胚停3例,保胎成功率為90.00%；對(duì)照組B超成形23例,胚停7例,保胎成功率為76.67%,兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 ⑤綜合療效 治療組總有效率90.00%；對(duì)照組總有效率76.67%。兩組總有效率比較,治療組明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：安子合劑治療腎虛型復(fù)發(fā)性流產(chǎn)臨床療效確切,能明顯改善患者小腹墜痛、腰骶酸痛、陰道流血等臨床癥狀,提高血清E2、P、β-HCG、IL-6水平,促進(jìn)孕囊及胚胎的發(fā)育,其安胎的成功率達(dá)90.0%。其安胎機(jī)理一方面與改善RSA患者黃體功能,調(diào)節(jié)卵巢內(nèi)分泌功能有關(guān)；另一方面亦可能與升高患者體內(nèi)IL-6含量,平衡Thl/Th2比例,調(diào)節(jié)機(jī)體自身免疫反應(yīng)有關(guān)。
[Abstract]:Objective: to investigate the clinical effect of Anzi mixture on the treatment of recurrent abortion of kidney deficiency type by observing the clinical symptoms, serum pregnancy hormone and embryo development of B-ultrasound before and after treatment, and to explore the clinical efficacy of Anzi mixture in the treatment of recurrent abortion of kidney deficiency type. The level of serum interleukin-6 (IL-6) was measured before and after treatment. Methods: sixty patients with recurrent abortion of kidney deficiency type were randomly divided into two groups: treatment group (n = 30), treated group (n = 30) and control group (n = 30), treated by oral administration of Anzi mixture and intramuscular injection of progesterone injection and / or chorionic gonadotropin (chorionic gonadotropin). Progesterone injection and / or chorionic gonadotropin were injected intramuscularly as a course of treatment. The clinical symptom scores, serum pregnancy hormone E2P, 尾 -HCG levels, and B ultrasound embryo development were observed in two groups before and after treatment. Results:. 1 symptom integral. The scores of symptoms before and after treatment in the two groups were significantly lower than those before treatment (P 0.05). The total score of symptoms in the two groups was also statistically significant after treatment. The total effective rate of TCM symptom improvement in the treatment group was 90.00.The control group was 76.677.The treatment group was significantly better than the control group (P 0.05). 2Serum pregnancy hormone. After treatment, the serum levels of E2P and 尾 -HCG in the two groups were higher than those before treatment, the difference was statistically significant (P 0.05), and the levels of hormones increased with the increase of gestational week, and the increase level of the treatment group was better than that of the control group. 3 concentration of serum IL-6. The serum IL-6 level increased after treatment in both groups, and there was a significant difference between the two groups before and after treatment (P 0.05), and the difference between the two groups was also significant (P 0.05). 4B Super-monitoring of embryonic Development. In the treatment group, there were 27 cases of B-ultrasound shading, 3 cases of embryo stopping, the success rate of fetal preservation was 90.000.In the control group, 23 cases of B-mode ultrasonography and 7 cases of embryo arrest, the success rate of fetal preservation was 76.67%. The difference between the two groups was statistically significant (P 0.05). 5. Comprehensive curative effect. The total effective rate of the treatment group was 90.00g and the total effective rate of the control group was 76.677.The total effective rate of the treatment group was significantly higher than that of the control group, and the difference was statistically significant (P 0.05). Conclusion: Anzi mixture is effective in the treatment of recurrent abortion of kidney deficiency type. It can obviously improve the clinical symptoms such as lower abdominal pain, lumbosacral pain, vaginal bleeding and so on, increase the serum levels of E2P, 尾 -HCG, IL-6, and promote the development of pregnancy sac and embryo. The mechanism is related to the improvement of luteal function and the regulation of ovarian endocrine function in patients with RSA. On the other hand, it may be related to increasing the content of IL-6, balancing the proportion of Thl/Th2 and regulating the autoimmune response of the body.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.21

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