本文選題：未足月胎膜早破　切入點(diǎn)：易黃湯加減　出處：《山西中醫(yī)學(xué)院》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探求易黃湯加減聯(lián)合抗生素對(duì)妊娠期生殖道感染進(jìn)行預(yù)防的效果,及其針對(duì)濕熱型未足月胎膜早破預(yù)防感染的療效。為臨床中預(yù)防治療胎膜早破提供經(jīng)驗(yàn),進(jìn)一步做好圍產(chǎn)期保健,提高妊娠質(zhì)量,促進(jìn)母兒健康。方法:收集年齡在19歲~40歲孕周為28W~34W的在我院治療的中醫(yī)辨證均屬濕熱型的未足月胎膜早破患者60例,隨機(jī)分成對(duì)照組和治療組,均予患者絕對(duì)臥床休息,抬高臀部并保持外陰清潔,抑制宮縮,促胎肺成熟,補(bǔ)充微量元素。對(duì)照組A組為抗生素(選用注射用頭孢呋辛鈉),治療組B組為易黃湯加減聯(lián)合抗生素,通過對(duì)治療后患者的體溫、母嬰心率、白細(xì)胞計(jì)數(shù)、血壓、外陰瘙癢、口苦口膩、胸悶納呆等癥狀統(tǒng)計(jì)分析,觀察易黃湯加減聯(lián)合抗生素的治療效果。結(jié)果:1.對(duì)照組、治療組預(yù)防感染的有效率分別為93.33%和96.55%,經(jīng)卡方檢驗(yàn)分析,兩組在預(yù)防感染方面無統(tǒng)計(jì)學(xué)差異(P0.05)。在用藥24小時(shí)、36小時(shí)、48小時(shí)、60小時(shí)、72小時(shí)后,兩組心率、血壓、體溫、胎心率比較無明顯差異(P0.05),與入院時(shí)心率、血壓、體溫、胎心率相比無統(tǒng)計(jì)學(xué)差異(P0.05)。以上結(jié)果說明,易黃湯加減聯(lián)合抗生素在對(duì)PPROM預(yù)防感染的應(yīng)用上療效與單純使用抗生素相當(dāng)。2.兩組用藥24小時(shí)后,對(duì)照組白細(xì)胞數(shù)值降低,與入院時(shí)白細(xì)胞數(shù)值相比無統(tǒng)計(jì)學(xué)意義(P0.05);治療組白細(xì)胞數(shù)值降低,與入院時(shí)白細(xì)胞數(shù)值相比有統(tǒng)計(jì)學(xué)意義((P0.05);兩組間比較,對(duì)照組、治療組白細(xì)胞數(shù)值有統(tǒng)計(jì)學(xué)差異(P0.05)。用藥48小時(shí)、72小時(shí)后,兩組間比較,對(duì)照組、治療組白細(xì)胞數(shù)值無統(tǒng)計(jì)學(xué)差異(P0.05),與入院時(shí)白細(xì)胞數(shù)值相比有統(tǒng)計(jì)學(xué)差異(P0.05)。以上結(jié)果說明,易黃湯加減聯(lián)合抗生素在降低PPROM發(fā)生感染的風(fēng)險(xiǎn)性的時(shí)間上,較單純應(yīng)用抗生素具有一定優(yōu)勢(shì)。3.對(duì)照組、治療組的中醫(yī)證候有效率分別為83.33%和96.55%,經(jīng)卡方檢驗(yàn)分析,兩組在中醫(yī)癥候療效方面有統(tǒng)計(jì)學(xué)差異(P0.05),治療后治療組中的中醫(yī)證候積分與對(duì)照組比較有明顯差異(P0.05),說明易黃湯加減聯(lián)合抗生素在對(duì)PPROM自身癥狀的改善較單純應(yīng)用抗生素,有一定療效。結(jié)論:本課題通過對(duì)60例中醫(yī)辨證屬濕熱型未足月胎膜早破患者隨機(jī)分為兩組治療后的療效觀察,易黃湯加減方聯(lián)合抗生素在對(duì)PPROM預(yù)防感染的應(yīng)用上療效與單純使用抗生素相當(dāng),但在降低PPROM發(fā)生感染的風(fēng)險(xiǎn)性的時(shí)間上較單純應(yīng)用抗生素具有一定優(yōu)勢(shì)。在用藥過程中,易黃湯加減方聯(lián)合抗生素與單純使用抗生素相比較,對(duì)外陰瘙癢、胸悶納差、口苦口粘等癥狀方面具有明顯改善作用。單純應(yīng)用抗生素是目前臨床上對(duì)妊娠期患者預(yù)防感染采取的主要治療方式,易黃湯加減方聯(lián)合抗生素在對(duì)PPROM患者的治療上,不僅能有效的預(yù)防感染以達(dá)到延長(zhǎng)孕齡促進(jìn)胎兒進(jìn)一步成熟的效果,還可以消除患者身體上其他方面的不適癥狀。
[Abstract]:Objective to explore the effect of Yihuang decoction combined with antibiotics on the prevention of pregnancy genital tract infection, and the effect of preventing infection with premature rupture of unmatured membranes of damp and heat type, so as to provide experience for clinical prevention and treatment of premature rupture of membranes. Further better perinatal health care, improve the quality of pregnancy, and promote maternal and infant health. Methods: 60 cases of premature rupture of unmatured membranes, which were treated in our hospital at the age of 19 years and 40 years old and gestational weeks of 28 W / 34 W, were all damp-heat type. They were randomly divided into control group and treatment group. The patients were given absolute bed rest, raised buttocks and kept vulva clean, inhibited uterine contraction, and promoted fetal lung maturation. Supplementation of trace elements. Control group A for antibiotics (selected for injection of cefuroxime sodium, treatment group B for Yi Huang decoction combined with antibiotics, through the treatment of patients' body temperature, maternal and child heart rate, white blood cell count, blood pressure, pruritus vulva, To observe the therapeutic effect of Yihuang decoction combined with antibiotics. Results: in control group, the effective rates of preventing infection in treatment group were 93.33% and 96.55, respectively. There was no significant difference in the prevention of infection between the two groups (P 0.05). There was no significant difference in heart rate, blood pressure, body temperature and fetal heart rate between the two groups after 24 hours, 36 hours, 48 hours, 60 hours and 72 hours, and there was no significant difference between the two groups in heart rate, blood pressure, body temperature at admission. There was no significant difference in fetal heart rate (FHR) between the two groups (P 0.05). The above results indicated that the efficacy of Yi Huang decoction combined with antibiotics in preventing PPROM infection was equivalent to that of antibiotics alone. Twenty-four hours after treatment, the white blood cells in the control group were decreased. There was no significant difference between WBC and WBC at admission (P 0.05); in the treatment group, leukocyte was decreased, and compared with WBC at admission (P 0.05); in the control group, there was no significant difference between the two groups, while in the control group, there was no significant difference between the two groups. After 48 hours and 72 hours of medication, there was no significant difference in white blood cell value between the two groups in the control group and the treatment group (P 0.05), and there was a significant difference in the white blood cell value between the two groups compared with the white blood cell value at admission (P 0.05). Yi-Huang decoction combined with antibiotics has some advantages over using antibiotics alone in reducing the risk of PPROM infection. The effective rates of TCM syndromes in the treatment group are 83.33% and 96.55, respectively. The chi-square test shows that the effective rates of TCM syndromes in the treatment group are 83.33% and 96.55, respectively. There was a significant difference in the curative effect of TCM symptoms between the two groups (P 0.05). The scores of TCM syndromes in the treatment group were significantly different from those in the control group (P 0.05), which indicated that Yi-Huang decoction combined with antibiotics was more effective in improving the symptoms of PPROM than in the simple use of antibiotics. Conclusion: 60 cases of premature rupture of unmatured membranes in traditional Chinese medicine were randomly divided into two groups after treatment. The efficacy of Yihuang decoction combined with antibiotics in preventing PPROM infection is similar to that of using antibiotics alone, but it has some advantages in reducing the risk of infection of PPROM. Compared with antibiotics alone, Yi Huang Tang Xianfang combined with antibiotics itched vulva, and had poor chest boredom. The simple use of antibiotics is the main treatment method to prevent infection in pregnancy patients. The combination of Yi Huang decoction and antibiotics is the main treatment for PPROM patients. Not only can effectively prevent infection to prolong gestational age to promote further maturation of the fetus, but also can eliminate other physical symptoms of patients.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R714.433

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