本文選題：藥物流產(chǎn) + 陰道流血��； 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過文獻研究,探討和總結(jié)藥物流產(chǎn)后陰道流血的中醫(yī)辨證論治方案,并進行臨床驗證。方法:收集近25年來藥物流產(chǎn)后陰道流血中醫(yī)辨證論治的文獻,探討總結(jié)出該疾病常見證型、辨證要點、治法、方藥。臨床收集病例120例,進行中醫(yī)辨證后,隨機分為對照組、實驗A組、實驗B組。三組均采用基本治療:米非司酮+米索前列醇口服藥物流產(chǎn),孕囊排除后,立即肌肉注射縮宮素,口服頭孢呋辛酯片。對照組:基本治療+縮宮素鼻噴霧劑;實驗A組:基本治療+口服生化湯;實驗B組:基本治療+參照常見中醫(yī)證型進行辨證論治。7天后仍陰道流血者再次進行中醫(yī)辨證,陰道流血停止或行清宮術(shù)則結(jié)束治療。對三組陰道流血時間、陰道流血量、清宮率、孕酮、HCG下降程度、月經(jīng)復(fù)潮等進行比較,使用excel 2007進行數(shù)據(jù)統(tǒng)計、spss19.0進行數(shù)據(jù)分析。結(jié)果:1、藥物流產(chǎn)后陰道流血的常見中醫(yī)證型瘀阻胞宮型、氣虛血瘀型、濕熱瘀阻型、陰虛血熱型、寒凝血瘀型。2、各證型可選用以下治法方藥,并臨證加減。瘀阻胞宮型,治宜活血化瘀止血,方可用生化湯加減;氣虛血瘀型,治宜益氣活血止血,方可選八珍湯和生化湯加減;濕熱瘀阻型,治宜清利濕熱,活血止血,可選用大黃牡丹皮湯合五味消毒飲加減;陰虛血熱型,治宜滋陰清熱止血,方可選用用兩地湯合生化湯加減;寒凝血瘀型,治宜溫經(jīng)活血,化瘀止血,方可選用生化湯加上肉桂、烏藥、艾葉。3、藥物流產(chǎn)后陰道流血使用中醫(yī)辨證論治,能有效縮短陰道流血時間、減少陰道流血量、減少7天后仍陰道流血的人數(shù)、降低清宮率、降低孕酮及血HCG、促進月經(jīng)復(fù)潮。結(jié)論:藥物流產(chǎn)后陰道流血中醫(yī)常見證型包括瘀阻胞宮型、氣虛血瘀型、濕熱瘀阻型、陰虛血熱型、寒凝血瘀型。中醫(yī)辨證論治能縮短藥物流產(chǎn)后陰道流血時間,對藥物流產(chǎn)后陰道流血具有重要意義。
[Abstract]:Objective: to discuss and summarize the treatment scheme of vaginal bleeding after drug abortion based on literature study. Methods: to collect the literature on syndrome differentiation and treatment of vaginal bleeding after drug abortion in recent 25 years, and discuss and summarize the common syndrome types, main points of syndrome differentiation, treatment methods and prescriptions of this disease. 120 cases were randomly divided into control group, experimental group A and experimental group B after TCM syndrome differentiation. Three groups were treated with basic treatment: mifepristone misoprostol oral abortion, pregnancy sac removed, immediately intramuscular injection of oxytocin, oral cefuroxime octyl ester tablets. Control group: basic treatment of oxytocin nasal spray; experimental group A: basic treatment of oral biochemical decoction; experimental group B: basic treatment with reference to the common TCM syndrome differentiation treatment 7. 7 days after still vaginal bleeding, Vaginal bleeding stops or the removal of the uterus ends the treatment. The vaginal bleeding time, vaginal bleeding volume, uterine clearance rate, decrease degree of progesterone HCG and menstrual dysphagia were compared among the three groups. Excel 2007 was used to analyze the data. Results 1. The common TCM syndrome types of vaginal bleeding after drug abortion were ecchymosis, qi deficiency and blood stasis, dampness and heat stasis, yin deficiency and blood heat, cold coagulation and blood stasis. Blood stasis should be treated with activating blood circulation to remove blood stasis and hemostasis; Qi deficiency and blood stasis should be treated with Qi deficiency and blood stasis to stop bleeding; only Bazhen decoction and biochemical decoction can be selected to reduce blood stasis; dampness and heat stasis should be treated to clear away dampness and heat and activate blood circulation to stop bleeding. You can choose rhubarb peony skin decoction to add or subtract five kinds of disinfectant drink; Yin deficiency and blood heat type, which should be treated with nourishing yin and clearing away heat to stop bleeding, then you can choose to use both two kinds of decoction combined with biochemical decoction to reduce; cold coagulation and blood stasis type, it is good to warm the channels to promote blood circulation, and to remove blood stasis to stop bleeding, Can you choose biochemical soup plus cinnamon, black medicine, Ai Ye. 3. The vaginal bleeding after drug abortion can be treated with TCM syndrome differentiation. It can effectively shorten the vaginal bleeding time, reduce the amount of vaginal bleeding, reduce the number of vagina bleeding after 7 days, and reduce the rate of clearing the palace. Reduce progesterone and blood HCG, promote menstrual resuscitation. Conclusion: the common syndrome types of vaginal bleeding after drug abortion include ecchymosis, qi deficiency and blood stasis, dampness and heat stasis, yin deficiency and blood heat, and cold coagulation and blood stasis. TCM treatment based on syndrome differentiation can shorten the time of vaginal bleeding after drug abortion, which is of great significance to vaginal bleeding after drug abortion.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R169.42

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