本文選題：先兆流產(chǎn) + 胎漏、胎動不安　； 參考：《河南中醫(yī)藥大學》2016年碩士論文

【摘要】：目的:本課題以傳統(tǒng)中醫(yī)理論為指導,在以往實際臨床療效和理論探討的基礎(chǔ)上,進一步對褚氏安胎方治療脾腎兩虛型先兆流產(chǎn)的臨床療效進行分析與評價,并探討其機理,為先兆流產(chǎn)提供一種安全、有效的中醫(yī)藥治療方法。方法:本研究共收集在河南中醫(yī)藥大學第二附屬醫(yī)院婦科門診就診的60例脾腎兩虛型先兆流產(chǎn)患者,采用隨機的方法將研究對象分為治療組(30例)和對照組(30例)。治療組給予褚氏安胎方加減進行治療,對照組給予滋腎育胎丸,7天為一療程,治療至妊娠滿12周。定期檢測β-HCG及孕酮水平,B超了解宮內(nèi)胚胎或胎兒發(fā)育情況,觀察兩組患者治療前后中醫(yī)證候改善情況,用藥后有無不良反應(yīng)及對所記錄原始資料進行整理,用統(tǒng)計學方法得出結(jié)論。結(jié)果:治療前基線比較結(jié)果:治療組與對照組在年齡、妊娠天數(shù)、流產(chǎn)次數(shù)、癥狀評分及β-HCG、孕酮等方面的差異均無統(tǒng)計學意義(P0.05),具有可比性;治療后資料統(tǒng)計結(jié)果:治療組痊愈8例,顯效17例,有效4例,無效1例,總有效率為96.7%;對照組痊愈5例,顯效11例,有效10例,無效4例,總有效率為86.7%,差異有統(tǒng)計學意義(P0.05),治療組優(yōu)于對照組。兩組治療前后血β-HCG水平比較,均有顯著統(tǒng)計學差異(P0.01)。兩組7周、8周血清孕酮水平相比較,有統(tǒng)計學意義(P0.05),治療組均優(yōu)于對照組;兩組6-7周血清孕酮水平增長水平比較有差異(P0.05),治療組優(yōu)于對照組;兩組治療前后血清孕酮水平比較,均有顯著統(tǒng)計學差異(P0.01)。結(jié)論:(1)褚氏安胎方治能有效治療脾腎兩虛型先兆流產(chǎn),提高繼續(xù)妊娠率,明顯改善臨床癥狀,且無明顯毒副作用,臨床應(yīng)用安全有效。(2)褚氏安胎方能有效提高患者妊娠8周前血清孕酮水平,提升妊娠早期黃體功能。(3)褚氏安胎方治療脾腎兩虛型先兆流產(chǎn)效果優(yōu)于滋腎育胎丸,對于臨床上脾腎兩虛型先兆流產(chǎn)患者更適合,且湯劑能夠迅速改善患者先兆流產(chǎn)癥狀,并增加患者繼續(xù)治療的信心。
[Abstract]:Objective: under the guidance of the traditional Chinese medicine theory and on the basis of the practical clinical curative effect and theoretical discussion, the clinical effect of Chu's An-fetus prescription in treating threatened abortion with deficiency of spleen and kidney was further analyzed and evaluated, and its mechanism was discussed. For threatened abortion to provide a safe, effective Chinese medicine treatment. Methods: a total of 60 patients with threatened abortion with deficiency of spleen and kidney were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Chu's Anti Fang, while the control group was treated with Zishen Yuet Pill for 7 days, until the pregnancy reached 12 weeks. The levels of 尾 -HCG and progesterone were detected regularly. B-mode ultrasound was used to understand the development of fetus or embryo, to observe the improvement of TCM syndromes before and after treatment, to observe whether there were any adverse reactions after treatment and to sort out the recorded raw data. Draw a conclusion by statistical method. Results: there were no significant differences in age, pregnancy days, abortion frequency, symptom score, 尾 -HCG and progesterone between the treatment group and the control group (P 0.05). After treatment, 8 cases were cured, 17 cases were effective, 4 cases were effective, 1 case was ineffective, the total effective rate was 96.7in the treatment group, while in the control group, 5 cases were cured, 11 cases were effective, 10 cases were effective, 4 cases were ineffective. The total effective rate was 86.7, the difference was statistically significant (P 0.05), the treatment group was superior to the control group. The serum 尾-HCG levels in the two groups were significantly different before and after treatment (P 0.01). The serum progesterone level of the two groups was significantly higher than that of the control group at 7 weeks and 8 weeks, and the serum progesterone level in the treatment group was better than that in the control group, and the increase level of serum progesterone in the treatment group was better than that in the control group at 6-7 weeks, and the serum progesterone level in the two groups was better than that in the control group before and after treatment. There was significant statistical difference between the two groups (P 0.01). Conclusion Ch'u 's antepartum prescription can effectively treat threatened abortion with deficiency of spleen and kidney, increase the rate of continuous pregnancy, improve clinical symptoms, and have no obvious side effects. The clinical application of Ch'u 's Anti formula can effectively improve the serum progesterone level before 8 weeks gestation and improve the luteal function in the early pregnancy. The effect of Chu's Anti foetus prescription in treating threatened abortion with deficiency of both spleen and kidney is better than that of Zishen Yufen pill. It is more suitable for the patients with threatened abortion with deficiency of spleen and kidney, and the decoction can rapidly improve the symptoms of threatened abortion and increase the confidence of the patients to continue treatment.
【學位授予單位】：河南中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R271.9

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