本文選題：復(fù)發(fā)性流產(chǎn) + 脾腎虧虛��； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究目的:研究探索中藥干預(yù)對復(fù)發(fā)性流產(chǎn)染色體多態(tài)性患者妊娠結(jié)局的影響。研究方法:選取2012年2月至2016年9月期間就診于中國中醫(yī)科學(xué)院廣安門醫(yī)院婦科門診的符合納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)的脾腎虧虛型RSA患者共97例,經(jīng)染色體核型分析分析,將染色體核型分析結(jié)果為染色體多態(tài)性的患者共50例作為多態(tài)組,染色體核型分析結(jié)果為染色體正常核型的患者47例作為對照組。予兩組患者以自擬補(bǔ)脾益腎助孕方進(jìn)行連續(xù)干預(yù)三個月經(jīng)周期后解除避孕。觀察指標(biāo):(1)兩組患者既往自然流產(chǎn)史次數(shù)對比;(2)服藥前兩組患者的病情程度分級;(3)服藥前兩組患者的早卵泡激素:包括血清卵泡生成素(FSH)、血清黃體生成素(LH)、血清雌二醇(E2)、LH/FSH水平對比;(4)兩組患者的中醫(yī)證候療效指數(shù)對比;(5)各組間服藥前后的中醫(yī)癥狀積分對比;(6)兩組患者自解除避孕后至再次妊娠間隔時長并對比;(7)兩組患者再次妊娠首診時停經(jīng)天數(shù)并對比;(8)兩組患者再次妊娠首診時人絨毛膜促性腺激素(hCG)、雌二醇(E2)、孕酮(P)水平并對比;(9)兩組患者早期妊娠成功率并對比;(10)隨訪至晚期妊娠,統(tǒng)計活產(chǎn)率、畸形率等。研究結(jié)果:(1)多態(tài)組與對照組既往自然流產(chǎn)史次數(shù)比較無差異(P0.05)。(2)多態(tài)組與對照組服藥前的病情分級比較無差異(P0.05)。(3)多態(tài)組與對照組服藥前早卵泡激素FSH、LH、E2、LH/FSH水平比較無差異(P0.05)。(4)兩組比較中醫(yī)證候療效指數(shù),多態(tài)組:痊愈8.00%,顯效66.00%,有效26.00%%,無效0%,總有效率為100%;對照組:痊愈4.26%,顯效57.45%,有效36.17%,無效2.13%,總有效率為97.87%,兩組總有效率比較無差異(P0.05)。(5)多態(tài)組、對照組經(jīng)過補(bǔ)脾益腎助孕方干預(yù)后,組間服藥前后相比,中醫(yī)癥狀積分有顯著性差異(P0.01)。(6)多態(tài)組與對照組自解除避孕后至再次妊娠間隔時長(≤6月),兩組相比(84.00%vs 78.72%)無差異(P0.05)。(7)多態(tài)組與對照組再次妊娠首診時停經(jīng)天數(shù)比較無差異(P0.05)。(8)多態(tài)組與對照組再次妊娠首診時人絨毛膜促性腺激素(hCG)、雌二醇(E2)、孕酮(P)對比均無差異(P0.05)。(9)多態(tài)組與對照組早期妊娠結(jié)局相比較,兩組的成功率相比(96.00%vs 93.62%)無差異(P0.05)。(10)多態(tài)組與對照組晚期妊娠結(jié)局相比較,兩組的活產(chǎn)率(96.00%vs 93.62%)、畸形率(均為0%)相比無差異(P0.05)。結(jié)論:(1)染色體多態(tài)性與自然流產(chǎn)史次數(shù)可能沒有相關(guān)性。(2)說明染色體多態(tài)性對脾腎虧虛型的病情輕重程度無影響。(3)染色體多態(tài)性對女性早卵泡激素水平可能無影響。(4)補(bǔ)脾益腎助孕方可以有效改善脾腎虧虛型患者的中醫(yī)臨床癥狀。(5)經(jīng)中藥干預(yù)后,染色體多態(tài)性患者解除避孕半年內(nèi)的受孕率與染色體對照患者無差別。(6)經(jīng)中藥干預(yù)后,染色體多態(tài)性患者再次受孕后首診時停經(jīng)天數(shù)與染色體對照患者無差別。(7)經(jīng)中藥干預(yù)后,染色體多態(tài)性患者再次妊娠時血清hCG、E2、P與染色體對照患者無差別。(8)經(jīng)中藥干預(yù)后,染色體多態(tài)性患者早期妊娠成功率與染色體對照患者無差別。(9)經(jīng)中藥干預(yù)后,染色體多態(tài)性患者活產(chǎn)率、畸形率均與染色體對照患者無差別。
[Abstract]:Objective: To explore the effect of traditional Chinese medicine intervention on pregnancy outcome of recurrent abortion chromosome polymorphisms. Methods: 97 cases of spleen kidney deficiency type RSA patients were selected from February 2012 to September 2016 in the gynecological clinic of the hospital of Guanganmen Hospital of Chinese Academy of traditional Chinese medicine (Chinese Academy of Chinese Medicine). A total of 50 patients with chromosome karyotype analysis were analyzed as polymorphic group, and 47 cases of normal karyotype of chromosome karyotype were used as control group. Two groups of patients were treated with self-made invigorating kidney benefiting kidney to relieve contraception after three months of menstrual cycle. The observation index: (1) two groups Comparison of the number of past natural abortion history; (2) grade of the two groups before taking the medicine; (3) the early follicle hormone in the two groups before taking the medicine: including serum follicular hormone (FSH), serum luteinizing hormone (LH), serum estradiol (E2), LH/FSH level to ratio; (4) two groups of patients with TCM syndrome effect index comparison; (5) before taking medicine between each group before taking medicine (6) two groups of patients from the release of contraception to the interval of pregnancy longer and compared; (7) the two group of patients with first pregnancy to stop the number of days and comparison; (8) the two group of first pregnancy first diagnosis of human chorionic gonadotropin (hCG), estradiol (E2), progesterone (P) level and contrast; (9) two groups of patients early pregnancy into Power and contrast; (10) follow up to late pregnancy, statistical live yield, deformity rate and so on. (1) there was no difference in the history of spontaneous abortion between the polymorphic group and the control group (P0.05). (2) there was no difference between the polymorphic group and the control group before taking the medicine (P0.05). (3) the level of early follicle hormone FSH, LH, E2, LH/FSH in the control group and the control group. There was no difference (P0.05). (4) the two groups compared the TCM syndrome curative effect index, polymorphic group: recovery 8%, effective 66%, effective 26.00%%, invalid 0%, the total effective rate was 100%; control group: cured 4.26%, 57.45%, effective 36.17%, 2.13%, total effective rate of 97.87%, total effective rate of two group was no difference (P0.05). (5) polymorphism group, the control group passes the spleen There was significant difference in TCM symptom score (P0.01). (6) there was no difference between the polymorphic group and the control group from the relief of contraception to the second pregnancy (less than June) and the two groups (84.00%vs 78.72%). (7) there was no difference in the number of days of menopause between the multiple group and the control group in the first pregnancy (P0.05). (8) there was no difference in the comparison of human chorionic gonadotropin (hCG), estradiol (E2) and progesterone (P) between the polymorphic group and the control group (P0.05). (9) there was no difference in the success rate between the two groups (96.00%vs 93.62%) compared with the control group (P0.05). (10) the polymorphism group was compared with the control group in the late pregnancy outcome, and the two group was compared. There was no difference in the rate of survival (96.00%vs 93.62%) and the rate of malformation (0%). Conclusion: (1) there is no correlation between chromosome polymorphism and the frequency of spontaneous abortion. (2) there is no effect on the severity of spleen and kidney deficiency syndrome. (3) the polymorphism of chromophore may have no effect on the level of female early follicle hormone. (4) supplementing the spleen. Renal assisted pregnancy can effectively improve the clinical symptoms of spleen and kidney deficiency patients. (5) there is no difference between chromosome polymorphism patients and chromosomal control patients in half a year after the prognosis of Chinese herbal medicine. (6) after the prognosis of Chinese medicine, the number of chromosomal polymorphisms in the first pregnancy after the first diagnosis is not poor with the chromosome control patients. (7) after the prognosis of Chinese medicine, the serum hCG, E2, P and chromosome control patients have no difference. (8) there is no difference between the early pregnancy success rate of the chromosome polymorphism patients and the chromosome control patients. (9) the survival rate and the malformation rate of the chromosome polymorphic patients are all with the chromosome pairs after the prognosis of the Chinese medicine. There is no difference in the patient.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R271.9

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