本文選題：復(fù)發(fā)性流產(chǎn) + 腎虛血瘀��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過觀察安子合劑治療腎虛血瘀型的復(fù)發(fā)性流產(chǎn)患者臨床癥狀的變化、血清妊娠激素(E2、P、β-HCG)、同型半胱氨酸(Hcy)水平以及盆腔B超監(jiān)測胚胎發(fā)育等情況,探討安子合劑治療復(fù)發(fā)性流產(chǎn)的臨床療效,以及安胎療效與血清同型半胱氨酸相關(guān)性的作用機理。方法:臨床收集2016年3月至2017年1月在江蘇省中醫(yī)院婦科門診就診及病房住院的腎虛血瘀型復(fù)發(fā)性流產(chǎn)患者60例,用簡單隨機分組方法分為治療組(30例)和對照組(30例)。治療組給予安子合劑+地屈孕酮片+復(fù)合維生素片(愛樂維)口服;對照組給予地屈孕酮片+復(fù)合維生素片(愛樂維)口服。4周為一觀察周期。分別觀察治療前后兩組患者證候積分變化、血清E2、P、β-HCG、同型半胱氨酸水平、盆腔B超監(jiān)測胚胎發(fā)育情況。通過SPSS23.0統(tǒng)計軟件進(jìn)行數(shù)據(jù)處理,判斷臨床療效,分析作用機理。結(jié)果:(1)臨床證候積分:兩組患者治療后積分均較治療前顯著降低(P0.05);治療組總積分降低幅度較對照組大(P0.05);中醫(yī)證候療效比較:治療組總有效率93.3%,顯著優(yōu)于對照組總有效率66.7%(P0.05)。(2)血清妊娠激素水平:通過折線圖走勢發(fā)現(xiàn),治療后兩組患者血清E2、P、β-HCG水平均呈上升趨勢;通過折線圖比較發(fā)現(xiàn),治療組上升幅度明顯高于對照組(p0005)。(3)血清同型半胱氨酸水平:兩組患者治療后Hcy水平均較治療前顯著下降(P0.05);且治療組下降幅度明顯優(yōu)于對照組(P0.05)。(4)盆腔B超監(jiān)測胚胎發(fā)育情況:治療組B超監(jiān)測胎心良好且胚胎發(fā)育成形共28例(93.3%);對照組監(jiān)測胎心良好且胚胎發(fā)育成形共21例(70.0%),治療組胎兒成活率顯著高于對照組(P0.05)。(5)綜合療效:治療組痊愈率16.7%,顯效率66.7%,有效率10%,總有效率93.3%;對照組痊愈率3.3%,顯效率26.7%,有效率36.7%,總有效率66.7%。兩組總有效率比較,治療組明顯優(yōu)于對照組(P0.05)。結(jié)論:安子合劑治療腎虛血瘀型復(fù)發(fā)性流產(chǎn)臨床療效確切,不僅能顯著改善患者的臨床癥狀,降低證候積分,提高妊娠激素水平,還能顯著降低血清同型半胱氨酸水平,改善胞宮微循環(huán),提高安胎成功率。
[Abstract]:Objective: to observe the changes of clinical symptoms of recurrent abortion patients with kidney deficiency and blood stasis type treated by Anzi mixture, the levels of serum pregnancy hormone E2P, 尾 -HCG, homocysteine Hcyine, and the monitoring of embryo development by pelvic B-ultrasound. To explore the clinical effect of Anzi mixture in the treatment of recurrent abortion and the mechanism of the correlation between the therapeutic effect and serum homocysteine. Methods: from March 2016 to January 2017, 60 cases of recurrent abortion with kidney deficiency and blood stasis type were collected from gynecological outpatient and ward of Jiangsu traditional Chinese Medicine Hospital. They were divided into treatment group (n = 30) and control group (n = 30). The treatment group was given diproprogesterone multivitamin tablets (Alovir) and the control group was given diproprogesterone multivitamin tablets (Alovir) for a period of 4 weeks. The changes of syndromes integral, serum E _ 2P, 尾 -HCG, homocysteine levels and pelvic B ultrasound were observed before and after treatment. The data were processed by SPSS23.0 software to judge the clinical effect and analyze the mechanism. Results (1) Clinical syndrome score: after treatment, the scores in both groups were significantly lower than those before treatment, the total score in the treatment group was lower than that in the control group, and the curative effect of TCM syndrome: the total effective rate of the treatment group was 93.3%, which was significantly better than that of the control group. The effective rate of 66.7%) serum pregnancy hormone level: through the trend of broken line, After treatment, the serum levels of E2P, 尾 -HCG in both groups showed an upward trend. The serum homocysteine level in the treatment group was significantly higher than that in the control group (P _ (0005). The serum homocysteine level in the treatment group was significantly lower than that in the pre-treatment group (P 0.05), and the decrease in the treatment group was significantly higher than that in the control group (P _ (0.05) P _ (0.05). Development: in the treatment group, the fetal heart was good and the embryo was formed in 28 cases, while in the control group, the fetal heart was good and the embryo was formed in 21 cases. The survival rate of the fetus in the treatment group was significantly higher than that in the control group. In the control group, the recovery rate was 3.3%, the markedly effective rate was 26.7%, the effective rate was 36.7%, and the total effective rate was 66.7%. The total effective rate of the two groups was significantly better than that of the control group (P 0.05). Conclusion: Anzi mixture is effective in the treatment of recurrent abortion with kidney deficiency and blood stasis. It can not only significantly improve the clinical symptoms of the patients, reduce the syndrome score, increase the level of pregnancy hormones, but also significantly reduce the level of serum homocysteine. Improve the uterine microcirculation and increase the success rate of fetus.
【學(xué)位授予單位】：南京中醫(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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