本文選題：中醫(yī)藥 + 壽胎丸��； 參考：《湖北中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的先兆流產(chǎn)(Threatened abortion)是指在懷孕的過程中(28周)發(fā)生的陰道出血,量較少,顏色為淡紅色、黯紅色或呈茶水樣的褐色,隨后出現(xiàn)輕微腹痛和(或)腰骶部墜脹痛,不伴有胎物組織排出的一種婦產(chǎn)科常見的疾病。先兆流產(chǎn)可以分為早期和晚期。早期先兆流產(chǎn)特指出現(xiàn)在妊娠12周末之前的流產(chǎn)征兆。隨著現(xiàn)代社會壓力的增加、環(huán)境污染及其它各種因素的影響,本病的發(fā)病率呈日益上升的趨勢,若治療及時、得當,則可以繼續(xù)妊娠。若治療不及時、不恰當,癥狀嚴重,則會演變成為難免流產(chǎn),不能繼續(xù)懷孕。先兆流產(chǎn)常常給孕婦及其家屬造成很大的心理恐慌,由此伴隨而來的不良后果常常會給很多家庭沉重的打擊,影響家庭和諧。因此,研究本病的治療有著很大的臨床意義。本研究是關(guān)于壽胎丸加減治療腎虛型早期先兆流產(chǎn)的臨床研究,了解補腎安胎法治療腎虛型早期先兆流產(chǎn)的臨床效果,與西醫(yī)治療相對比,從而為補腎安胎法治療先兆流產(chǎn)提供一定的指導(dǎo)依據(jù)。法1.收集資料:共62位病人,均為2012年10月——2015年10月在我院(十堰市中醫(yī)醫(yī)院)中醫(yī)婦科門診就診的病人,都符合納入早期先兆流產(chǎn)(中醫(yī)證型為腎虛型)的相關(guān)標準。根據(jù)實驗要求,將病人隨機分成2組,命名為中醫(yī)組、西醫(yī)組,其中中醫(yī)組31位患者,西醫(yī)組31位患者。2.治療方法:中醫(yī)組給予湯劑壽胎丸加減服用(藥物成分:菟絲子30g、阿膠10g(烊化)、續(xù)斷12g、桑寄生20g、白術(shù)12g、黨參15g、杜仲12g),同時再根據(jù)患者的各自癥狀的不同進行方藥加減;西醫(yī)組按普通治療給以口服地屈孕酮片治療,10mg每次,每8小時1次,初次劑量為40 mg[1],要求兩組患者臥床休息、勿勞累[2]。每組治療都以1星期為1個療程,共研究2個療程。觀察患者在治療前后陰道出血量、腹痛情況及相關(guān)臨床結(jié)果的變化,以了解療效情況。用SPSS19.0軟件對結(jié)果統(tǒng)計分析:等級資料用秩和檢驗,計數(shù)資料采用卡方χ2檢驗,計量資料采用t檢驗,以雙側(cè)檢驗為標準,若P0.05為認為有統(tǒng)計學(xué)意義。結(jié)果1.在觀察過程中,中醫(yī)組及西醫(yī)組分別剔除治療過程中擅自停藥者1例。2.綜合臨床療效比較:經(jīng)過2個療程的處理后,對2組實驗者的臨床療效進行綜合評估,痊愈:中醫(yī)組25例,西醫(yī)組19例;顯效:中醫(yī)組3例,西醫(yī)組4例;有效:中醫(yī)組1例,西醫(yī)組4例;無效:中醫(yī)組1例,西醫(yī)組3例。故總有效率為:中醫(yī)組93.33%,西醫(yī)組90%。治療前后,2組均存在顯著差異(P0.05);將治療后的結(jié)果進行比較,中醫(yī)組與西醫(yī)組存在顯著差異(P0.05),提示中醫(yī)組療效高于西醫(yī)組。3.從臨床癥狀開始緩解所需的平均時間上進行比較,中醫(yī)組3.32天,西醫(yī)組6.08天,具有可比性(P0.05),中醫(yī)組效果優(yōu)于西醫(yī)組。4.根據(jù)B超檢查孕囊發(fā)育情況判定,孕囊發(fā)育程度為:中醫(yī)組西醫(yī)組。5.依據(jù)患者血清β-HCG增長變化情況評估,2個療程后2組患者血清β-HCG均比治療前增高,且P0.05,具有差異性。2種治療方案均有較為有效的保胎作用。但將各組患者治療后的血清β-HCG進行統(tǒng)計學(xué)計算,P0.05。故可認為2組的療效從高到低排列為:中醫(yī)組西醫(yī)組。6.根據(jù)治療前后P、E2的變化情況來看,治療后2組血清P、E2值均比治療前上升,且升高幅度為中醫(yī)組西醫(yī)組。經(jīng)統(tǒng)計計算,差異有顯著意義(P0.05)。結(jié)論壽胎丸加減能有效的改善以腎虛為主的早期先兆流產(chǎn)的相關(guān)臨床癥狀,可有效的改善陰道出血癥狀,促進血清β-HCG、P、E2值的增長,有利于孕囊成長。壽胎丸加減治療腎虛型先兆流產(chǎn)療效明確。
[Abstract]:Objective threatened abortion (Threatened abortion) refers to vaginal bleeding in the course of pregnancy (28 weeks), with less volume, light red, dark red or brown in tea water, followed by mild abdominal pain and (or) lumbosacral distention and pain, and a common obstetrics and gynecology disease without fetal tissue. Threatened abortion can be divided into early stages. Early and late stage. Early Threatened Abortion refers to the symptoms of abortion before the 12 week of pregnancy. With the increase of modern social pressure, environmental pollution and other factors, the incidence of this disease is increasing. If the treatment is timely and appropriate, it can continue pregnancy. If the treatment is not timely, inappropriate, and the symptoms are serious, the meeting will be performed. It is difficult to miscarry and cannot continue to conceive. Threatened abortion often causes great psychological panic to pregnant women and their families. The adverse consequences associated with them often give many families a heavy blow and affect family harmony. Therefore, the study of the treatment of this disease is of great significance. This study is about the treatment of kidney with Shou fetal pill. The clinical study of the Early Threatened Abortion of the deficiency type, to understand the clinical effect of the treatment of the Early Threatened Abortion of kidney deficiency type by the method of invigorating kidney and fetus, and comparing with the treatment of Western medicine, so as to provide certain guidance for the treatment of threatened abortion by the method of invigorating kidney and fetus. 1. the data of 62 patients were all in October 2012 - in our hospital (Shiyan traditional Chinese Medicine) in October 2015 According to the experimental requirements, the patients were randomly divided into 2 groups, named as traditional Chinese medicine group and Western medicine group, including 31 patients in traditional Chinese medicine group and 31 patients in western medicine group with.2. treatment methods: Chinese medicine group was given Decoction Shou Tai pill plus or minus (Medicine). Ingredients: dodder 30g, gelatin 10g (closing), continuous 12g, parasitic 20g, Atractylodes macrocephala 12g, Codonopsis 15g, Eucommia 12g), and then according to the different symptoms of the patients to carry out prescriptions and subtraction; the western medicine group is given oral Dydrogesterone Tablets treatment according to ordinary treatment, 10mg every 8 hours 1 times, the initial dose is 40 mg[1], two groups of patients rest in bed, Do not tired [2]. for each group of treatment for 1 weeks as 1 courses, a total of 2 courses of treatment. Observe the amount of vaginal bleeding, abdominal pain and changes in clinical results before and after treatment, to understand the effect. The results are statistically analyzed with SPSS19.0 software: rank sum test, chi square 2 test for counting data, measurement data adopted T test, with bilateral test as the standard, if P0.05 is considered to have statistical significance. Results 1. in the observation process, the Chinese medicine group and the western medicine group eliminated the treatment process in the treatment process, 1 cases of.2. comprehensive clinical efficacy comparison: after 2 courses of treatment, the clinical efficacy of the 2 groups of subjects were comprehensively evaluated, cured: 25 cases of traditional Chinese medicine, western medicine. Group 19 cases: 3 cases in Chinese medicine group and 4 cases in western medicine group, effective: 1 cases in traditional Chinese medicine group and 4 cases in western medicine group; 1 cases in traditional Chinese medicine group and 3 cases in western medicine group, so the total effective rate is 93.33% in traditional Chinese medicine group, and there are significant differences between the 2 groups before and after 90%. treatment in western medicine group (P0.05); there are significant differences between the Chinese medicine group and the western medicine group (P0.05). The curative effect of the medical group was higher than the average time required by the western medicine group.3. from the clinical symptoms to remission. 3.32 days in the traditional Chinese medicine group and 6.08 days in the western medicine group were comparable (P0.05). The effect of the traditional Chinese medicine group was superior to the western medicine group.4. according to the B ultrasonic examination of the development of the pregnancy sac. The development degree of the gestation sac was based on the serum beta -HCG growth of the patients in the western medicine group of the Chinese medicine group. After 2 courses of treatment, the serum beta -HCG in the 2 groups was higher than that before the treatment, and P0.05, and the difference.2 treatment scheme had a more effective protective effect. But the serum beta -HCG after the treatment of each group was calculated, and P0.05. could be considered as the treatment of the 2 groups from high to low: the western medicine group of the traditional Chinese medicine group was treated according to the treatment of.6.. The changes of P and E2 before and after treatment showed that the serum P and E2 values in the 2 groups were all higher than that before the treatment, and the increase was in the western medicine group of the traditional Chinese medicine group. The difference was significant (P0.05) by statistical calculation. Conclusion Shou fetal pill can effectively improve the related clinical symptoms of Early Threatened Abortion with kidney deficiency, which can effectively improve the symptoms of vaginal bleeding. Promoting the growth of serum -HCG, P and E2 is beneficial to the growth of gestational sac. Shou Tai pill is effective in the treatment of threatened abortion with kidney deficiency.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R271.9

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