地屈孕酮与黄体酮单药或联用治疗黄体功能不全型先兆流产的临床研究

目的 探讨地屈孕酮与黄体酮单药或联用治疗黄体功能不全型先兆流产的疗效及安全性。方法 收集2015年4月-2016年4月河南科技大学第一附属医院收治的黄体功能不全型先兆流产患者186例作为研究对象，根据随机数字表法将其分为A、B、C组，各包含患者62例。A组患者使用地屈孕酮单药进行治疗，B组患者使用黄体酮单药进行治疗，C组患者使用地屈孕酮联合黄体酮进行治疗。对3组患者治疗效果、激素水平、治疗结局以及不良反应进行观察与比较。结果 A组治疗总有效率为72.58%，B组为66.13%，均显著低于C组的90.32%，差异有统计学意义（P<0.05）。治疗后3组患者孕酮（P）、雌二醇（E2）以及人粗绒毛膜性腺激素（hCG）均较治疗前显著升高，且以C组升高最为显著（P<0.05）。A组患者治疗成功率为83.87%，B组为82.26%，均低于C组的95.16%，但差异无统计学意义。A组不良反应发生率为9.68%，B组为12.90%，C组为14.52%，3组差异无统计学意义。结论 地屈孕酮与黄体酮联用治疗黄体功能不全型先兆流产疗效优于单药治疗，安全性较高，值得临床推广应用。

Clinical effect of single use or combination of dydrogesterone and progestin in treatment of threatened abortion caused by uteal phase defect

Objective To explore the clinical effect of single use or combination of dydrogesterone and progestin in treatment of threatened abortion caused by uteal phase defect. Methods Totally 186 patients with threatened abortion caused by uteal phase defect accepted in The First Affiliated Hospital of Henan from April 2015 to April 2016 were selected and randomly divided into groups A, B, and C with 62 cases in each group. Patients in group A were given dydrogesterone, those in group B were given progestin, and those in group C were given dydrogesterone combined with progestin. Then the clinical effect, expression of hormones, treatment outcome, and adverse reaction were observed and compared. Results The total effective rates of groups A and B were 72.58% and 66.13%, respectively, which were obviously lower than 90.32% of group C with statistically significance (P<0.05). The expression levels of P, E2, and hCG of three groups after treatment were higher than those before, those in group C were the highest among them (P<0.05). The successful treatment rates of groups A, B, and C were 83.87%, 82.26%, and 95.16%, respectively, which had no great difference. Conclusion Combination use of dydrogesterone and progestin has better effective rate in treatment of threatened abortion caused by uteal phase defect compared to single use of these two drugs, which has good safety and worth of clinical application.