补肾健脾安胎汤联合地屈孕酮治疗肾虚型高龄先兆流产临床研究

目的：观察补肾健脾安胎汤联合地屈孕酮治疗肾虚型高龄先兆流产的临床疗效及对血清总三碘甲状腺激素(TT3)、雌二醇(E2)、孕酮(P)水平的影响。方法：选取肾虚型高龄先兆流产患者60例，按随机数字表法分为观察组与对照组各30例。2组孕妇均采用地屈孕酮治疗，观察组加用补肾健脾安胎汤治疗，对照组加用维生素E胶囊治疗。比较2组临床疗效、中医证候评分、相关性激素指标、子宫动脉血流参数[搏动指数(PI)、阻力指数(RI)]、继续妊娠率及症状缓解时间。结果：观察组总有效率为93.33%，对照组为70.00%,2组比较，差异有统计学意义(P<0.05)。治疗后，2组出血、小腹坠痛、腰酸软、夜尿频多、头晕耳鸣等中医证候评分均较治疗前降低(P<0.05)，且观察组上述各项评分均低于对照组(P<0.05)。治疗后，2组血清E2、P、TT3水平均较治疗前升高(P<0.05)；且观察组E₂、P均高于对照组(P<0.05)；而2组TT3水平比较，差异无统计学意义(P>0.05)。治疗后，2组PI、RI水平均较治疗前下降(P<0.05)，且观察组PI、R...

Clinical Study of Bushen Jianpi Antai Decoction Combined with Dydrogesterone inthe Treatment of Senile Threatened Abortion of Kidney Deficiency Type

Abstract： Objective： To observe the clinical effect of Bushen Jianpi Antai Decoction combined withDydrogesterone in the treatment of elderly patients with kidney deficiency syndrome threatened abortionand the influence of serum total triiodothyroid hormone (TT3)， estradiol (E2) and progesterone (P) levels.Methods： A total of 60 cases of patients with elderly threatened abortion of kidney deficiency type wereselected and divided into the observation group and the control group according to the random number tablemethod， with 30 cases in each group. Both groups were treated with Dydrogesterone； the observationgroup was additionally treated with Bushen Jianpi Antai Decoction，and the control group was additionallytreated with Vitamin E Capsules. The clinical effects，traditional Chinese medicine (TCM) syndrome scores，related indexes of sex hormones，uterine artery blood flow parameters [pulsatility index (PI) and resistanceindex (RI)]，ongoing pregnancy rates and relief time of symptoms were compared between the two groups. Results： The total effective rate was 93.33% in the observation group and 70.00% in the control group，the difference being significant (P＜0.05). After treatment， TCM syndrome scores including bleeding，bearing-down pain in lower abdomen，soreness and weakness of waist，frequent nocturia，and dizzinessand tinnitus in the two groups were decreased when compared with those before treatment (P＜0.05)，andthe above scores in the observation group were lower than those in the control group (P＜0.05). Aftertreatment， the levels of E2， P and TT3 in serum in the two groups were increased when compared withthose before treatment (P＜0.05)；the levels of E2 and P in the observation group were higher than those inthe control group (P＜0.05)，but there was no significant difference being found in the comparison of TT3levels between the two groups (P＞0.05). After treatment，the levels of PI and RI in the two groups weredecreased when compared with those before treatment (P＜0.05)， and the levels of PI and RI in theobservation group were lower than those in the control group (P＜0.05). After 6 nonths of follow-up，thecontinued pregnancy rate was 90.00% in the observation group and 66.67% in the control group，and thedifference between the two groups was statistically significant (P＜0.05). The symptom remission time ofthreatened abortion in the observation group was shorter than that in the control group，and the differencewas statistically significant (P＜0.05). Conclusion： Bushen Jianpi Antuan Decoction combined withdydrogesterone in the treatment of elderly threatened abortion can up-regulate serum P and E2 levels，improve clinical efficacy， improve clinical symptoms， increase the rate of continued pregnancy， andaccelerate symptom relief.