当归芍药散加减治疗早期复发性流产血栓前状态临床研究

目的探讨当归芍药散加减对早期复发性流产血栓前状态患者中医证候及血液指标影响,观察保胎成功率。方法采用随机数字表法将76例早期复发性流产血栓前状态患者分为对照组和观察组各38例。对照组予低分子肝素钙注射液,每日1次,每次4000 IU,皮下注射。观察组在对照组基础上予当归芍药散加减,每日1剂,每日2次,口服。2组均30 d为1个疗程,连续治疗2个疗程。比较2组治疗前后中医证候积分,凝血四项[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(FIB)]、血小板聚集率、血清孕酮和绒毛膜促性腺激素(β-HCG)水平,比较2组保胎成功率。结果与本组治疗前比较,2组治疗后中医证候积分明显降低(P<0.05);2组治疗后比较,观察组中医证候积分明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后APTT、PT、TT明显延长(P<0.05),FIB水平明显降低(P<0.05);观察组治疗后APTT、PT、TT明显长于对照组,FIB水平明显低于对照组(P<0.05)。观察组治疗后血小板聚集率正常率为77.14%(27/38),对照组为41.18%(14/38),观察组明显高于对照组(P<0.05)。与本组治疗前比较,2组治疗后孕酮水平升高(P<0.05);2组治疗后比较,观察组孕酮水平高于对照组(P<0.05)。观察组保胎成功率为65.79%(25/38),对照组为36.84%(14/38),观察组明显高于对照组(P<0.05)。结论当归芍药散加减可有效改善患者临床证候,提升孕酮水平,提高保胎成功率。

Clinical Study on Modified Danggui Shaoyao Powder for Treatment of Patients with Early Recurrent Abortion before Thrombosis

Objective To explore the effects of modified Danggui Shaoyao Powder on the clinical symptoms and blood indexes of patients with early recurrent abortion before thrombosis and fetus protection success rate.Methods Totally 76 patients with early recurrent abortion before thrombosis were divided into control group and observation group according to random number table method,with 38 cases in each group.The control group was treated with low molecular weight heparin calcium injection,while the observation group was treated with modified Danggui Shaoyao Powder on the basis of the control group,one dosage per day,twice a day,orally.30 d were one treatment course for both groups,for consecutive two courses.TCM symptom scores,coagulation four[activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT),fibrinogen(FIB)],platelet aggregation rate,serum progesterone andβ-human chorionic gonadotropin(β-HCG)level before and after treatment in both groups were compared,and fetus protection success rates were compared.Results Compared with before treatment,TCM symptom scores in the two groups were significantly reduced(P<0.05);After treatment,TCM symptom score in the observation group was significantly lower than that in the control group(P<0.05).Compared with before treatment,the APTT,PT and TT in the two groups increased after treatment,and the FIB level in the two groups decreased;After treatment,the APTT,PT and TT in the observation group were significantly longer than those in the control group,and the FIB level was significantly lower than that in the control group(P<0.05).The normal rate of platelet aggregation rate in the observation group was 77.14%(27/38),and that in the control group was 41.18%(14/38).The observation group was significantly higher than the control group(P<0.05).Compared with before treatment,the progesterone level in the two groups increased after treatment(P<0.05).The progesterone level in the observation group was higher than that in the control group(P<0.05).The fetus protection success rate in the observation group was 65.79%(25/38),and that in the control group was 36.84%(14/38).The observation group was significantly higher than the control group(P<0.05).Conclusion Modified Danggui Shaoyao Powder can effectively improve the clinical symptoms of patients,increase progesterone levels,and improve fetus protection success rate.