间苯三酚用于妊娠20周前先兆流产治疗的多中心临床研究

目的观察间苯三酚治疗妊娠20周前先兆流产的临床疗效。方法选择2010-2011年就诊于4家医院的妊娠4～20周的先兆流产患者127例,将其按妊娠时间随机分为A、B、C、D4组,A、B组为早期妊娠（妊娠4～12周）,C、D组为中期妊娠（妊娠12～20周）。A组及C组应用间苯三酚联合常规保胎药治疗,B组及D组单独使用常规保胎药物进行治疗。对4组先兆流产患者的疗效予以评估,包括观察阴道流血和下腹疼痛情况,记录用药天数,监测妊娠4～8周患者治疗前后外周血HCG及孕酮水平的变化,追踪妊娠结局。同时监控药物不良反应。结果 A组经治疗后阴道流血发生率从86.84%降至18.42%,B组阴道流血发生率从64.10%降至20.51%,差异有统计学意义（P〈0.05）。A组经治疗后腹部不适发生率从44.74%降至7.89%,B组腹部不适发生率从28.20%降至5.13%,差异无统计学意义。妊娠4～8周的患者经联合治疗后体内HCG从（44612±49365）IU/L上升到（120802.67±56900）IU/L,但常规治疗者仅从（28080±43892）IU/L上升到（55166±36250）IU/L,差异有统计学意义（P〈0.05）。A组和B组治疗天数分别为（7.97±3.83）d、（11.44±6.32）d,差异有统计学意义（P〈0.01）;C组和D组治疗天数分别为（6.42±3.12）d、（9.53±7.75）d,差异有统计学意义（P〈0.05）。随访妊娠结局共失访10例,B组自然流产1例,C组自然流产2例,D组自然流产4例。使用间苯三酚的不良反应1例皮疹,1例皮肤潮红。结论间苯三酚治疗先兆流产安全有效,可以明显改善患者阴道流血和下腹疼痛的症状,促进早期妊娠HCG生长,不良反应少,具有较好的临床价值。

A multi-center study on the clinical value of phloroglucinol on the threatened abortion treatment during the first 20 weeks of pregnancy

Objective To evaluate the medical effects of phloroglucinol on the threatened abortion treatment during the first 20 weeks of pregnancy.Methods 127 cases of threatened abortion patients were recruited from four hospitals from 2010 to 2011.The patients were divided into four groups.Group A （4-12 weeks after pregnancy） and group C （12-20 weeks after pregnancy） were given with both phloroglucinol and routine drugs.Group B （4-12 weeks after pregnancy） and group D （12-20 weeks after pregnancy） were given with routine drugs.Vaginal bleeding,lower abdominal pain,the levels of HCG and progesterone,and the pregnancy outcomes were monitored.Results The incidence of vaginal bleeding in the group A and B patients was decreased from 86.84% to 18.42% and 64.10% to 20.51% in B group,respectively,and the difference was significant （P＆lt;0.05）.The incidence of abdominal discomfort in the group A and B patients was decreased from 44.74% to 7.89% and 28.20% to 5.13%,respectively,and the difference was not significant.During the 4-8 weeks of pregnancy,patients receiving the combined treatment had an increased in the level of HCG from （44612± 49365）IU/L to （120802.67±56900）IU/L.Patients receiving conventional treatment also had an increased in the level of HCG from （28080±43892）IU/L to （55 166±36 250）IU/L,and the difference was significant （P ＆lt;0.05）.The treatment days of A group and B group were （7.97±3.83）days and （11.44±6.32）days,the treatment days were （6.42±3.12）days and （9.53±7.75）days in C group and D group,there is significant difference between A group and B group （P ＆lt; 0.01）,and between C group and D group （P＆lt;0.05）.There was fewer untoward reaction after given Phloroglucinol.Conclusions Phloroglucinol is safe and effective in the treatment of threatened abortion patients..Vaginal bleeding and abdominal pain can be controlled within a relatively short period after given phloroglucinol and routine drugs.It can increase the level of HCG in the early pregnancy patients.