应用活血化瘀法治疗复发性流产文献评价

目的通过文献研究对活血化瘀法在复发性流产治疗中应用的疗效和安全性进行评价。方法检索中国知网、重庆维普中文科技期刊数据库、中国生物医学文献数据库和万方数据库中应用活血化瘀法治疗复发性流产的临床研究文献,采用系统综述的文献研究方法,提取文献中报告的辨证、用药、疗效和不良事件等相关信息,分析活血化瘀法治疗复发性流产的疗效、安全性和可行性。结果符合研究标准文献共25篇,其中13篇文献报告了患者的中医证型为血瘀或包含血瘀证的本虚标实型。治疗复发性流产常用的具有活血化瘀作用的中药有当归、丹参、赤芍、川芎、益母草、红花、蒲黄、桃仁、五灵脂等。与西医治疗或中医常规保胎治疗比较,在中药保胎方中增用活血化瘀药物能提高复发性流产患者胎儿的活产率。各研究未报告明显的不良事件。结论活血化瘀法在复发性流产的治疗中有其应用价值和可行性,但目前临床研究证据的质量不高,有必要进行设计良好的高质量的随机对照试验进一步验证。

Literature Review of the Application of Quickening Blood and Transformin g Stasis in Treatment of Recurrent Spontaneous Abortion

Objective To evaluate the therapeutic effect and safe ty of quickening blood and transforming stasis on recurrent spontaneous abortion from literature study.Methods Clinical research literature on quickeni ng blood and transforming stasis for recurrent spontaneous abortion was searched from China National Know ledge Internet(CNKI),VIP database,Chinese Biomedical Literature Database(CBM) and Wanfang Database.Systematic review was used to extract the syndrome ident ification,treatment,therapeutic effect and adverse event from the literature. The therapeutic effect,safety and feasibility of quickening blood and transform ing stasis for recurrent spontaneous abortion were analyzed.Res ults Twenty five articles were included.Thirteen articles reported the patients with blood stas is syndrome or root deficiency and tip repletion syndrome with blood stasis.The commonly used Chinese medicinals to quicken blood and transform stasis were Dan ggui(Radix Angelicae Sinensis),Danshen(Radix et Rhizoma Salviae Miltiorrhizae),Chishao(Radix Paeoniae Rubra),Chuanxiong(Rhizoma Chuanxiong),Yimucao(Her ba Leonuri),Honghua(Flos Carthami),Puhuang(Pollen Typhae),Taoren(Semen Per sicae) and Wulingzhi(Faeces Togopteri).Comparing with conventional western med icine and Chinese medicine,the combination of quickening blood and transforming stasis medicinals could improve the live birth rate of patients with recurrent spontaneous abortion.There was no obvious adverse event reported.Conclusion Qu ickening blood and transforming stasis is valuable and feasible for recurrent sp ontaneous abortion.Since the quality of current studies is generally low,it is necessary to conduct randomized-controlled trials to confirm the therapeutic e ffect and safety of quickening blood and transforming stasis.