221例复发性流产患者中医证候分布规律研究

目的:对221例复发性流产患者中医证候分布进行研究,揭示复发性流产的中医证候分布规律,为复发性流产的孕前中医诊治提供参考。方法:按照循证医学的思想,设计中医证候调查量表,采用SPSS 13.0建立数据库,对221例复发性流产患者中医证候构成情况及与年龄、流产次数的关联情况进行了探讨。结果:复发性流产肾虚证占89.1%、脾肾两虚证占10.4%、气血虚弱证占0.5%,各证型分布差异具有统计学意义(P0.01)。其中肾虚证又包含单纯肾虚证以及肾虚夹血瘀等五种亚型。21～27岁年龄组单纯肾虚证占59.6%,脾肾两虚证占13.5%;28～34岁单纯肾虚证47.1%,肾虚夹血瘀证占21.0%;≥35岁单纯肾虚证38.7%,肾虚夹血瘀证占29.0%。结论:复发性流产以肾虚证为主要证型,临床应注意到肾虚证中包含较多的兼夹证(亚型);随着年龄的增长,肾虚夹血瘀证增加,在复发性流产的孕前治疗中要考虑到血瘀的因素。

Study on Distribution Regularity of TCM Syndromes in 221 cases of Patients with Recurrent Spontaneous Abortion

Objective:The purpose of the present study is to uncover the distribution regularity of TCM syndromes in the patients with recurrent spontaneous abortion(RSA),thus provide reference for traditional Chinese medical diagnosis and treatment before pregnancy.Methods:According to the idea of based-evidence medical,design a TCM syndrome investigation scale,establish database using SPSS 13.0,then make a study on the TCM syndromes composition of RSA and find out its association with age and abortion times.Results:The kidney deficiency syndrome accounted for 89.1% of RSA,deficiency of spleen and kidney syndrome 10.4%,while qi and blood deficiency syndrome 0.5%,distribution of TCM syndromes showed statistical difference(P<0.01).Among them,the kidney deficiency syndrome included five subtypes such as simple kidney deficiency and kidney deficiency combined with blood stasis.Simple kidney deficiency syndrome accounted for 59.6% of group aged 21~27,while deficiency of spleen and kidney accounted for 13.5%.In 28~34 year-old group,simple kidney deficiency accounted for 47.1%,kidney deficiency combined with blood stasis accounted for 21.0%.Simple kidney deficiency syndrome and kidney deficiency combined with blood stasis syndrome respectively accounted for 38.7% and 29.0% of patients aged 35 years or over.Conclusion:The main syndrome of RSA was kidney deficiency,and in clinic,it should be noticed that there were many intermingling syndromes(subtypes).The kidney deficiency combined with blood stasis syndrome increased with the age increasing,so blood stasis is a factor that must be considered during traditional Chinese medical treating before pregnancy.