摘要
目的探讨滋肾育胎丸联合地屈孕酮片对不明原因复发性流产患者的保胎效果及雌孕激素的影响。方法回顾性纳入2022年1月至2024年10月河南中医药大学第一附属医院诊治的不明原因复发性流产患者82例,根据治疗方案分为地屈孕酮组和联合组。地屈孕酮组(n=39)为常规干预+地屈孕酮片治疗,联合组(n=43)为常规干预+地屈孕酮片+滋肾育胎丸联合治疗。地屈孕酮组和联合组不明原因复发性流产患者均从入组后立即开始药物治疗,持续治疗至孕12周或超过其最近一次流产事件发生时的孕周2周。比较地屈孕酮组和联合组的妊娠结局(足月产、早产生存、流产、保胎成功)、治疗前后激素水平(人绒毛膜促性腺激素、雌二醇、孕酮)、中医证候积分。结果联合组保胎成功率83.72%(36/43)较地屈孕酮组58.97%(23/39)高,差异有统计学意义(χ^(2)=6.206,P=0.013)。地屈孕酮组和联合组治疗后血清人绒毛膜促性腺激素、雌二醇及孕酮浓度水平均较治疗前上升;联合组血清人绒毛膜促性腺激素、雌二醇[分别为(112576.79±569.83)IU/L、(497.22±74.58)ng/L]均高于地屈孕酮组[分别为(85430.10±543.06)IU/L、(415.18±62.27)ng/L],差异有统计学意义(t=220.296、5.376,均P<0.05);地屈孕酮组和联合组治疗后的孕酮比较,差异无统计学意义(t=1.954,P>0.05)。治疗后,地屈孕酮组和联合组中医证候主次症积分及总积分均较治疗前下降,联合组[分别为(11.94±1.78)分、(5.76±0.87)分、(17.70±1.59)分]均低于地屈孕酮组[分别为(16.36±2.45)分、(8.29±1.23)分、(24.65±2.28)分],差异有统计学意义(t=9.407、10.830、16.131,均P<0.05)。结论滋肾育胎丸联合地屈孕酮片可提高不明原因复发性流产患者的保胎成功率,有效调节激素水平,并改善中医证候。
Objective To explore the efficacy of Zishen Yutai Pills combined with dydrogesterone tablets on the pregnancy outcome and the levels of estrogen and progesterone in patients with unexplained recurrent spontaneous abortion.Methods A total of 82 patients with unexplained recurrent spontaneous abortion treated at the First Affiliated Hospital of Henan University of Chinese Medicine from January 2022 to October 2024 were retrospectively selected.Patients were assigned to the two groups according to the treatment plan:the dydrogesterone group(n=39,received standard intervention plus dydrogesterone tablets)and the combined group(n=43,received standard intervention plus dydrogesterone tablets and Zishen Yutai Pills).Both groups began drug treatment immediately upon enrollment and continued until 12 weeks of gestation or two weeks after the latest miscarriage event.The pregnancy outcomes(full-term delivery,survival of preterm infants,miscarriage,successful pregnancy maintenance),hormone levels(human chorionic gonadotropin,estradiol,progesterone),and traditional Chinese medicine(TCM)syndrome scores before and after treatment were compared.Results The success rate of miscarriage prevention in the combined group was 83.72%(36/43),higher than 58.97%(23/39)in the dydrogesterone group,with a statistically significant difference(χ^(2)=6.206,P=0.013).After treatment,serum human chorionic gonadotropin(hCG),estradiol,and progesterone levels increased in both the dydrogesterone and the combined groups,and the levels of serum hCG,estradiol in the combined group((112576.79±569.83)IU/L and(497.22±74.58)ng/L,respectively)were higher than those in the dydrogesterone group((85430.10±543.06)IU/L and(415.18±62.27)ng/L,respectively),with statistically significant differences(t=220.296,5.376,both P<0.05).After treatment,the progesterone levels between the two groups showed no statistically significant difference(t=1.954,P>0.05).After treatment,both the dydrogesterone group and the combined group showed decreases in the primary and secondary symptom scores and total scores of TCM syndromes compared to before treatment.Furthermore,the above scores in the combined group((11.94±1.78)points,(5.76±0.87)points,and(17.70±1.59)points,respectively)were lower than those in the dydrogesterone group((16.36±2.45)points,(8.29±1.23)points,and(24.65±2.28)points,respectively),with statistically significant differences(t=9.407,10.830,16.131,all P<0.05).Conclusion The combination of Zishen Yutai Pills and dydrogesterone tablets can improve the success rate of miscarriage prevention in patients with unexplained recurrent spontaneous abortion,effectively regulate hormone levels,and improve TCM syndromes.
作者
张丽君
周立
ZHANG Lijun;ZHOU Li(Department of Obstetrics and Gynaecology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)
出处
《中国药物应用与监测》
2025年第9期1580-1583,共4页
Chinese Journal of Drug Application and Monitoring
基金
河南省中医药科学研究专项课题(2023ZXZX1006)。
关键词
不明原因复发性流产
滋肾育胎丸
地屈孕酮片
保胎效果
雌孕激素
unexplained recurrent spontaneous abortion
Zishen Yutai Pills
dydrogesterone tablets
miscarriage prevention effect
estrogen and progesterone
