【作者】 赵宇；

【导师】 凌霞；

【作者基本信息】 长春中医药大学 ， 中医妇科学， 2011， 硕士

【摘要】 先兆流产属于祖国医学的“胎漏”“胎动不安”范围,运用中医药治疗先兆流产的历史源远流长。早在古代,便已经存在了对胎动不安、胎漏的病因病机总结的专著,并出现了治疗原则的文献叙述,祖国医学各家都有相关的独特观点,并且经过后人继承与创新,已经成为现代中医各家治疗先兆流产的基石。而近代现代医学迅速发展,先兆流产的认识多基于动物实验与临床实验,对病因病机的认识已经达到基因、免疫水平,注重孕激素对妊娠维持的作用,多运用地屈孕酮、黄体酮、维生素E、绒促性素针等治疗此病。这些药物对先兆流产的诊治虽然产生了巨大的推动作用,但其治疗机制不明,副作用的相关报道也日益出现;亦有相关西方的学者对黄体酮的机制产生了质疑,某些学者认为黄体酮及其类似物对维持妊娠是无效的,另有报道称运用药物干预后对新生儿体重有一定影响。中西医结合疗法成为近20年来越来越为人接受的有效方法,秉承了二者的特长,尽量摒弃双方的缺陷,成为现代治疗先兆流产的主要方法,并在临床上取得了显著疗效。本文旨在研究单纯自制中药制剂助孕宁对早期先兆流产的作用,并进行临床观察取得显著效果。以资证明中医药保胎效果显著,且无明显毒副作用,易为广大患者接受。故如何充分发挥中医药的优势,进一步完善中医药以及中西医结合治疗先兆流产的规范,如何研制有效的外用制剂,成为我们继续探索的方向。一文献综述本文简要地综述了“胎漏”“胎动不安”的起源及发展历程,阐述了各个时期、各大医家的主要观点。探讨了先兆流产的现代起源与病因病机,并举例了西药诊治先兆流产的机理、优势及局限。简单分析了近些年中药、西药的临床运用情况。提出自制中药制剂助孕宁冲剂对于肾虚型先兆流产的有效作用,为中药单方单药的疗效研究奠定了基础。二临床研究目的:观察研究补肾活血法的院内自制药剂助孕宁冲剂对早期先兆流产的疗效。方法:将60例早期先兆流产患者随机分为治疗组30例,采用助孕宁冲剂治疗;对照组30例,采用肌注黄体酮针治疗,观察比较疗效。结果:实验组与对照组相比有着相同或者相似的疗效结果。说明助孕宁冲剂具有与黄体酮相似的作用,本方方药组成合理,治疗早期先兆流产具有显著疗效。结论:补肾活血法对早期先兆流产的治疗与西药黄体酮治疗效果一致,治疗后不良反应甚至低于黄体酮治疗的对照组。更多还原

【Abstract】 Threatening miscarriage refers to 28 weeks gestation that often appear vaginal bleeding, a small amount for wine or hemorrhagic leucorrhea, no pregnancy things eduction, arise paroxysmal next bellyacke or low back pain. Mainly includes genetic factors, uterus anatomic anomaly, infection factors, endocrine abnormalities, such as immune disorders, corpus luteum dysfunction accounts for 20% of the endocrine factors a 60%.At present the method of morden medicine to the special group for maternal following use, there are certain controversial security. Based on the present situation, explore Chinese medicine treatment of this disease has broad prospects, we in the theory of TCM clinical practice under the guidance of the disease pathogenesis, analysis, the method of the kidney and treatment of this disease. ZHUYUNNING granule’s according to the kidney and therapeutic method, applied to clinical threatening miscarriage treatment. Their clinical effect of TCM therapy for strengthening obserational study of threatening miscarriage experiment research, reveal compound mechanism of TCM therapy for threatening miscarriage, looking for scientific formula basis, for better service to clinical, provides new evidence.Objective :This paper aims to study TCM simply homemade to ZHUYUNNING, the role of early threatening miscarriage, clinical observating achieved significant results. Traditional Chinese medicine with qualification certificates to the effect significantly, with no obvious side effects, easy for the majority of patients accepted. So how to play the advantage of filling, further improve Chinese medicine combining traditional Chinese and western medicine treatment of traditional Chinese medicine and the standard, early threatening miscarriage topical agents how to develop effective, become we continue to explore direction.Methods: 60 patients with threatening miscarriage patients were randomly divided into the treatment group 30 cases, using zhuyunning granule, 30 cases in treatment, the muscle note progestin needle treatment, observing effect comparison.Results: compared with control group with same or similar results. Explain to zhuyunning granule with progestin similar effects, stack of herbs, with reasonable treatment early threatening miscarriage remarkable curative effect.Conclusion:The kidney and the treatment method of early threatening miscarriage with western medicine progestin therapeutic effect is consistent, after treatment, the adverse reactions (can add a scale, explain progestin side) and even lower than progestin treatment control group.更多还原