【作者】 郭红玉；

【导师】 何贵翔；

【作者基本信息】 南京中医药大学 ， 中医学， 2010， 硕士

【摘要】 目的：观察滋肾疏肝宁心法合黄体酮对肾虚肝郁型早期先兆流产的临床疗效,探讨中药联合黄体酮安胎的优效性,同时对患者血清催乳素(PRL)水平进行动态监测,观察其在妊娠早期的变化规律,以及对早期先兆流产预后的评估。方法：选择中医辨证属肾虚肝郁型早期先兆流产患者86例,分为实验组48例和对照组38例。其中实验组采用中药配合黄体酮治疗,对照组单用黄体酮治疗。观察时间为4周,对两组治疗前后情况进行统计分析,并于治疗前及治疗后3周(共4次),每周早晨9：00-10：00之间空腹抽血测定血清PRL、孕酮(P)、人绒毛膜促性腺激素(β-HCG)值,进行治疗前后的自身对照及组间对照以及血清PRL值的变化趋势。结果：中药配合黄体酮组在改善主要症状、肝郁症状及中医证侯总有效率均优于对照组。治疗后血清P及β-HCG值均有显著升高,血清PRL呈逐步上升趋势,治疗组和对照组组间无显著差异性。保胎成功者血清PRL上升趋势明显,保胎失败者血清PRL无明显变化或呈下降趋势。结论：滋肾疏肝宁心法合黄体酮治疗肾虚肝郁型早期先兆流产临床疗效确切,能有效提高早期妊娠血清P及β-HCG水平,同时能升高血清PRL。血清PRL在妊娠早期呈上升趋势提示妊娠结局良好,故妊娠早期动态监测血清PRL对预测早期先兆流产的妊娠结局有一定的指导意义。更多还原

【Abstract】 OBJECTIVE:To observe the clinical efficacy of therapy in the way of nourishing kidney and liver,as well as discuss the optimal efficiency of Chinese meditine cooprate progestin.Meanwhile testing dynamically serum prolactin to determine the evolution,and to determine its vaule in prediction of the first-trimester threatened abortion.METHODS:86 patiens were randomly assigned to 2 groups,the experimental group(n=48) and the control group(n=38).The experimental group utilize Chinese meditine cooprate progestin,the control group utilize progestin.Viewing time is 4 weeks, statistical analysis the data of prethearph and post-treatment.Every week the serum PRL,P and P-human menopausal gonadotropin are tested(4 times) on an empty stomach between 9:00 and 10:00,comparing these three indices and clinical symptoms respectively of the each group or between the groups before and after treatment and anlysing the tendency of the level of PRL.RESULTS:The improvement of cardinal symptoms,stagnation of liver-QI symptoms is more significant in the t.c.m cooprate progestin group than the control group.The serum P and P-HCG increase in the both groups after treatment.The serum PRL also increase along with pregnancy. The serum PRL is increasing significantly in the success group as times gose while this is not significant in the group of has a failure of gestion.CONCLUTION:It’s a significant of the clinical efficacy of the herbal theraph in the way of nourishing kidney and liver for first-trimester threatened abortion, improving the level of serum PRL,P andβ-HCG.It suggests a good outcome of first-trimester threatened abortion with the level of serum PRL increasing under treatment.Serial test on the serum PRL is valuable in clinical practice in predicting pregnancy outcome of first-trimester threatened abortion.更多还原