【作者】 汪莎；

【导师】 谢靳；

【作者基本信息】 湖北中医药大学 ， 中西医结合临床， 2010， 硕士

【摘要】 目的：观察化瘀止血方治疗流产后子宫出血不净(血瘀证)的疗效性和安全性。方法：1.临床资料所选病例均来源于2008年10月-2009年12月因流产后子宫出血不净在湖北省中医院门诊就诊,符合西医诊断为子宫复旧不良,中医辨证为血瘀证的患者48例,随机分为化瘀止血方治疗组(32例)和加味生化颗粒对照组(16例)。两组在年龄、病程、治疗前中医证侯积分及病情分级等方面经统计学分析,无显著差异性(p>0.05),具有可比性。2.药物用法治疗组：化瘀止血方(免煎颗粒),每日一剂,分三次冲服。对照组：加味生化颗粒,每日3次,每次一袋,冲服。治疗期间均停用其他治疗流产后子宫出血不净的药物及可能影响观察结果的药物。3.疗效及安全性观测两组患者在治疗前1天及用药结束后3天内分别进行中医证候评分和综合疗效评分。治疗前与治疗结束后分别做血常规、尿常规、肝肾功能(ALT、BUN、Cr)、EKG检查。4.统计方法采用SPSS. V13.0软件辅助处理,计量资料用t检验,计数资料用χ2检验,等级资料采用Ridit分析.结果：1.临床综合疗效评定比较：治疗组总有效率90.625%,对照组总有效率87.500%。治疗后,两组综合疗效比较,p>0.05,无显著差异。2.中医证候疗效比较：治疗组愈显率84.375%,总有效率90.625%,对照组愈显率81.250%,总有效率87.500%。3.中医证候积分比较：治疗前后证候总积分变化组内比较,均p<0.05,有显著差异,治疗前后证候总积分变化组间比较均p>0.05,无显著差异。4.止血疗效比较：两组患者治疗后止血疗效比较,p>0.05,无显著差异。5.两组治疗前后子宫三径情况比较：两组治疗前后组内子宫三径比较,p<0.05,有显著差异,而组间治疗前后子宫三径比较无显著差异p>0.05。6.不良反应及毒副作用比较：治疗组治疗前后安全性指标比较无显著性差异,两组在临床试验期间,均未出现明显不良反应及毒副作用。结论：化瘀止血方能有效治疗血瘀证流产后子宫出血不净,能帮助子宫复旧,明显改善流产后恶露持续时间及相关症状,临床应用安全有效,有较好的临床应用前景。更多还原

【Abstract】 ObjectiveTreatment of stasis to stop bleeding after abortion bleeding does not net (blood stasis) of the efficacy and safety.Methods1. Clinical cases were selected from October 2008-2009 years in December in line with Western medicine clinic in our hospital was diagnosed as uterine involution bad, medicine blood stasis is not the net after abortion bleeding in patients with the diagnosis of 48 cases were randomly divided Blood hemostasis for the treatment group (32 cases) and Modified biochemical particle control group (16 cases). The two groups in age, duration, TCM Hou score, disease classification and so on through statistical analysis, no significant difference (p> 0.05), comparable.2. Drug use treatment group:Blood hemostasis side (to avoid fried grain), one dose a day, three times a Chongfu. Control group: Modified biochemical particles, three times a day, every bag. Out during treatment were no other treatment of uterine bleeding after abortion drug and the net result may affect the observed drug.3. Efficacy and safety of observing two groups of patients before Treatment one day, and three days after treatment score and comprehensive TCM efficacy score. Before and after treatment so routine, urine routine, liver and kidney function (ALT, BUN, Cr), EKG examination.4. Statistical Methods SPSS.V13.0 auxiliary processing software, using t test measurement data, count data using X2 test, using Ridit level data analysis.Results:1. Comprehensive comparison of clinical efficacy evaluation:The total effective 90.625%, control group was 87.5%. After treatment, more comprehensive effect, p> 0.05, no significant difference.2. TCM after the points to determine efficacy of comparison:the treatment group markedly effective rate of 84.375%, the total effective rate was 90.625%, markedly effective rate of 81.25% in control group, the total effective rate was 87.5%.3. The total symptom score comparison:before and after treatment comparison group, both p<0.05, statistically significant changes after treatment, symptom total score between the two groups were p> 0.05, not significant.4. Comparison of hemostatic efficacy:Hemostatic efficacy of the two groups were compared after treatment, p> 0.05, no significant difference.5. Uterus before and after treatment in both groups compared to the situation three tracks:two groups were compared before and after treatment of uterine three-path, p<0.05, significant difference between the groups before and after treatment of uterine three-path no significant difference p> 0.05.6. Comparison of adverse reactions and side effects:treatment group before and after the safety index was no significant difference between treatment and control groups in the clinical trial period, no significant adverse reactions and side effects.Conclusion:Blood stasis to stop bleeding to effectively treat uterine bleeding after abortion is not the net, can help uterine involution, lochia significantly improved the duration of post-abortion and related symptoms, the clinical application of safe and effective and has good prospect for clinical application.更多还原