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| 胶艾汤合寿胎丸联合地屈孕酮治疗脾肾两虚型早期先兆流产的临床观察研究 |
| Clinical Observation on the Combination of Jiao Ai Decoction and Shou Tai Wan with Dydrogesterone in Treating Early Threatened Abortion with Spleen-Kidney Deficiency Syndrome |
| 投稿时间：2025-07-25 修订日期：2025-07-25 |
| 中文关键词: 早期先兆流产 胶艾汤合寿胎丸 地屈孕酮 妊娠激素 凝血功能 子宫动脉血流 |
| 英文关键词: early threatened abortion Jiao’ai decoction and Shoutai Wan dydrogesterone progesterone coagulation function uterine artery hemodynamics |
| 基金项目:浙江省中医药科技计划项目基金，2024ZL658；浙江省医药卫生计划项目基金，2023KY854 |
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| 中文摘要: |
| 目的 旨在验证针对脾肾两虚型早期先兆流产使用胶艾汤合寿胎丸联合地屈孕酮的治疗价值,为新版《中成药治疗先兆流产临床应用指南》优化提供依据。方法 纳入100例脾肾两虚型先兆流产患者,随机分为试验组与对照组各50例。对照组仅接受地屈孕酮治疗,试验组同步联合胶艾汤合寿胎丸治疗,疗程为14天。随后比较两组治疗前后孕期激素水平、孕囊体积、中医证候评分、凝血功能指标、子宫动脉血流动力学参数及妊娠结局。结果 治疗后,试验组中医证候评分改善更优(P＜0.05)。两组P、β-HCG水平均升高,试验组升幅更显著(P＜0.05)。试验组APTT、PT延长,Fib、D-D下降,子宫动脉PI、RI、S/D值较对照组明显改善(P＜0.05)；孕囊体积增大,无统计学意义。试验组治疗总有效率为82%,活产率为80%,均高于对照组。此外,两组在不良妊娠结局方面未出现显著性差异。结论 胶艾汤合寿胎丸联合地屈孕酮治疗先兆流产在调节内分泌、改善凝血状态和子宫血流方面具有显著优势,提升妊娠维持率和临床疗效,安全可靠。 |
| 英文摘要: |
| Objective: To evaluate the effects and underlying mechanisms of Jiao’ai decoction combined with Shoutai Wan in the management of spleen-kidney deficiency-syndrome early threatened abortion, and to provide evidence for the revision of the new “Clinical Application Guidelines for Chinese Patent Medicines in Treating Threatened Abortion.”Methods: A total of 100 patients with early threatened abortion of spleen and kidney deficiency syndrome were randomly divided into a treatment group and a control group (n=50 each) using a random number table. The control group received dydrogesterone alone, while the treatment group received a combination of Jiao"ai Decoction and Shoutai Wan in addition to dydrogesterone. Both groups were treated for 14 days. The following parameters were compared before and after intervention: serum hormone levels , gestational sac volume, traditional Chinese medicine (TCM) syndrome scores, coagulation function indicators , uterine artery hemodynamic indices, and pregnancy outcomes.Results: After treatment, the TCM syndrome scores improved significantly in the treatment group (P<0.05). Serum P and β-HCG levels increased in both groups, with a significantly greater increase observed in the treatment group (P < 0.05). The treatment group also showed prolonged APTT and PT, decreased Fib and D-dimer levels, and significantly improved uterine artery PI, RI, and S/D values compared to the control group (P<0.05). Gestational sac volume increased in the treatment group, but the difference was not statistically significant. The live birth rate in the treatment group was 80%, and the total effective rate was 82%, both significantly higher than those in the control group (P <0.05). There were no significant differences in adverse pregnancy outcomes between the two groups.Conclusions: Jiao’ai Decoction combined with Shoutai Wan and dydrogesterone demonstrates significant advantages in regulating endocrine function, improving coagulation status, and enhancing uterine blood flow in patients with threatened abortion. The combined therapy effectively improves pregnancy maintenance and clinical outcomes, with a favorable safety profile. |
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