摘要
目的:评价耳穴埋针联合地屈孕酮治疗早期妊娠先兆流产合并绒毛膜下血肿的临床疗效。方法:将80例患者随机分为观察组和对照组,每组40例。对照组口服地屈孕酮治疗,每次10mg,每日2次,至妊娠12周;观察组在对照组基础上加用耳穴埋针治疗,耳穴取盆腔、皮质下、肾、心、肝、交感及内分泌,两耳交替治疗,每3日更换1次,每周休息1d,共干预3周。比较两组治疗前、治疗10d、治疗20d患者辅助性T淋巴细胞(Th细胞)比例、抑制性T淋巴细胞(Ts细胞)比例、Th/Ts比值及血清CA125水平,采用B超评估绒毛膜下血肿面积、孕囊面积变化,并比较两组临床疗效。结果:观察组有效率为80.0%(32/40),高于对照组的65.0%(26/40,P<0.05)。两组治疗10、20d后Th、Th/Ts均明显低于治疗前(P<0.01),Ts较治疗前明显升高(P<0.01);治疗20d后观察组Th、Th/Ts低于对照组(P<0.01),Ts高于对照组(P<0.01)。治疗10、20d后,两组血清CA125水平均较治疗前下降(P<0.01),且观察组低于对照组(P<0.01)。治疗10、20d后,观察组绒毛膜下血肿面积/孕囊面积的比值明显低于对照组(P<0.01)。结论:耳穴埋针联合地屈孕酮可提高治疗早期妊娠先兆流产合并绒毛膜下血肿的有效率,调节免疫因子,促进血肿吸收,与地屈孕酮具有较好的协同作用。
Objective To evaluate the therapeutic effect of auricular acupuncture combined with dydrogesterone for threatened abortion in early pregnancy complicated with subchorionic hematoma. Methods A total of 80 patients were randomized into an observation group and a control group, 40 cases in each one. In the control group, dydrogesterone was taken orally twice a day, 10 mg a time until 12-week into pregnancy. In the observation group,auricular acupuncture was applied at penqiang(TF5), pizhixia(AT4), shen(CO10), xin(CO15), gan(CO12), jiaogan(AH6a) and neifenmi(CO18) on the basis of the control group, the auricular points on both sides were used alternatively. The auricular points were replaced every 3 days with 1 day break, totally 3 weeks(20 days) were required. Before treatment and after 10, 20 days of treatment, the percentage of helper T lymphocyte(Th) and inhibitory T lymphocyte(Ts), ratio of Th and Ts and serum level of CA125 were compared in the two groups. The areas of subchorionic hematoma and gestational sac were evaluated by B ultrasound. The therapeutic effect in the two groups were compared. Results The effective rate in the observation group was 80.0%(32/40), which was superior to 65.0%(26/40) in the control group(P<0.05). After 10, 20 days of treatment, the percentage of Th and ratio of Th and Ts were lower than before treatment, the percentage of Ts were increased in the two groups(P<0.01). After 20 days of treatment, the percentage of Th and ratio of Th and Ts in the observation group were lower than the control group(P<0.01), the percentage of Ts was higher than the control group(P<0.01). After 10, 20 days of treatment, the serum levels of CA125 were reduced compared before treatment in the two groups(P<0.01), and the serum levels of CA125 in the observation group were lower than the control group(P<0.01). After 10, 20 days of treatment, the ratio of subchorionic hematoma area and gestational sac area in the observation group was lower than the control group(P<0.01). Conclusion Auricular acupuncture c
作者
吴家满
宁艳
廖坚
陈瑜
胡珊
卓缘圆
WU Jia-man;NING Yan;LIAO Jian;CHEN Yu;HU Shan;ZHUO Yuan-yuan(Department of TCM, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518028, Guangdong Province, China;Department of Acupuncture and Moxibustion, Shenzhen TCM Hospital, Shenzhen 518033, GuangdongProvince)
出处
《中国针灸》
CAS
CSCD
北大核心
2019年第10期1046-1050,共5页
Chinese Acupuncture & Moxibustion
基金
深圳市三名工程资助项目:SZSM201612046
