Systematic Evaluation Of Traditional Chinese Medicine Combined With Progesterone In The Treatment Of Recurrent Miscarriage And Summary Of The Tutor's Experience

Background Recurrent abortion is a common disease in gynecological clinics and the most common complication of pregnancy,with an incidence of about 5%.At present,although modern medicine has achieved some ther apeutic effects on recurrent abortion,it still needs to be improved.In the past 20 years,many clinical studies on Chinese medicine combined with progesterone in the treatment of recurrent abortion have been published,which provide a lot of evidence for clinical practice,but there has not been a rigorous evaluation and systematic review of these studiesObjectives Comprehensively and systematically retrieve randomized controlled trials of traditional Chinese medicine for recurrent miscarriage,summarize the current status of evidence in clinical studies,and compare the efficacy and safety of traditional Chinese and western medicine with western medicine or traditional Chinese medicine,and evaluate the treatment of recurrent miscarriage for clinical practice.Provide high-level evidence-based medicine evidence,and discuss methodological issues in clinical research from the perspective of evidence-based medicine,and propose corresponding improvements to improve th e quality of domestic traditional Chinese medicine for recurrent abortion.In addition,the instructor's experience in treating recurrent miscarriage was introduced to provide more references for clinical treatment of recurrent miscarriage.Material and methods The author uses evidence-based medicine,the electronic datab ases retrieved by computer include full-text journal database of CNKI,WEIPU Chine se science and technology journal database,Wan fang database,Chin ese biomedical I iterature database,Pub Med medical literature retrieval service system.Each database i s searched from the database established until March 15,2020.The first part was to evaluate the m ethodological quality of the 14 included articles.The second part is the meta-analysis of the randomized contr olled trial included by RevMan5.3 software.Of the 14 included articles,a total of 1487 patients with recurrent abortion were includ ed in the study.The quality of included studies is generally low and there is a high r isk of bias.Among the 14 in cluded literature,the outcome indexes measured varied,mainly including total effective rate,pregnancy success rate,TCM syndrome score,progesterone,HCG value,and time of symptom disappearance before and after treat ment.The meta-analysis results of 14 RCTS showed that the experimental group(Chi nese and western medicine group)was:(1)improve the overall effective rate(RR=1.27.12=0%<50%,95%CI=[1.20,1.34],Z=8.90.P<0.00001<0.05),improve the success rat e of pregnancy(RR=1.38,12=0%<50%,95%CI=[1.22,1.56].Z=5.09.P<0.00001<0.05),improve the score of TCM syndromes(SMD=-4.31,95%CI=[-4.74.3.88],Z=19.51,P<0.05),Shortening the time of vaginal bleeding(SMD=-2.27,95%CI=[-4.1],-1.22],Z=3.62,P=0.0003<0.05)was better than the control group.(2)HCG levels at 6 weeks(SM D=1743.28,95%CI=[-2357.89.5845.46],Z=0.83,P=0.40>0.05),8 weeks(SMD=-456.27,95%CI=[-1053.97,141.44],Z=1.50,P=0.13>0.05),10 weeks(SMD=-394.10.95%CI=[-950.47,117.26],Z=1.51,P=0.13>0.05),increased the levels of progesterone at six weeks(S MD=-4.47,95%CI=[-57.21,48.27],Z=0.17,P=0.87>0.05).eight weeks(SMD=16.93,95%CI=[-20.41 54.27],Z=0.89,P=0.37>0.05),ten weeks(SMD=-0.20,950%CI=[-5.00,4.60],Z=0.08,P=0.93>0.05),There was no significant difference between the control group(west ern medicine group)and the control group(SMD--2.27,95%CI=[-4.63,0.09],Z=1.89).Conclusion Chinese medicine combined with progesterone in the treatment of recurrent abortion has potential efficacy and better safety.The combined application of traditional Chinese medicine and western medicine progesterone therapy can improve the total effective rate and pregnancy success rate of patients with recurrent abortion and reduce the incidence of second abortion compared with the single western medicine treatment.Also,it can be helpful to reduce symptoms,shorten the time of vaginal bleeding,reduce adverse reactions.There are methodological problems in the clinical study of Chinese and western medicine for the treatment of recurrent abortion,including study designing,inclusion subjects,treatm ent selection and controlling measures,and efficacy evaluation indicators.Therefore,the results are highly biased.These conclusions require further high-quality randomized controlled trials to confirm the evaluation indicators.Finally,the experience of the tutor is introduced for the purpose of clinical guidance.Whether it is evidence-based medicine or experience summary or case analysis,it is expected to serve for more effective clinical treatment.In order to better guide clinical p ractice and academic research,the use of evidence-based m edicine in the treatment of recurrent abortion is a better plan.The third part of this paper introduces the specific experience of the tutor in the treatment of recurrent abortion and the sharing of cases.Mentor flexible according to the theory of traditional Chinese medicine combined with modern medicine dialectical,clever use of traditional Chinese medicine combined with western medicine,treatment of keeping on prevention of the disease,the prevention and treatment of combined with periodic princip le,pregnancy,pregnancy after the fetus,both reduces the western medicine adverse reaction and discomfort symptoms,and can be adjusted through the body's endocrine environment to increase the success rate of pregnancy and reduce the recurrence rate.In addition,in the treatment process at the same time pay attention to the patient's physical and mental recuperation,and the clinical efficacy is significant.