| Objective:By observing the changes of subchorionic hematoma volume,serum b-HCG,progesterone,D-dimer,CA125 value,vaginal bleeding stopping time,TCM syndrome integral changes and adverse reactions in patients with early threatened abortion complicated with mild to moderate subchorionic hematoma and kidney deficiency syndrome treated with Yishen Hexue Antai Yin and Diqu progesterone,the mechanism of action was preliminarily explored.The purpose of this study is to provide an effective and safe treatment for early threatened abortion with mild to moderate subchorionic hematoma and kidney deficiency syndrome.Methods:This study was conducted by a completely randomized,single-blind,parallel control method.Patients with early threatened abortion complicated with mild or moderate subchorionic hematoma and kidney deficiency syndrome diagnosed in the obstetrics and gynecology clinic and ward of the first affiliated Hospital of Anhui University of Chinese Medicine from April 2020 to February 2021 were selected according to the inclusion criteria of this study.a total of 60 cases were randomly divided into control group(n = 30)and observation group(n = 30).The control group was given basic treatment such as Diqu progesterone,vitamin E soft capsule and folic acid tablets,while the observation group was treated with Yishen Hexue Antai Yin on the basis of the control group.7 days as a course of treatment,two courses of treatment were observed.The changes of subchorionic hematoma volume,serum b-HCG,progesterone,D-dimer,CA125 value,stopping time of vaginal bleeding,TCM syndrome score and adverse reactions were recorded before,one week and two weeks after treatment.The test results were analyzed by SPSS statistical analysis software.Results:1.General and baseline information.There was no significant difference in age,pre-pregnancy BMI,pregnancy history and menopause days between the observation group and the control group.There was no significant difference in the time of vaginal bleeding,the degree of SCH,SCH volume,SCH volume / gestational sac volume,serum b-HCG,progesterone,D-dimer,CA125 and TCM syndrome score between the two groups before treatment.2.Comprehensive clinical efficacy.Patients in both groups were followed up to 14 weeks of pregnancy,and there were no cases of embryo arrest and spontaneous abortion in the observation cycle.The total effective rate of Yishen Hexue Antai Yin combined with western medicine group was93.3%,and that of simple western medicine group was 73.3%,with significant difference(P < 0.05).3.Volume change of SCH.One week and two weeks after treatment,the volume of SCH and the volume of SCH / gestational sac in the observation group were lower than those in the control group,and the difference was statistically significant(P < 0.05).In the observation group,the volume of SCH after one week of treatment was lower than that before treatment,but the volume of SCH / gestational sac decreased,and the volume of SCH and the volume of SCH / gestational sac after two weeks of treatment were significantly lower than those before treatment.In the control group,the volume of SCH increased slightly after one week of treatment,but the volume of SCH / gestational sac decreased,and the volume of SCH and the volume of SCH / gestational sac decreased after two weeks of treatment,and the difference was not statistically significant(P > 0.05),and there was no significant difference between the control group and the control group(P >0.05),and the volume of SCH and the volume of SCH / gestational sac after two weeks of treatment were significantly lower than those before treatment(P < 0.05).4.Changes of serum b-HCG,progesterone,D-dimer and CA125.One week after treatment,the levels of serum b-HCG and progesterone in the Yishen Hexue Antai Yin group were higher than those in the simple western medicine group,and the values were also significantly higher than those before treatment(P <0.05).Two weeks later,the levels of serum b-HCG and progesterone in the Yishen Hexue Antai Yin group were still higher than those in the simple western medicine group,and showed a gradual upward trend compared with those before treatment and one week after treatment,with significant difference(P < 0.05).One week after treatment,the value of blood D-dimer in the Yishen Hexue Antai Yin group was not significantly different from that in the simple western medicine group(P > 0.05),but slightly lower than that before treatment,but the difference was not significant(P > 0.05).Two weeks after treatment,the value of blood D-dimer in the Yishen Hexue Antai Yin group was lower than that in the simple western medicine group,and it was significantly lower than that before treatment and one week after treatment(P < 0.05).There was no significant difference in the value of blood D-dimer before treatment,one week after treatment and two weeks after treatment in the simple western medicine group(P > 0.05).One week after treatment,the value of blood CA125 in the Yishen Hexue Antai Yin group was lower than that in the simple western medicine group,and the difference was not significant(P > 0.05).Two weeks later,the value of blood CA125 in the Yishen Hexue Antai Yin group was slightly lower than that in the simple western medicine group,and the blood CA125 value in the Yishen Hexue Antai Yin group decreased gradually compared with that before treatment and one week after treatment,and the difference was not significant(P > 0.05).5.The stop time of vaginal bleeding and the change of TCM syndrome score.The average stopping time of vaginal bleeding was 5.73 ± 2.43 days in the observation group and 8.07 ± 2.86 days in the control group,the difference was statistically significant(P < 0.05).One week after treatment,the TCM syndrome score of patients in the Yishen Hexue Antai Yin group was lower than that in the simple western medicine group,and the integral value was also significantly lower than that before treatment(P < 0.05).Two weeks later,the TCM syndrome score in the Yishen Hexue Antai Yin group was lower than that in the simple western medicine group,and the TCM syndrome score decreased gradually compared with that before treatment and one week after treatment,and the difference was also significant(P < 0.05).6.Safety related indicatorsDuring the course of observation,the safety-related indexes of all cases were not significantly abnormal.Conclusion:1.In the treatment of early threatened abortion with mild to moderate SCH kidney deficiency syndrome,increasing Yishen Hexue Antai Yin is superior to the western medicine group in protecting fetus,reducing the volume of hematoma,promoting the absorption of hematoma,shortening the time of vaginal bleeding and improving clinical symptoms.2.Increasing Yishen Hexue Antai Yin group and simply using western medicine group could increase the level of serum b-HCG and progesterone,but it was more obvious in Yishen Hexue Antai Yin group.3.Increasing Yishen Hexue Antai Yin group can significantly reduce the value of maternal blood D-dimer after two weeks of treatment.It is speculated that Yishen Hexue Antai Yin can reduce the hypercoagulable state of pregnant blood,reduce the vascular resistance between mother and fetus,and improve the blood circulation at the interface between mother and fetus.4.Yishen Hexue Antai Yin combined with western medicine group is safe and effective in the treatment of early threatened abortion with mild to moderate subchorionic hematoma and kidney deficiency syndrome,and no obvious adverse reactions and side effects are found,so it is worthy of clinical application. |
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