Observation On The Clinical Effect Of Gushen Xiaoyu Antai Therapy In The Treatment Of Early Threatened Abortion With Subchorionic Hematoma

Objective:To observe the clinical efficacy of the method based on kidney consolidation,anti-stasis and antifetal method on patients with early threatened abortion combined with subchorionic hematoma.To investigate the effects of the method to improve the rate of fetal preservation;to relieve the symptoms of pre-eclampsia such as abdominal cramps and back pain;to promote the absorption of SCH hematoma area;to shorten the time of vaginal hemostasis;and to investigate the effects on the hormone level during pregnancy.Methods:Among the patients attending the Affiliated Hospital of Jiangxi University of Chinese Medicine in 2019-2020,75 samples were strictly selected according to the inclusion criteria,patients were informed of relevant matters,consent was obtained from patients and their families,and an informed consent form was signed.The 75 patients were randomly divided into treatment and control groups using a random number table.38 patients in the treatment group were treated with the method of consolidating the kidney and eliminating the fetus,specifically using traditional Chinese medicine combined with oral dydrogesterone tablets;37 patients in the control group were treated with dydrogesterone tablets symptomatically,and if the bleeding was obvious in both groups,hemostatic combination was added to the treatment.A course of treatment was given for 7 days,and 2 courses of treatment were used continuously.The following observations were made on the first day of treatment and the end of treatment:1)the changes in the TCM symptoms score and the time of vaginal hemostasis;2)ultrasound monitoring of the absorption of subchorionic hematoma;3)Serun human chorionic gonadotropin（β-HCG）,estradiol（E₂）and progesterone（P）,so as to observe the clinical efficacy of the patients and evaluate the rate of fetal preservation by the method of consolidating the kidney and eliminating silt and blood to stabilize the fetus.Results:75 patients were enrolled,including one case in the treatment group who couldn’t cooperate with the treatment in the middle of the treatment period due to geographical reasons,and 74 cases were actually included,37 in each of the treatment and control groups.6 cases in the treatment group were ineffective,including 4 cases of miscarriage due to severe bleeding and 2 cases of embryonic arrest.In the control group,11 cases were ineffective,including 7 cases of miscarriage due to severe bleeding and 4 cases of embryonic abortion.The fetal retention rate in the treatment group was 83.78%compared with 70.27%in the control group.In terms of the TCM syndrome score:The TCM syndrome score was statistically significant in both groups compared with that before treatment（P<0.05）,but the effect of the method of consolidating the kidney and eliminating the silt to stabilize the fetus was better than that of oral dextran alone.In terms of promoting the absorption of SCH hematoma area:There was a difference in SCH between the two groups after treatment compared with that before treatment（P<0.05）,with a significant difference in the treatment group with the method of consolidating kidney and eliminating fetus（P<0.05）,and the effect was better than that of the control group with oral dydrogesterone tablets.In terms of improving the time of vaginal hemostasis:the time of vaginal hemostasis was statistically significant in both groups after treatment（P<0.05）,but the effect of the treatment group with the method of consolidating the kidney and eliminating fetus was better than that of the control group with the oral administration of drospirenone tablets.As for the improvement of progesterone:β-HCG and E₂of patients in both groups were different after treatment compared with those before treatment,（P<0.05）,and the treatment group with the method of consolidation of kidney and elimination of fetus had a significant difference（P<0.05）,and the effect was better than that of the control group with oral dydrogesterone tablets.However,in this experiment,in terms of progesterone improvement,both groups were effective in promoting progesterone growth,and there was no statistical difference between the results of the two groups compared with each other after treatment（P>0.05）.Conclusion:1.The method of consolidating the kidney and eliminating silt and blood to calm the fetus has good clinical effects in improving the rate of fetal preservation in the treatment of early preeclampsia combined with SCH,is safe and feasible,and is worthy of clinical promotion and application.2.In the treatment of early preeclampsia combined with SCH,the method of consolidating the kidney and eliminating silt and blood has outstanding advantages in relieving the symptoms of preeclampsia such as lumbago and abdominal cramps.3.Kidney consolidation and fetus anti-stasis method has obvious advantages in promoting the absorption of SCH hematoma area and shortening the time of vaginal hemostasis.4.Both the method and the tablet have clinical effects on the improvement of Serun human chorionic gonadotropin（β-HCG）and estradiol（E₂）in patients,and the effect of the method is better than that of the tablet.5.In the elevation of progesterone（P）levels,there was an effect in both the treatment and control groups,but the results were not statistically significant when comparing the two.