| ObjectiveTo observe the clinical effeciency of three methods in treating threatened abortion, which to explore and compare the clinical efficiency between traditional Chinese medicine, progesterone and human chorionic gonadotropin.MethodsThe study has enrolled 153 patients’medical records which were diagnosed as threaten abortion and kidney deffiencency syndrome in TCM while achieving residential treatment from the department of gynecology in the First Affiliated Hospital of Guangzhou Traditional Chinese Medicine University during 2011 to 2014.According to the treatment that patients have achieved, they were divided into three groups.The patients in group 1 accepted traditonal Chinese medicine, progesterone and hCG. The patients in group 2 only accepted traditional Chinese medicine. The patients in group 3 accepted traditonal Chinese medicine with progesterone. The value of serum of β-hCG and progesterone, ultrasonography before and after treatment were all collected during hospitalization. The difference about the value of serum of β-HCG and progesterone between three group has been compared in this study.The study has set the growth rate of serum β-hCG as Y-axis while the days of amenorrhea as X-axis. The relationship between the growth rate of serum β-hCG and time has been described by chart and linear equations. The study compared the difference in growth rate of serum β-hCG between three groups while analysing their correlation.TCM syndrome integral before and after treatment of each group were collected and compared.Results1. Three groups of paitents were no statistical difference in age, the days of amenorrhea and the history of adverse pregnancy (P>0.05)2. There were 65 cases in group 1,48 case in group 3 while 40 cases divided into control group 2. The outcome about cure, excellent, effective and noneffective of treatment were:group 121.54%,38.46%,29.23%,10.77%; group 2 10%,42.5%,30%,17.5% while group 3 8.33%,31.25%,35.42%,25%.3.After treatment the total cure rate in group 1 was 89.23%,while 82.5% in group 2,75% in group 3. Threre were no statistical difference in treatment efficiency between three groups.4. There was no statistical difference between three groups in serume progesterone both before and after treatment (P>0.05)5. There was no statistical difference in group 3, in serume progesterone before and after treatment (P>0.05). In group 1 the serume progesterone elevated after treatment which showed statistical significance(P<0.05). The serume progesterone decilined after treatment in group 2 which also showed statistical significance (P<0.05)6. There was no statistical difference between three group in serume β-hCG before treatment (P>0.05). There was statistical difference between three groups in serume β-hCG during 6 weeks (P<0.05). The level of serume β-hCG in group 1 was lower than both group 2 and 3, which showed statistical significance (P<0.05).While there was no statistical difference between group 2 and 3 (P>0.05)7. There was statistical difference between three groups in serume β-hCG during 7 weeks (P<0.05). The level of serume β-hCG in group 1 was lower than group 2 which showed statistical significance (P< 0.05).While there was no statistical difference between group 2 and 3, group 1 and group 3 (P>0.05).8.The level of serume β-hCG in 5 weeks and 7 weeks were compared statistically different in each group (P<0.05).9. According to the results of therapy, all the medical records were divided into two groups, the successful group and the failure group. The serume progesterone, serume β-hCG before and after treatment were compared between two groups, which showed statistically different except the serume β-hCG after treatmen (P<0.05).10. The serum progesterone before and after treatment and post-treatment serum hCG were taken logisitic multivariate regression analysis. It has found out that the outcome of therapy were significantly affected by the post-treatment serum of progesterone P<0.01, regression coefficient was 0.074, OR valued 1.076.11. In the comparison of the days of amenorrhea and serum β-hCG growth rate, the days of amenorrhea showed no statistical difference(P> 0.05).The comparison of serum β-hCG growth rate, only group 1 and group 2 showed statistical difference (P<0.05).12. As the days of amenorrhea increased, the grow rate of serume β-hCG declined. In group 1 the linear equations between the grow rate of serume β-hCG and the days of menopause has been calculated as Y=-0.029x+2.135, R2=0.023. In group 2 the linear equations between the grow rate of serume β-hCG and the days of amenorrhea has been calculated as Y=-0.024x+1.621, R2=0.211. In group 3 the linear equations between the grow rate of serume β-hCG and the days of amenorrhea has been calculated as Y=-0.018x+1.457, R2=0.05.13. There was no statistical difference in the TCM syndrome integral of kidney deficiency syndrome betweent three groups before treament (P＞0.05).There was no statistical difference in the TCM syndrome integral of kidney deficiency syndrome betweent three groups after treament (P>0.05). There was statistical difference in the TCM syndrome integral of kidney deficiency syndrome in each groups before and after treament (P<0.05).14. The history of adverse pregnancy was positively correlated with pre-treatment serum β-hCG value which showed statistical significance (P<0.05).Conclusion:1. TCM, TCM combined with progesterone, HCG and progesterone combined with TCM, three methords of treatments in treating threatened abortion were all effective. There was a significant increase in serum 3-hCG levels after treatment.2. There were no statistical difference between three groups in successful cases and failure cases. Three methords were considered no statistical difference in effectiveness.3. The supplement of HCG can improve the secretion of progesterone.4. The progesterone before and after treatment and post-treatment serume of β-hCG were considered to be the independent factors of results of treatments.5. Considering the progesterone before and after treatment and post-treatment serume β-hCG three factors together, only post-treatment serume progesterone had significant effect on the result of treatment. As one unite elevated, the susscefule rate elevated 1.076 times. The post-treatment serume progesterone has been considered to be an important factor of predicting the result of treatment.6. The difference between group 1 and group 2 and 3 in serum β-hCG levels during 6 weeks were considered to be related to hCG pharmacokinetics. As treatment carried on the difference were reducing in 7weeks.7. TCM combined with progesterone, hCG got higer serum β-hCG growth rate than only TCM treatment. With the growth in the number of days amenorrhea, serum β-hCG growth rate continued to decline, the comparison of the decline trend of serum β-hCG growth rate betweent three treament: group 1＜group 2<group 3. It has been considered complementary hCG can prolonged serum β-hCG growth. Having miscarriage history and risks of miscarriage patients should consider the use of progesterone, hCG in vitro complement. Serum β-hCG is considered as an index to assess the speed of embryonic development.8. The study consider adverse pregnancy history has influence on the level of pre-treament serume β-hCG.9. Formula Shou Taiwan can improve symptoms like vaginal bleeding, abdominal pain, backache during early threatened abortion. |
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