2018 年第 6 期 第 13 卷

加味益脾增液汤联合益脾生津颗粒治疗妊娠晚期羊水过少的临床研究

Clinical observation of modified Yipi Zengye decoction combined with Yipi Shengjin granule in treatment of oligohydramnios in late pregnancy

作者：饶梅冬窦蕾

英文作者：

单位：830001乌鲁木齐市妇幼保健院中医妇科

英文单位：

关键词：羊水过少；妊娠晚期；加味益脾增液汤；益脾生津颗粒；羊水指数；凝血功能

英文关键词：

• 摘要：

• 【摘要】目的    探讨加味益脾增液汤联合益脾生津颗粒治疗妊娠晚期羊水过少的临床效果。方法    选取2014年8月至2016年12月乌鲁木齐市妇幼保健院收治的200例妊娠晚期羊水过少孕妇，按照随机数字表法分为对照组和观察组，各100例。对照组采用静脉滴注5%葡萄糖溶液和饮水治疗；观察组在对照组基础上口服益脾生津颗粒和加味益脾增液汤治疗。比较2组治疗前后羊水指数、最大羊水池深度、临床疗效、脐血流收缩期最大血流速度/舒张末期最小血流速度（S/D）比值、凝血功能指标和不良妊娠结局。结果    治疗14 d后，观察组羊水指数及最大羊水池深度均大于对照组［（12.3±2.3）cm比（7.8±2.7）cm、（50±7）mm比（31±7）mm］，差异均有统计学意义（均P＜0.001）。观察组治疗总有效率高于对照组［95.0%（95/100）比70.0%（70/100）］，差异有统计学意义（P＜0.001）。治疗14 d后，观察组脐血流S/D比值低于对照组［（1.80±0.27）比（2.90±1.01）］，差异有统计学意义（P＜0.001）。治疗前后，2组凝血功能指标组间比较及组内比较，差异均无统计学意义（均P＞0.05）。观察组不良妊娠结局发生率明显低于对照组［3.0%（3/100）比13.0%（13/100）］，差异有统计学意义（P=0.009）。结论    加味益脾增液汤联合益脾生津颗粒可改善妊娠晚期羊水过少孕妇羊水指数及最大羊水池深度，且对凝血功能无明显影响，有助于改善胎儿脐血流，降低不良妊娠结局发生率。

• 【Abstract】Objective    To investigate the clinical effect of modified Yipi Zengye decoction combined with Yipi Shengjin granule on oligohydramnios in late pregnancy. Methods    Totally 200 pregnant women with oligohydramnios in late pregnancy admitted in Maternal and Child Health Hospital of Urumqi from August 2014 to December 2016 were randomly divided into control group and observation group, with 100 cases in each group. The control group was treated with maternal hydration therapy; the observation group was treated with modified Yipi Zengye decoction combined with Yipi Shengjin granule on the basis of control group. Amniotic fluid index(AFI), maximum depth of amniotic fluid pool, maximum systolic velocity/minimum end-diastolic velocity of umbilical blood flow（S/D）, coagulation indexes, clinical therapeutic effect and adverse pregnancy outcomes were analyzed. Results    After 14 d treatment, AFI and maximum depth of amniotic fluid pool in observation group were significantly higher than those in control group［（12.3±2.3）cm vs （7.8±2.7）cm,（50±7）mm vs （31±7）mm］（P＜0.001）. Total effective rate in observation group was significantly higher than that in control group［95.0%（95/100） vs 70.0%（70/100）］（P＜0.001）. After treatment, the S/D value in observation group was significantly lower than that in control group［（1.80±0.27） vs （2.90±1.01）］（P＜0.001）. Coagulation indexes showed no significant differences between groups before and after treatment（P＞0.05）. Incidence of adverse pregnancy outcomes in observation group was significantly lower than that in control group［3.0%（3/100） vs 13.0%（13/100）］（P=0.009）. Conclusion    Modified Yipi Zengye decoction combined with Yipi Shengjin granule treating oligohydramnios in late pregnancy can increase amniotic fluid index and maximum depth of amniotic fluid pool, improve fetal umbilical blood flow and reduce adverse pregnancy outcomes.