严红艳

【摘要】 目的：對药物流产后患者予以益母草膏、屈螺酮炔雌醇片联合治疗的效果进行探究，并分析其对血清孕酮、相关细胞因子的影响。方法：选取2018年3月-2019年6月于笔者所在医院妇科门诊接受药物流产的130例患者，应用随机法分为常规组及联合组，各65例。常规组给予常规治疗（头孢呋辛酯片+屈螺酮炔雌醇片），联合组在常规组基础上加用益母草膏。对比两组治疗后症状改善情况、血清孕酮水平、Th1及Th2细胞因子水平。结果：联合组阴道出血结束时间、腹痛消失时间均明显早于常规组（P<0.05）。治疗前，两组血清孕酮水平、Th1及Th2细胞因子水平比较，差异均无统计学意义（P>0.05）;治疗后，联合组血清孕酮水平、IL-2、TNF-α、IFN-γ、IL-6水平均明显低于常规组，IL-4、IL-10水平均明显高于常规组（P<0.05）。结论：对药物流产患者予以益母草膏联合屈螺酮炔雌醇片联合治疗，既可有效改善药流后阴道出血、腹痛症状，调节机体免疫功能，又可维持Th1、Th2细胞因子平衡，为药物流产后患者的生命安全提供了有力保证，值得推广。

【关键词】 益母草膏 屈螺酮炔雌醇片 药物流产 血清孕酮 细胞因子 安全性

doi：10.14033/j.cnki.cfmr.2020.18.053 文献标识码 B 文章编号 1674-6805（2020）18-0-03

Effect of Leonurus Ointment Combined with Drospirenone and Ethinylestradiol Tablets on Serum Progesterone and Related Cytokines in Patients after Medical Abortion/YAN Hongyan. //Chinese and Foreign Medical Research， 2020， 18（18）： -126

[Abstract] Objective： To explore the effect of the combination of Leonurus Ointment and Drospirenone and Ethinylestradiol Tablets on the patients after medical abortion， and to analyze the effects on the serum progesterone and related cytokines. Method： From March 2018 to June 2019， 130 patients who received medical abortion in the gynecological outpatient department of our hospital were selected and randomly divided into the conventional group and the combined group， 65 cases in each group. The conventional group received conventional treatment （Cefuroxime Axetil+Drospirenone and Ethinylestradiol Tablets）， and the combined group was added with Leonurus Ointment on the basis of the conventional group. The symptoms improvement， serum progesterone， Th1 and Th2 cytokines levels were compared between the two groups after treatment. Result： The end time of vaginal bleeding and the disappearance time of abdominal pain in the combined group were significantly earlier than those of the conventional group （P<0.05）. Before treatment， the levels of serum progesterone， Th1 and Th2 cytokines were compared between the two groups， and the differences were not statistically significant （P>0.05）. After treatment， the levels of serum progesterone， IL-2， TNF-α， IFN-γ and IL-6 in the combined group were significantly lower than those of the conventional group， and the levels of IL-4 and IL-10 were significantly higher than those of the conventional group （P<0.05）. Conclusion： The combination of Leonurus Ointment and Drospirenone and Ethinylestradiol Tablets can not only improve the symptoms of vaginal bleeding and abdominal pain， regulate the immune function of the body， but also maintain the balance of Th1 and Th2 cytokines， which provides a strong guarantee for the life safety of the patients after medical abortion and is worth promoting.

[Key words] Leonurus Ointment Drospirenone and Ethinylestradiol Tablets Medical abortion Serum progesterone Cytokines Safety

First-authors address： Zhushan County Peoples Hospital， Zhushan 442200， China

近年来，部分宫内早孕女性为了节约手术费用或恐惧手术流产而选择药物流产[1]。药物流产是指通过服用药物软化宫颈、促使子宫蜕膜变形坏死、子宫收缩，使胎囊排出体外的流产术，也是一种避孕失败的挽救措施，对女性身体损害较小，但存在阴道出血多、腹痛、宫腔粘连、月经紊乱等不良症状[2]。因此，药流后需服药治疗，避免出现不良症状。本研究以130例药物流产患者为例，旨在探究益母草、屈螺酮炔雌醇片联合治疗的临床效果，具体如下。

1 资料与方法

1.1 一般资料

选取2018年3月-2019年6月于笔者所在医院妇科门诊接受药物流产的130例患者。纳入标准：（1）年龄18～40岁;（2）孕周<10周;（3）经常规检查及B超确诊为宫内妊娠;（4）自愿药物流产。排除标准：（1）血液系统疾病;（2）合并宫腔粘连、生殖系统感染等疾病;（3）合并精神障碍、重要脏器损害;（4）胚胎宫内死亡。应用随机法分为常规组及联合组，每组65例。常规组年龄18～40歲，平均（27.56±3.29）岁;孕周（4.48±2.11）周;孕次（1.35±0.45）次。联合组年龄18～38岁，平均（27.32±3.21）岁;孕周（4.51±2.16）周;孕次（1.44±0.43）次。此次研究经医院伦理委员会批准，患者已签署知情协议书。两组年龄、孕周、孕次比较，差异均无统计学意义（P>0.05），有可比性。

1.2 方法

常规组按照医嘱服用……