| Object:To observe the clinical effect of acupoint application of Antaiyihao to improve symptoms in kidney-deficiency patients with threatened abortion, analyze the relevant factors of symptom improvement, so as to provide a scientific evidence for choosing a safe and effective TCM nursing method for these patients in clinic.Method:Seventy-eight women with kidney-deficiency threatened abortion from Hangzhou Hospital of Traditional Chinese Medicine were chosen as study subjects based on convenient sampling. They were randomly divided into intervention group (N=39) and control group (N=39). The combination of traditional Chinese and western medicine treatment made by the TCM-doctor and routine health education were used in the control group and interventional group. Besides, the interventional group also received acupoint application of Antaiyihao. The intervention was done once a day, six to eight hours each time, seven times as a course, and two courses consecutively in total. The TCM syndrome scores (main symptoms integral/minor symptoms integral), human chorionic gonadotrophin (HCG), progesterone (P), estradiol (E2) and Self-Rating Anxiety Scale (SAS) were recorded before entering the group, seven days after entering the group, and fourteen days after entering the group. Observation method and visual analogue scale (VAS) were adopted to evaluate the state of vaginal bleeding, waist soreness and abdominal pain every day by study subjects themselves. Then the researcher would calculate relief time of vaginal bleeding, soreness of waist, and abdominal pain. All the women were followed up until 12 weeks after pregnancy, and ongoing pregnancy rate according to Nuchal translucency (NT) was compared between the two groups.Result:Seventy-three women completed data collection, with thirty-six women in the control group and thirty-seven women in the intervention group. There was no significant difference in ongoing pregnancy rates between two groups (P>0.05).1. Three repeated measurement results of before entering the group, seven days after entering the group, fourteen days after entering the group showed that the minor symptoms integral of the two groups had no statistically significant difference (P>0.05), but there were significant interactions between group and time(P<0.05). And the main symptoms integral was statistically significant (P<0.05), which had a reducing trend as the time of entering group prolonged (P<0.05). The main symptoms integral of interventional group reduced more than that of the control group.2. There was no significant difference in duration rate of vaginal bleeding between the two groups (P>0.05), the median duration time of vaginal bleeding was four days and six days in the control group and the interventional group respectively. There were significant differences in the duration rate of soreness of waist and abdominal pain between the two groups (P<0.05). The median duration time of waist soreness in the control group and interventional group was twelve days and three days respectively. While the median duration time of abdominal pain was eleven days and six days in the control group and interventional group respectively.3. Cox’s proportional hazards regression model showed acupoint application, hysteroscopy, duration of waist soreness before entering the group, estational age were important independent influence factors for shortening the duration time of soreness of waist and abdominal pain for kidney-deficiency patients with threatened abortion. Among them, acupoint application (RR=6.44,95%CI:3.07-13.59), hysteroscopy (RR=0.39, 95%CI:0.39-0.82), duration of waist soreness before entering the group (RR=0.92,95%CI:0.85～0.99) were found to be factors influencing waist soreness improvement (P<0.05).Acupoint application (RR=3.44,95%CI:1.84～6.45), gestational age (RR=0.61,95%CI:0.41～0.92) were found to be factors influencing abdominal pain improvement (P<0.05).4. Fourteen days after entering the group, progesterone was increased significantly (P<0.05), but there was no significant difference compared between the two group (P>0.05).5. Fourteen days after entering the group, scores of SAS progesterone was reduced significantly (P<0.05), but there was no significant difference compared between the two group (P>0.05).Conclusions:1 Acupoint application of Antaiyihao can improve the main symptom of kidney-deficiency patients with threatened abortion, and it is a protective factor for soreness of waist and abdominal pain.2 Strengthen health educations for those who has hysteroscopy history, with long time of waist soreness before entering the group, and more than six weeks of the gestational age clinically.3 During the acupoint application, there is no influence on levels of human chorionic gonadotrophin, progesterone, estradiol, self-rating anxiety scale score, and it is safe without harmful effect, and it deserved clinical populization and application. |
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