Meta Analysis And Clinical Observation Of Chinese Medicine In The Treatment Of Threatened Abortion

Objective:Using the method of evidence-based medicine to evaluate the clinical efficacy and safety of traditional Chinese medicine in the treatment of threatened abortion,in order to provide scientific basis for clinical treatment of threatened a.bortion with traditional Chinese medicine.At the same time,we observe the effect of Shoutai Pill combined with progesterone in the treatment of patients with early kidney deficiency threatened abortion,hoping to provide scientific basis for clinical treatment of threatened abortion with combination of traditional Chinese and Western medicine.Methods:1.Meta analysisThrough the key words to search the clinical research literature of traditional Chinese medicine in the treatment of threatened abortion in Chinese periodical full text database,Wan-fang database,China Scientific Journal Database and PubMed from January 01,2010 to December 31,2016,then the required literatures are obtained and using the modified Jadad score to evaluate the quality of the included literature,and using RevMan 5.3 software for meta-analysis.2.Clinical observationAccording to the diagnostic criteria,inclusion criteria and exclusion criteria collect 40 cases early threatened abortion patients with kidney deficiency in gynecological clinic from January 01,2016 to December 31,2016.They are given Shoutai Pill oral therapy and progesterone injection intramuscularly and observed the change of the clinical total effective rate and the TCM syndrome score,serum level of progesterone(P)and ? human chorionic gonadotropin(p-hCG)among the patients after treatment.The datas are analyzed statistically by SPSS23.0.Results:1.Meta analysis1.1 The results of the literature screening:the 23 literatures meet the standard,all of them are domestic clinical research(1 dissertation and 22 journal articles).The total sample is 2934,including the treatment group of 1539 cases,the control group of 1395 cases.1.2 Meta analysis results:(1)The total clinical effective rate analysis:The total clinical effective rate show that TCM treatment is significantly higher than Western medicine treatment,OR=3.58,95%CI=[2.85,4.50];The total clinical effective rate of oral Chinese medicine treatment is better than oral Western medicine,OR=2.30,95%CI=[1.51,3.50];The total clinical effective rate of oral Chinese medicine treatment is better than injection Western medicine treatment,OR=5.18,95%CI=[3.70,7.24];The total clinical effective rate of oral Chinese medicine treatment is better than oral and intramuscular injection of Western medicine,OR=2.78,95%CI=[1.70,4.54].(2)Progesterone level analysis:Compare with the western medicine control group,the use of TCM in the treatment of threatened abortion patients greatly improve the level of Progesterone,SMD=2.05,95%CI?[1.52,2.57].(3)Analysis of TCM syndrome score:Compare with the western medicine control group,the use of Chinese medicine treatment of patients with threatened abortion significantly reduce TCM syndrome score,SMD=-2.84,95%CI=[-3.67,-2.00].2.Clinical observationDuring the clinical observasion,5 patients are fall off because of the failure to insist on the treatment.We collect 35 patients finally.2.1 Clinical comprehensive effect:After treatment,the total effective rate is 91.43%.2.2After treatment,the patients' TCM syndrome score is decrease.Meanwhile it reduces the bleeding,the vagina bleeding time,soreness of waist,abdominal pain or bulge and other symptoms(P<0.05).It also can elevate serum level of P and ?-hCG(P<0.05).Conclusions:1.Meta analysis1.1 The treatment of Chinese medicine can significantly improve the clinical total effective rate and the level of P after treatment,reducing the TCM syndrome score after treatment,and traditional Chinese medicine treatment is superior to different use of western medicine treatment.1.2Chinese medicine in the treatment of threatened abortion is a safe and effective method.But there is a potential publication bias because the quality of included literatures are comparatively low.The clinical is still needed standard RCT to further confirm its reliability.2.Clinical observation2.1 Shoutai Pill and progesterone in treatment of early threatened abortion of kidney deficiency have a good therapeutic effect.2.2After treatment,it can improve vagina bleeding,soreness of waist and abdominal pain and other symptoms,improve serum level of P and ?-hCG conducive to maintaining normal pregnancy.