Analysis Of Premature Rupture Of Membrane In The South Area Of The Five Ridges And Its Syndrome Elements Characteristics And Syndrome Distribution

ObjectivesThis prospective research managed to distinguish clinical syndrome characteristics,syndrome elements and syndrome distribution differentiation based on traditional Chinese medicine among native patients with premature rupture of membrane(PROM)in south area of the Five Ridges via traditional Chinese therapy combined with modern medical statistics analysis in order to further standardize clinical diagnoses and improve the curative effect of traditional Chinese medicine.MethodsBased on epidemiology researches and case control studies,393 hospitalized cases in our department diagnosed PROM and 400 normal parturition cases were collected from November 1,2016 to January 31,2018.Group A established as term-after premature rupture of membranes(TPROM)contained 324 cases,group B as preterm premature rupture of of membranes(PPROM)contained 69 cases.Group C established as none PROM(NPROM)contained 400 normal parturition cases.Single and multiple factor analysis of variance and logistic regression based on clinical evidence collected via traditional Chinese therapy were used to elaborate high risk factors and outcomes of infants and mothers.Clustering analysis was used to elaborate differentiation of syndrome elements and syndrome distribution of native patients in south area of the Five Ridges based on traditional Chinese medicine.Results1.Compared to group C,neonatal birth weight,suffocation and incidence rate of hyperbilirubinemia in group B were elevated.Incidence rate of postpartum hemorrhage were both elevated in group A and B compared to group C.2.Demonstrated by single factor analysis,elements as upper reproductive tract infection,history of abortion and odinopoeia showed a convincible correlation with PPROM,as well as pregnancy accompanied with anemia,diabetes mellitus,elevated CRP or PCT.Five elements were significantly related to TPROM(P<0.10)including upper reproductive tract infection,abnormal fetal position,pregnancy accompanied with diabetes mellitus,hypertensive disorciers in pregnancy,and elevated WBC or NHU%.Elements above wore then analyzed by logistic regression analysis,demonstrating that high risk factors of PPROM(P<0.05)contained abortion and odinopoeia history(P=0.000,OR=7.321,95%CI[3.475-15.425]),elevated CRP or PCT(P=0.000,OR=4.483,95%CI[2.165-9.282]),pregnancy accompanied with anemia(P=0.001,OR=4.007,95%CI[1.747-9.193]),elevated WBC or NEU%(P=0.001,OR=3.242,95%CI[1.624-6.472]),upper reproductive tract infection(P=0.021,OR-2.181,95%CI[1.127-4.221]).High risk factors of TPROM(P<0.05)contained pregnancy accompanied with diabetes mellitus(P=0.000,OR=3.261,95%CI[2.027-5.247]),abnormal fetal positjon(P=0.003,OR=2.018,95%CI[1.277-3.191]),hypertensive disorders in pregnancy(P=0.025,OR=1.676,95%CI[1.067-2.631]),elevated WBC or NEU%(P=0.028,OR=1.490,95%CI[1.043-2.128]),upper reproductive tract infection(P=0.022,OR=1.47695%CI[1.057-2.060]).3.98 of the most common syndromes among lota]393 PROM cases col lected in this research,adminivtrated by clustering analysis and clinical therapy,could be practical ly classified lby fol lowing syndromes:deficiency of Qi and Xue,Qi-stagnation and phlegm-damp,blood stasis and damp-heat.Syndromes of TPROM consisted of four types:deficiency of Qi and Xue;combination of Qi-stagnation and phlegm-damp;blood stasis;damp-heat.Sydromes of PPROM consisted of three types:Qi-stagnation and blood stasis and phlegm-damp;deficiency of Qi and Xue;damp-heat.The locations and natures of PROM obtained from statistic analysis towards 98 sydromo elements'characteristics and distribution.TPROM locations contained uterus,stomach,spleen;natures contained deficiency of blood,Qi-stagnation,blood stasis,deficiency of Qi,deficiency of Yang,damp.PPROM locations contained uterus;natures contained blood stasis and Qi-stagnation.ConclusionsIncidence rate of TPROM could be related to pregnancy accompanied with diabetes mellitus and hypertensive disorders in pregnancy,abnormal fetal position,upper reproductive tract infection and elevated WBC or NEU%;where as PPROM outcomes appeared correlated with history of abortion and odinopoeia,elevated CRP or PCT,elevated WBC or NEU%,upper reproductive tract infection and pregnancy accompanied with anemia.According to results of clustering and syndrome elements characteristics and distribution anlysis towards total 393 PROM cases,syndromes of TPROM could be classified by four types:deficiency of Qi and Xue,Qi-stagnation and phlegm-damp,blood stasis and damp-heat.PPROM consisted of three types:Qi-stagnation and blood stasis and phlegm-damp;deficiency of Qi and Xue;damp-heat.Locations of PROM mainly sited in uterus.Defficiency of spleen function as the fundamental pathogenesis,together with a key effect of Qi-blood disorder and damp-heat,accordingly resulted in the accurrence and progression of PROM.