Clinical Observation Of Yimutuohuajian Combined With Mifepristone And Misoprostol In The Treatment Of Missed Abortion With Blood Stasis

Objective:The focus of this study is on the clinical efficacy of Yimutuohuajian combined with mifepristone and misoprostol in the treatment of blood stasis type missed abortion,and explores its possible mechanism of action.Provide a basis for clinical use.Methods:Inpatients with gynecology from The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 20 to December 2018 were selected.Strictly,60 patients were screened according to the criteria and divided into two groups by random number method:30 patients in the control group were given mifepristone+misoprostol.In the treatment group,30 cases were treated with Yimutuohuajian decoction on the basis of the control group.The two groups were used as observation nodes 24 h and 7 days after taking misoprostol,respectively.The number of embryos in the two groups,the amount of vaginal bleeding,the serum serological index（HCG,P,E₂）,Curettage rate,The total effective rate and TCM symptom scores were recorded,and the indicators before and after treatment were statistically analyzed.Result:1.The age,menopause days,number of abortions,parity,average gestational sac,pregnancy serological markers（HCG,P,E₂）and TCM syndrome scores of the two groups before the drug administration were statistically analyzed by SPSS21.0.p>0.05,comparable.2.Clinical efficacy:The total effective rate of the control group was 63.33%,and the total effective rate of the treatment group was 86.67%.The data obtained by test showed p=0.037<0.05,and the total effective rate of the two groups was different.3.Number of cases of gestational sac discharge:The data of the number of gestational sacs discharged from the two groups after administration of misoprostol were statistically different（p<0.05）.4.The amount of vaginal bleeding:The amount of vaginal bleeding within 24 hours after administration of misoprostol in the two groups was graded,and there was a difference in the rank sum test（p<0.05）.5.Curettage rate:The cure rate of the treatment group and the control group were13.33%and 36.67%,respectively.After test,p=0.037<0.05,the two groups were different.6.Pregnancy serological indicators（β-HCG,P,E₂）:Compared with the serological indexes of the pre-treatment pregnancies on the 7th day after treatment with misoprostol,the two groups were p<0.05,which were all different.The levels of HCG in the control group before and after treatment and the levels of HCG,P and E₂ in the treatment group were significantly higher than those in the treatment group by t test（p<0.01,significant difference）.The comparison on the 7th day after the administration of misoprostol between the groups was statistically analyzed.After p<0.05,the difference was significant.7.TCM syndrome scores:The data belonged to the measurement data,the statistical analysis did not conform to the normal distribution,and there was no homogeneity of the variance.After the rank sum test,the comparison between the two groups was significant（p<0.05）;From the comparison between groups,the TCM syndrome scores after treatment were compared,p=0.036<0.05,there were differences.8.Safety analysis:There were no significant changes in the basic vital signs（T,P,R,BP）and serological safety indicators,electrocardiogram,and urine routine of all subjects after treatment.Conclusion:Yimutuohuajian combined with mifepristone,misoprostol and mifepristone in combination with misoprostol can be effective in the treatment of blood stasis syndrome in missed abortion,but the former can alleviate the suffering of patients,improve efficiency and reduce curettage rate,reducing the amount of vaginal bleeding,promoting the discharge of the embryo sac,shortening the time of embryo discharge,reducing the levels of serum HCG,P,E2,improving the symptoms of TCM,and having no obvious discomfort,the Yimutuohuajian decoction has a good Clinical use value.