CAJ | 학술논문

目的：探讨补肾活血法联合优思明对于人工流产术后宫腔粘连的预防效果。方法随机选择100例在我院人流的自愿患者（纳入标准），随机分为两组：试验组和对照组，两组孕周、孕次、年龄等方面都无明显差异性，对照组在人工流产后第1d开始给予优思明口服，每天1次，每次1片，共21d。月经来潮后，月经第5d开始继续服用，持续服用3个月，如果无月经来潮，则停药第7d开始下一个疗程，也持续服用3个月.试验组在对照组基础上加上补肾活血方。随访观察两组患者人流术后各项指标：首次月经复潮的时间、有无周期性的腹痛、有无经量减少、有无宫腔积血（通过B超检查）、有无宫腔粘连及其宫腔粘连的程度（宫腔镜检查）。结果试验组人流术后首次月经复潮的时间为（27±2）d，周期性腹痛0例，经量减少2例，无宫腔积血患者出现，轻度宫腔粘连患者2例，中度宫腔粘连患者2例，重度宫腔粘连患者0例，对照组人流术后月经复潮时间（28±3）d，周期性腹痛2例，经量减少4例，宫腔积血患者2例，轻度宫腔粘连患者3例，中度宫腔粘连患者4例，重度宫腔粘连患者1例。试验组与对照组比较：人流术后月经首次复潮时间无明显的差异性，P>0.05；月经量减少有明显的差异性， P<0.05；宫腔积血的发生率有明显差异性，P<0.05；轻、中、重度宫腔粘连发生率有明显的差异性，P<0.05，宫腔粘连的总发生率有明显的差异性，P<0.05，结论补肾活血法联合优思明应用于人工流产术后对于宫腔粘连的预防疗效好，预防范围广，安全性强，值得在临床中推广应用。
목적：탐토보신활혈법연합우사명대우인공유산술후궁강점련적예방효과。방법수궤선택100례재아원인류적자원환자（납입표준），수궤분위량조：시험조화대조조，량조잉주、잉차、년령등방면도무명현차이성，대조조재인공유산후제1d개시급여우사명구복，매천1차，매차1편，공21d。월경래조후，월경제5d개시계속복용，지속복용3개월，여과무월경래조，칙정약제7d개시하일개료정，야지속복용3개월.시험조재대조조기출상가상보신활혈방。수방관찰량조환자인류술후각항지표：수차월경복조적시간、유무주기성적복통、유무경량감소、유무궁강적혈（통과B초검사）、유무궁강점련급기궁강점련적정도（궁강경검사）。결과시험조인류술후수차월경복조적시간위（27±2）d，주기성복통0례，경량감소2례，무궁강적혈환자출현，경도궁강점련환자2례，중도궁강점련환자2례，중도궁강점련환자0례，대조조인류술후월경복조시간（28±3）d，주기성복통2례，경량감소4례，궁강적혈환자2례，경도궁강점련환자3례，중도궁강점련환자4례，중도궁강점련환자1례。시험조여대조조비교：인류술후월경수차복조시간무명현적차이성，P>0.05；월경량감소유명현적차이성， P<0.05；궁강적혈적발생솔유명현차이성，P<0.05；경、중、중도궁강점련발생솔유명현적차이성，P<0.05，궁강점련적총발생솔유명현적차이성，P<0.05，결론보신활혈법연합우사명응용우인공유산술후대우궁강점련적예방료효호，예방범위엄，안전성강，치득재림상중추엄응용。
Objective To investigate the result and effect of combination treatment in reinforcing kidney and activating blood circulation with Yasmin to prevent intrauterine adhesions after abortion. Methods 100 cases were randomly selected in our hospi-tal from voluntary patients with abortion,and randomly divided into experimental group and control group equally. Two groups have no differences in age,gestational age and pregnant times. The control group started taking Yasmin at the first day after abor-tion,1 tablets daily and totally for 21 days,stop taking Yasmin for seven days (if menstruation,stop drug since fifth day of men-struation),and begin to the next course of treatment,continuous for 3 months. The experimental group add taking reinforcing kid-ney and activating blood circulation on the basis of control group. Postoperative follow-up observation of the first menstruation Menstruation and the amount of time whether to reduce,with or without periodic abdominal pain,B ultrasonic examination with or without uterine hemorrhage,hysteroscopy and observe whether the extent of intrauterine adhesions. Results The experimental group was 27±2 days for the frist menses,no case for periodic abdominal pain,2 cases for decreasing amount of menstrual blood,2 cases mild intrauterine adhesions,2 cases moderate intrauterine adhesions,no any case for severe intrauterine adhesions and uter-ine hematocele. The Results of control group is that 28±3 days for the frist menses,2 periodic abdominal pain,4 cases for decreas-ing amount of menstrual blood,2 cases for uterine hematocele,3 cases mild intrauterine adhesions,4 cases moderate intrauterine adhesions and 1 case for severe intrauterine adhesions. The comparison of two groups shows that the first menstruation time has no significant difference,P>0.05,the amount of menstrual blood has significant difference,P<0.05,the total incidence of uterine hematocele has significant difference,P<0.05,the mild、moderate or severe intrauterine adhesions between the two groups were sig-nificantly different sex,P<0.05,the total incidence of intrauterine adhesions has significant difference,P<0.05. Conclusion Rein-forcing kidney and activating blood circulation with Yasmin to prevent artificial abortion intrauterine adhesions has good effective-ness,as well as wide prevention and strong security,which is worthy of generalization in clinica application.