温中饮联合脐敷治疗脾胃虚寒型妊娠恶阻30例疗效观察

米海霞　刘凤霞　马大正

[摘要] 目的 探讨温中饮联合脐敷对脾胃虚寒型妊娠恶阻呕吐、厌食等临床症状的干预效果。 方法 将我院符合诊断标准的60例脾胃虚寒型妊娠恶阻门诊患者随机分为治疗组30例及对照组30例。对照组采用西医补液治疗，治疗组在西医补液的基础上予温中饮联合脐敷治疗， 治疗前后对临床症状、体征积分及尿酮体进行统计，比较两组治疗效果。 结果 治疗组有效率、治愈率分别为96.7%、40.0%，显著高于对照组的63.3%、13.3%（P<0.05）；治疗后中医症状、体征评分低于对照组（P<0.05）；治疗3 d，尿酮体转阴率治疗组为63.3%，对照组为56.7%，差异无统计学意义（P>0.05），治疗5 d、7 d，治疗组尿酮体转阴率（均为93.3%）显著高于对照组（均为63.3%）（P<0.05）。 结论 温中饮联合脐敷治疗脾胃虚寒型妊娠恶阻疗效确切，值得临床应用。

[关键词] 妊娠恶阻；经方；脐敷；脾胃虚寒

[中图分类号] R271.4 [文献标识码] B [文章编号] 1673-9701（2016）16-0131-04

[Abstract] Objective To study the curative effect of hyperemesis gravidarum in terms of the pattern of Spleen and Stomach deficiency-cold treated by Wenzhong Decoction combined with umbilical compress therapy. Methods A total of 60 patients of hyperemesis gravidarum in terms of the pattern Spleen and Stomach deficiency-cold were divided into treatment group and control group， each of 30 cases. The control group was provided with fluid infusion while the treatment group was treated by Wenzhong Decoction combined with umbilical compress therapy besides of fluid infusion. The score of clinical symptom， sign， and urine ketone were compared before and after therapy， the treatment effect of the two groups was compared. Results The total effective rate and the cure rate in the treatment group were 96.7%， 40.0%， was better than 63.3%，13.3% in the control group（P<0.05）. The scores of clinical symptom and sign in the treatment group were lower than that in the control group（P<0.05）. The urine ketone conversion rate was 63.3% in the therapy group and 56.7% in the control group after 3 days therapy. There was no statistical significance between two groups（P>0.05）. The urine ketone conversion rate was all 93.3% in the therapy group and was higher than 63.3% in the control group after 5 and 7 days therapy. There was statistical significance between the two groups（P<0.05）. Conclusion It has a good effect that Wenzhong Decoction combined with umbilical compress therapy in treating hyperemesis gravidarum in terms of the pattern of Spleen and Stomach deficiency-cold， which is worth to further apply for the clinical practice.

[Key words] Hyperemesis gravidarum； Classical prescription； Umbilical compress therapy； Spleen and Stomach deficiency-cold

妊娠恶阻是指妊娠早期出现恶心呕吐，头晕倦怠，甚至食入即吐者。亦称为“子病”、“病儿”、“阻病”。多因脾胃虚弱或肝胃不和导致冲气上逆、胃失和降。若呕吐日久，浆水不入，伤及气阴，可继发气阴两虚的恶阻重症。流行病研究显示，其在孕妇中的发生率约为1%[1]。

马大正老师为第三批、第五批全国老中医药专家学术经验继承指导老师，浙江省名中医，享受国务院颁发的政府特殊津贴专家。马老师善用经方及外治法治疗妇科疾病，药简效佳，许多非治疗妇科疾病的经方，根据异病同治的原理，病机相似，即可拿来应用。现就妊娠恶阻一病中马老师以理中汤、吴茱萸汤、橘皮汤、小半夏加茯苓汤4张经方为主合为温中饮联合脐敷治疗脾胃虚寒型妊娠恶阻进行临床研究，现报道如下。

1 资料与方法

1.1 一般资料

选取2014年6月～2015年7月期间我院符合诊断标准的60例脾胃虚寒型妊娠恶阻住院患者，随机分为治疗组30例及对照组30例，年龄分布范围为：<26岁治疗组14例，对照组13例；26～29岁治疗组9例，对照组12例；>29岁治疗组7例，对照组5例。……