Clinical application of Bushen Jianpi Gutai Decoction in threatened abortion

Xiu-Rong Wang,Yi-Ru Liu,Xiao-Ying Meng,Kui-Mei Zhang,Xiao-Xia Wang,Wen-Ming Cao*

1 Department of Obstetrics &Gynecology,Changle People's Hospital,Changle 262400,China.

Abstract Objective:To discuss the clinical application of the "seven,five and three" odd-numbered law theory and analyze the effect on serum sex hormone level.Methods:A total of 100 patients with early threatened abortion admitted from January 2021 to October 2021 were randomly divided into study group and control group,with 50 patients in each group.Patients in the control group were treated with dydrogesterone tablets,while patients in the study group were treated with Bushen Jianpi Gutai Decoction combined with dydrogesterone tablets.Clinical efficacy and progesterone level before and after treatment were observed and compared between the two groups,as well as clinical symptom relief time of the two groups,including hemostasis time,abdominal pain relief time and lumbar acid relief time,and sex hormone level of the two groups were observed and compared.Results:The clinical efficacy was significantly better than control patients (P ＜ 0.05),no significant difference in progesterone level comparison before treatment (P ＞ 0.05),significantly better than control patients (P ＜ 0.05),hemostasis,abdominal pain remission and waist acid remission were significantly shorter than control patients (P ＜ 0.05),and both significantly better sex hormone levels after treatment (P ＜ 0.05).Conclusion:Traditional Chinese medicine has certain advantages in the treatment of threatened abortion,odd-numbered law theory guides the regulation of Yin and Yang in the female menstrual cycle and reproductive function is mainly the regular change of Yin and Yang.Under the guidance of "seven,five,three" odd-numbered law theory of Traditional Chinese medicine master Xia Guicheng,master the key date and the best time of its transformation,regulate Yin and Yang in the female body,to prevent the occurrence and development of menstrual diseases and adverse childbirth.Bushen Jianpi Gutai decoction can effectively treat threatened abortion,significantly improve the clinical symptoms,improve the level of serum sex hormone,worthy of clinical promotion.

Keywords:Yin and Yang of female body,Bushen Jianpi Gutai Decoction,Early threatened abortion,Odd-numbered law theory

Introduction

Threatened abortion [1] refers to the occurrence of a small amount of vaginal bleeding before 28 weeks of pregnancy,often dark red or bloody leucorrhea,no discharge of pregnancy material,followed by paroxysmal lower abdominal pain or lumbago.Gynecological examination did not open the uterine orifice,the membranes did not break,the size of the uterus and pregnancy consistent.Pregnancy 12 weeks before the onset of threatened abortion symptoms of patients called early threatened abortion.The incidence of early threatened abortion accounts for 10%-15% of all pregnancies,and the proportion of spontaneous abortion is about 85%,and it is increasing year by year[2].

Threatened abortion in the traditional medicine of the motherland when "fetal leakage","fetal movement","pregnancy abdominal pain"and other categories.Pregnancy appears a small amount of vaginal bleeding,or waist acid,abdominal pain,lower abdominal drop and other symptoms.The common causes are congenital deficiency;Internal injury and trauma caused by acquired exhaustion.The growth and development of embryo are most closely related to spleen,kidney Chong channel and Ren channel.Kidney contains essence,main reproduction,the birth of pregnancy.According to traditional Chinese medicine,if the kidney essence is sufficient,the kidney’s Qi is abundant and the embryo can develop and grow normally.Kidney is congenital,spleen is acquired,congenital to the acquired,acquired to support congenital,the two phases must be used to maintain normal pregnancy.If damaged,can lead to fetal leakage,fetal movement,and even unavoidably abortion.

Modern medicine believes that the etiology of early precursor abortion is more,which is mainly related to genetic defects,maternal systemic diseases,endocrine abnormalities,abnormal immune function,abnormal reproductive organs,trauma stimulation,bad habits,environmental factors and other on.Therapy is divided into general treatment and etiological treatment of [3].Currently,common clinical methods are to monitor progesterone (P),chorionic gonadotropin (β-HCG),estrogen (E2),and ultrasound.In recent years,many scholars have also taken the pregnancy-related plasma protein A(PAPP-A),progesterone-induced blocking factor (PIBF),and uterine spiral artery blood flow as screening indicators for the development of early pregnancy embryos and the basis for the diagnosis of early threatened abortion [4-7].

The incidence of early abortion has increased in recent years with the increase in women′s work pressure,changes in living habits,delayed childbearing age,premature and uncontrolled sexual life and the increase in the rate of induced abortion,which seriously affects the health of pregnant women and the fetus and reduces the quality of birth.In the long-term observation of clinical practice,scholar Xia Guicheng proposed the odd-numbered law theory of "seven,five,three".Looking through ancient books [8],the odd-numbered law theory comes from Su Wen on Ancient Innocence [9].By the time a woman is seven years old,her kidneys are full,so her teeth start to be replaced and her hair starts to grow.Long to the age of 14,Tiangui is mature,Ren channel also through,strong pulse running,menstruation came on time,so can bear.By the age of 2l,the kidney is full of qi,so wisdom teeth grow out and the body is at its peak.At the age of 28,muscles and bones are firm,hair growth is at its peak,and the body is at its strongest.At the age of 35,Yangming meridians first turn decline,followed by the face began to dry,hair began to fall out.At the age of 42,the Sanyang meridians began to decline from head to face,and the face became completely dry and dull,and the hair began to turn white.At the age of 49,Ren channel has been empty,and Chong channel has also turned decline and no more blood,Tiangui is completely dried up,menstruation then stopped and no longer come tide,so it makes the body completely aging and can no longer give birth.The odd-numbered law theory of "seven,five,three" also reflects kidney,spleen and liver activity.

Professor Xia Guicheng pointed out in the odd-numbered law theory of "seven,five,three":the time point of "three,five,seven" after pregnancy is crucial."3" refers to about 30 days of conception,that is,early pregnancy is more difficult to find clinically."5" refers to about 50 days of conception,which is the critical moment to be valued,while "7" refers to about 70 days after conception.In addition,there is a distinction of three,five and seven months,with clinical studies having found the most prone to miscarriage at three,five and seven months after conception.Under the guidance of the "seven,five,three"odd-numbered law theory of Xia Guicheng,master the key date and best time of the transformation of Yin and Yang,standardize female Yin and Yang,and prevent the development of bad fetuses.Xia believes that women belong to Yin,and the functional activity changes according to the odd-numbered law theory of Yang.The"seven,five,three" odd-numbered law theory represent several forms of Yin length,which is closely related to women′s menstrual cycle,reproductive physiology,fetal birth and viscera and meridians.It has a significant role in clinical guidance therapy for [10].Based on this,this study mainly discusses the clinical application of Xia Guicheng"seven,five and three" odd-numbered law theory in early threatened abortion of kidney,spleen and fetal consolidation soup.

Data and Methods

Clinical data

100 cases of threatened abortion patients admitted to our hospital from January 2021 to October 2021 were randomly divided into study group and control group,with 50 cases in each group.All patients were diagnosed with threatened abortion after diagnosis.Diagnostic criteria reference:Diagnostic Criteria for Diseases of Obstetrics and Gynecology (2nd Edition) (Precision).In the control group,patients were 22-38 years old,with an average of 26.53 ± 3.21 years old and an average gestational age of 17.13 ± 2.29 weeks.There were 15 cases with a history of abortion and 35 cases without a history of abortion.Patients in the study group ranged in age from 21 to 39 years,with an average of 25.78 ± 3.31 years and an average gestational age of 16.91 ± 3.65 weeks.There were 17 patients with a history of abortion,and 33 patients without a history of abortion.There was no significant difference in general data between the two groups (P＞ 0.05),indicating comparability.All patients and their families were informed and signed informed consent for this study,and this study was approved by the ethics Committee of our hospital(Ethics Code:2021-11-01).

Inclusion criteria:(1) Patients diagnosed with threatened abortion;(2) The size of the uterus is consistent with the gestational week and the uterine orifice is not opened and the membranes are not broken.Exclusion criteria :(1) Complicated with other organ or system dysfunction;(2) With cognitive or communication and mental disorders;(3) Patients who are allergic to drugs used in this study.

Method

General treatment:The two groups of patients are told to rest,avoid excessive labor,prohibit sex life,do not eat spicy and stimulating food,reasonable nutrition,regular work and rest,and psychological counseling,adjust mood,relieve tension.

Control group:Dydrogesterone tablet 10 mg Q12H,oral,continued to 12 weeks of gestation.(Daphton,specification:10 mg,20 Plate/Board,1 Board/Box,manufacturer:Company:Abbott Healthcare Products B.V;Manufacturers:Abbott Biologicals B.V;Approval text number:H20130110)

Study group:Taking the flexor progesterone tablets (dose and usage with the control group),based on the combined with Bushen Jianpi Gutai Decoction (Figure 1).Daily 1 agent,after half an hour in the morning and evening dress warm.Two weeks is a course of treatment.

Figure 1 Composition and efficacy of the Bushen Jianpi Gutai Decoction

Observing indicators

Clinical efficacy was observed and compared between the two patient groups.Efficacy standard reference:Clinical Diagnosis and Treatment of Obstetrics and Gynecology,clinical efficacy is divided into effective,effective and invalid.Efficacy:the clinical symptoms completely disappeared,the patient′s contractions were significantly improved,the fetus were normal;effective:the patient′s clinicalsymptoms were basically improved,the contractions improved,the fetus was normal after B ultrasound examination;invalid:the patient′s clinical symptoms have not improved or even more serious.

The progesterone levels before and after treatment of the two groups were observed and compared,and the clinical symptom remission time was observed and compared between the two groups,including the time of hemostasis,abdominal pain remission time and waist acid remission time,and the sex hormone levels were observed and compared between the two groups.

Chorionic gonadotropin [11] (β-HCG) is mainly secreted by compound trophoblasts,secreted on day 6 after the formation of fertilized eggs,detected in maternal serum on day 10.The secretion of progesterone (P) during normal pregnancy is divided into three stages,Progesterone is the essential hormone [12] necessary to maintain early pregnancy.Estrogen (E2) in the first early pregnancy,6 weeks from the ovary and 6 to 10 weeks from the ovary and placenta.[13]was synthesized by fetal-placental units after 10 weeks.Physiologically,normal pregnancy is a fertilized egg after 7 days,B ultrasound examination fetus to 0.85 cm at 6 weeks,visible gestational sac,and gestational buds;7-8 weeks pregnant,yolk sac and fetal heart,placenta formation;about 70 days pregnant fetal formation.

Therefore,in the 30 days of pregnancy,50 days of pregnancy,70 days of pregnancy,3 months of pregnancy several key points of dynamic monitoring of the indicators,timely find whether the embryonic development is in line with the normal pregnancy,take the necessary remedial measures,to achieve the prevention and control of the occurrence of adverse pregnancy.This is consistent with the"seven,five,three" odd-numbered law theory during pregnancy.

Statistical Methods

All collected data were analyzed using SPSS 20.0 statistical software,measurement data were represented as "mean standard deviation",t-tested,count data use cases (percentage),and x2Test,P＜0.05 was statistically significant.

Results

Clinical efficacy

The clinical efficacy of the two groups was observed and compared,divided into dominant,effective and ineffective,and the study group was significantly better than the control group (P＜0.05),as shown in Table 2.

Table 2 Comparison of the clinical efficacy between the two patient groups

Table 3 Comparison of progesterone levels before and after treatment between the two patient groups

Progesterone levels

The progesterone levels before and after treatment were observed and compared,and the two groups ranged from 18 to 32 ng/ml,(P＞0.05),which were significantly better compared with control patients(P＜ 0.05),as shown in Table 3

Time of remission of clinical symptoms

The remission time of clinical symptoms was observed and compared between the two groups,including:hemostasis time,abdominal pain remission time and waist acid relief time,the study group patient hemostasis time,abdominal pain remission time and waist acid relief time were significantly shorter than the control patients (P＜ 0.05),as detailed in Table 4.

Sex hormone levels

Sex hormone levels were observed and compared between both groups,including follicle-stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2),progesterone (P),testosterone (T),prolactin (PRL),and were significantly better compared with control patients (P＜0.05),as shown in Table 5.

Table 4 Comparison of clinical symptom remission time in the two patient groups

Table 5 Comparison of sex hormone levels after treatment in the two groups

Discussion

Threatened abortion is the most common complication of early pregnancy.In recent years,the incidence of threatened abortion has been on the rise [14].Misdiagnosis of early threatened abortion,misdiagnosis and delayed treatment can lead to adverse pregnancy outcomes,such as incomplete abortion,expired abortion or intrauterine development delay,seriously threatening women′s physical and mental health,affecting family harmony and social stability.Therefore,timely treatment and strict monitoring can greatly avoid adverse pregnancy outcomes and improve the quality of pregnancy.

The master of Chinese medicine stressed that [15,16] fetal safety should be used to nourish the kidney qi,and calm the mind and protect the spleen and stomach,which is corresponding to the "seven,five,three" odd-numbered law theory,and intends to nourish the kidney,strengthen the spleen and consolidate the fetus soup.Traditional Chinese medicine (TCM) has certain advantages in the treatment of threatened abortion [17].TCM has a long history of treatment of threatened abortion and has the advantages of precise efficacy,diverse methods,good safety and few adverse effects.In recent years,TCM treatment has no longer limited to traditional treatment methods,but combined with modern medical research,and the treatment effect is relatively ideal.Based on the theory of "seven,five,three" odd-numbered law theory,the key time points after pregnancy are selected for dynamic monitoring,and analyze the correlation of various indicators and pregnancy outcome for follow-up research,which can reduce the occurrence of threatened abortion and provide a basis for predicting the relevant pregnancy outcome and lactating fetus.

β-HCG is mainly secreted by compound trophoblasts,secreted on day 6 after the formation of fertilized eggs,detected in maternal serum on day 10,rising significantly within 50 days of pregnancy,and doubled,peak secretion at 8-10 weeks of gestation,gradually decreased after about 70 days of gestation,until the middle and late pregnancy.The secretion of progesterone during normal pregnancy is divided into three stages:the first stage from 5 to 6 weeks pregnancy,progesterone secretion from the ovary,by pregnancy lutea;the second stage from 6-8 weeks pregnancy,ovarian and trophoblast cells secretion;the third stage from 8 weeks after gestation to delivery,progesterone is secreted from the placenta,progesterone levels rise rapidly,improve endometrial tolerance.Estrogen was synthesized by fetal-placental units after 10 weeks.Estrogen can not only reflect the follicular quality and ovarian luteal function,but also judge whether the placental function is normal.When its content increases,the luteal function can be compensated,thus maintaining pregnancy.Physiologically,normal pregnancy is a fertilized egg after 7 days,B ultrasound examination fetus to 0.85 cm at 6 weeks,visible gestational sac,and gestational buds;7-8 weeks pregnant,yolk sac and fetal heart,placenta formation;about 70 days pregnant fetal formation;12 weeks pregnant fetus can measure double top diameter,placenta completely formed.Pregnant women at 20 weeks can consciously fetal heart,feasible fetal electrocardiogram,20-24 weeks can use ultrasound for fetal system examination,to screen for fetal structural abnormalities.It was found that uterine spiral artery RI,PI,S/D levels from 6 to 7 early threatened abortion weeks were higher than normal pregnant the same week.

In the early pregnancy,the fetal element is not stable,before 12 weeks of pregnancy:30 days after pregnancy,50 days,70 days,90 days several key nodes,regulate Yin and Yang,promote the healthy growth and development of their embryos.Clinically,the pathogenesis of threatened abortion is mostly deficiency of spleen and kidney,liver qi,qi and blood loss,and retention is not fixed.The"seven,five,and three" odd-numbered law theory happen to reflect the activities of liver,spleen and kidney.It is more effective to regulate its Yin and Yang at the corresponding nodes.The results of this study showed that the patients in the study group were significantly better than the control patients (P＜ 0.05).There was no significant difference in pretreatment progesterone levels between the two groups(P＞ 0.05),and the study group was significantly better than control patients (P＜ 0.05).The study group hemostasis time,abdominal pain relief time,and waist acid remission time were significantly shorter than the control patients (P＜ 0.05).The effect of sex hormone levels were significantly better in the study group compared with the control group (P＜ 0.05).

Bushen Jianpi Gutai Decoction can effectively treat early threatened abortion,significantly improve clinical symptoms and improve serum sex hormone level,which is worth clinical promotion.Based on the summer old "seven,five,three" odd-numbered law theory,choose early pregnancy key points for dynamic monitoring,analysis of the correlation with pregnancy outcome,and detailed follow-up research,can more accurate and deep study prenatal drugs for early precursor abortion in different pregnancy mechanism,improve the success rate of early pregnancy,to predict related pregnancy outcome and the rational use of drugs provide basis.It will open up a wider space for the treatment of early threatened abortion and further promote the development of TCM.