目的 探討地屈孕酮與黃體酮單藥或聯(lián)用治療黃體功能不全型先兆流產(chǎn)的療效及安全性。方法 收集2015年4月-2016年4月河南科技大學第一附屬醫(yī)院收治的黃體功能不全型先兆流產(chǎn)患者186例作為研究對象，根據(jù)隨機數(shù)字表法將其分為A、B、C組，各包含患者62例。A組患者使用地屈孕酮單藥進行治療，B組患者使用黃體酮單藥進行治療，C組患者使用地屈孕酮聯(lián)合黃體酮進行治療。對3組患者治療效果、激素水平、治療結局以及不良反應進行觀察與比較。結果 A組治療總有效率為72.58%，B組為66.13%，均顯著低于C組的90.32%，差異有統(tǒng)計學意義（P<0.05）。治療后3組患者孕酮（P）、雌二醇（E2）以及人粗絨毛膜性腺激素（hCG）均較治療前顯著升高，且以C組升高最為顯著（P<0.05）。A組患者治療成功率為83.87%，B組為82.26%，均低于C組的95.16%，但差異無統(tǒng)計學意義。A組不良反應發(fā)生率為9.68%，B組為12.90%，C組為14.52%，3組差異無統(tǒng)計學意義。結論 地屈孕酮與黃體酮聯(lián)用治療黃體功能不全型先兆流產(chǎn)療效優(yōu)于單藥治療，安全性較高，值得臨床推廣應用。

Objective To explore the clinical effect of single use or combination of dydrogesterone and progestin in treatment of threatened abortion caused by uteal phase defect. Methods Totally 186 patients with threatened abortion caused by uteal phase defect accepted in The First Affiliated Hospital of Henan from April 2015 to April 2016 were selected and randomly divided into groups A, B, and C with 62 cases in each group. Patients in group A were given dydrogesterone, those in group B were given progestin, and those in group C were given dydrogesterone combined with progestin. Then the clinical effect, expression of hormones, treatment outcome, and adverse reaction were observed and compared. Results The total effective rates of groups A and B were 72.58% and 66.13%, respectively, which were obviously lower than 90.32% of group C with statistically significance (P<0.05). The expression levels of P, E2, and hCG of three groups after treatment were higher than those before, those in group C were the highest among them (P<0.05). The successful treatment rates of groups A, B, and C were 83.87%, 82.26%, and 95.16%, respectively, which had no great difference. Conclusion Combination use of dydrogesterone and progestin has better effective rate in treatment of threatened abortion caused by uteal phase defect compared to single use of these two drugs, which has good safety and worth of clinical application.