补肾养血安胎汤治疗复发性流产的临床研究  

Clinical study of Bushen Yangxue Antai Decoction in treating recurrent abortion

作　　者：屈小会[1] 马萌 张利[1] 安晓娟 康汝光[1] 徐炜炜 QU Xiaohui;MA Meng;ZHANG Li;AN Xiaojuan;KANG Ruguang;XU Weiwei(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China;Department of Obstetrics and Gynecology,Qian County Hospital of Chinese Medicine,Xianyang 713300,Shaanxi,China)

机构地区：[1]陕西中医药大学第二附属医院妇产科,陕西咸阳712000 [2]陕西乾县中医医院妇产科,陕西咸阳713300

出　　处：《中国性科学》2021年第1期129-132,共4页Chinese Journal of Human Sexuality

摘　　要：目的探讨复发性流产(RA)患者应用补肾养血安胎汤治疗的临床效果。方法选取2016年3月至2017年12月陕西中医药大学第二附属医院妇产科收治的94例RA患者作为研究对象。采取随机数字表法分成观察组(n=47)与对照组(n=47)。对照组予以常规保胎方案(绒促性素+黄体酮)治疗,观察组在此基础上内服补肾养血安胎汤治疗,所有患者均治疗至妊娠12周。比较两组临床疗效,治疗前后妊娠激素[人绒毛膜促性腺激素β(β-HCG)、孕酮(P)]水平、中医证候总积分及血清辅助性T细胞(Th)1/Th2细胞因子[γ干扰素(IFN-γ)、白介素(IL)-4、IL-10和IFN-γ/IL-4、IFN-γ/IL-10比值]变化,不良反应及妊娠情况。结果观察组总有效率和妊娠成功率分别为95.7%、85.1%,均明显高于对照组(83.0%、61.7%)差异具有统计学意义(P<0.05)。两组治疗后血清β-HCG、P浓度较治疗前均显著增加(P<0.05),证候总积分均显著减少(P<0.05);且观察组改善更显著(P<0.05)。与治疗前对比,两组治疗后血清IFN-γ水平及IFN-γ/IL-4和IFN-γ/IL-10比值均显著下降(P<0.05),血清IL-4、IL-10浓度均显著升高(P<0.05);且观察组改善更显著(P<0.05)。观察组不良反应率(8.5%)与对照组(6.4%)比较,差异无统计学意义(P>0.05)。结论RA患者应用补肾养血安胎汤治疗可有效缓解患者肾虚血亏相关症状,上调体内妊娠激素表达水平,促进血清Th1/Th2细胞因子平衡向Th2方向偏移,保胎效果显著,患者耐受性较好。Objective To investigate the clinical effect of Bushen Yangxue Antai Decoction in the treatment of recurrent abortion(RA).Methods 94 patients with RA admitted to the Department of Obstetrics and Gynecology of the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from March 2016 to December 2017 were selected as the research subjects,and randomly divided into observation group(n=47)and control group(n=47)by using random number table method.The control group was treated with routine fetal protection scheme(choradiotrophin+progesterone),and the observation group was additively treated with Bushen Yangxue Antai Decoction.All patients were treated until 12nd weeks of gestation.The clinical efficacy,changes of pregnancy hormones[human chorionic gonadotropinβ(β-HCG),progesterone(P),total syndrome score and serum helper T cells(Th)1/Th2 cytokines[γinterferon(IFN-γ),interleukin(IL-4),IL-10,IFN-γ/IL-4,IFN-γ/IL-10 values]before and after treatment,side effects as well as pregnancy outcomes were compared between the two groups.Results The total effective rate and pregnancy success rate of the observation group were 95.7%and 85.1%,respectively,which were significantly higher than those of the control group(83.0%and 61.7%,P<0.05).After treatment,serumβ-HCG and P concentrations were significantly increased(P<0.05),and the total syndrome score was significantly decreased(P<0.05)in both groups.The improvement in the observation group was more significant(P<0.05).Compared with before treatment,serum IFN-γlevel,IFN-γ/IL-4 and IFN-γ/IL-10 ratio in 2 groups after treatment were significantly decreased(P<0.05),while serum IL-4 and IL-10 concentrations were significantly increased(P<0.05).The improvement in the observation group was more significant(P<0.05).There was no significant difference in adverse reaction rate between the observation group(8.5%)and the control group(6.4%)(P>0.05).Conclusions In treating RA,Bishenyuanxue Antai Decoction can effectively relieve the symptoms related to kidney deficiency

关 键 词：复发性流产 补肾养血安胎汤 妊娠激素 TH1/TH2细胞因子平衡 肾虚血亏 

分 类 号：R714[医药卫生—妇产科学]