安子合剂联合低分子肝素治疗复发性流产血栓前状态的临床研究  

Clinical study on Anzi mixture combined with low molecular weight heparin in the treatment of prethrombotic state of recurrent miscarriage

作　　者：赵娜 陆启滨[2] ZHAO Na;LU Qibin(The People’s Hospital of Suining County,Suining 221200,Jiangsu,China;Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]睢宁县人民医院,江苏睢宁221200 [2]江苏省中医院,江苏南京210029

出　　处：《现代中西医结合杂志》2021年第11期1176-1179,1186,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：江苏省研究生实践创新计划(SJCX18_0501)。

摘　　要：目的观察安子合剂联合低分子肝素治疗复发性流产血栓前状态患者的临床疗效,探讨其作用机制。方法收集2018年9月—2019年9月在江苏省中医院妇科门诊及病房治疗的复发性流产血栓前状态早孕期患者60例,将其随机分为治疗组和对照组,每组30例。治疗组给予安子合剂+低分子肝素治疗,对照组予低分子肝素治疗,4周为1个疗程,观察4周。观察2组患者治疗前后中医症状积分、血清妊娠激素[雌二醇(E 2)、孕酮(P)、人绒毛膜促性腺激素(β-HCG)]、血浆D-二聚体、抗凝血酶Ⅲ水平变化,统计2组盆腔B超监测胚胎发育情况及中医症状疗效。结果治疗后2组中医症状积分及D-二聚体水平均明显降低(P均<0.05),且治疗组明显低于照组(P均<0.05);2组治疗后E 2、P、β-HCG及抗凝血酶Ⅲ水平均明显升高(P均<0.05),且治疗组明显高于对照组(P均<0.05);治疗组B超胚胎存活率、中医症状总有效率明显高于对照组(P均<0.05)。结论安子合剂联合低分子肝素治疗复发性流产血栓前状态疗效显著,与其可纠正高凝状态,提高妊娠激素水平有关。Objective It is to observe the clinical efficacy of Anzi mixture combined with low molecular weight heparin in the treatment of patients with prethrombotic state of recurrent miscarriage,and to explore its mechanism of action.Methods Sixty patients with recurrent miscarriage in the prethrombotic state during early pregnancy treated in the gynecological clinic and ward of Jiangsu Provincial Hospital of Traditional Chinese Medicine from September 2018 to September 2019 were collected and randomly divided into treatment group and control group,with 30 cases in each group.The treatment group was treated with Anzi mixture+low-molecular-weight heparin,and the control group was treated with low-molecular-weight heparin.4 weeks was a course of treatment.The changes of TCM symptom scores,the levels of serum pregnancy hormone,plasma D-dimer,and antithrombin Ⅲ were observed before and after treatment in the two groups,the embryonic development was evaluated by pelvic B ultrasound and the efficacy of TCM symptoms was assessed.Results After treatment,the TCM symptom scores and D-dimer level of the two groups were significantly reduced(P<0.05),and the treatment group was significantly lower than the control group(P<0.05);the levels of estradiol,progesterone,human chorionic gonadotropin and antithrombin Ⅲ were significantly increased after treatment in the two groups(P<0.05),and the treatment group was significantly higher than the control group(P<0.05);the embryo survival rate under B ultrasound and total effective rate of TCM syndromes in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion Anzi mixture combined with low molecular weight heparin has a significant effect on the prethrombotic state of recurrent miscarriage,which is related to correcting the hypercoagulable state and increasing the level of pregnancy hormones.

关 键 词：复发性流产血栓前状态 安子合剂 D-二聚体 抗凝血酶Ⅲ 

分 类 号：R714.21[医药卫生—妇产科学]