补肾安胎冲剂联合地屈孕酮治疗肾虚型早期先兆流产30例  

Clinical Effect of Granules for Tonifying the Kidney and Preventing Miscarriage Combined with Dydrogesterone in Treatment of Early Threatened Abortion with Kidney Deficiency:An Analysis of 30 Cases

作　　者：余欣慧[1] 蒋平[1] YU Xin-hui;JIANG Ping(The First Affiliated Hospital of Anhui University of Chinese Medicine, Anhui Hefei 230031, China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《安徽中医药大学学报》2021年第4期19-23,共5页Journal of Anhui University of Chinese Medicine

基　　金：国家自然科学基金项目(81804133)。

摘　　要：目的观察补肾安胎冲剂联合地屈孕酮治疗肾虚型早期先兆流产的临床疗效及其对基质细胞衍生因子-1α(stromal cell derived factor-1α,SDF-1α)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)水平的影响。方法选取60例肾虚型早期先兆流产患者,将其随机分为治疗组和对照组,每组30例。治疗组予以补肾安胎冲剂联合地屈孕酮口服,对照组予以地屈孕酮口服,疗程2周。比较两组患者治疗前后中医症状积分及综合疗效,ELISA法检测血清SDF-1α、MMP-9水平。结果两组综合疗效比较,治疗组综合疗效明显优于对照组(P<0.05)。与治疗前比较,两组中医症状总积分和阴道流血时间、出血量积分均明显降低(P<0.05),治疗组的小腹疼痛或坠胀、腰酸痛、头晕耳鸣、夜尿频数、两膝酸软积分均明显降低(P<0.05)。除出血量积分外,治疗组各症状积分和总积分降低程度明显大于对照组(P<0.05)。治疗组血清SDF-1α、MMP-9水平较治疗前显著升高,差异均有统计学意义(P<0.05);治疗组血清SDF-1α、MMP-9水平升高值均显著大于对照组(P<0.05)。结论补肾安胎冲剂联合地屈孕酮保胎疗效明确,可显著改善临床症状,提高患者生活质量,其作用机制可能与上调SDF-1α、MMP-9水平,纠正母胎界面血管生成障碍有关。Objective To investigate the clinical effect of granules for tonifying the kidney and preventing miscarriage combined with dydrogesterone in the treatment of early threatened abortion with kidney deficiency and its effect on the levels of stromal cell derived factor-1α(SDF-1α)and matrix metalloproteinase-9(MMP-9).Methods A total of 60 patients with early threatened abortion with kidney deficiency were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the treatment group were given oral granules for tonifying the kidney and preventing miscarriage combined with dydrogesterone,and those in the control group were given oral dydrogesterone;the course of treatment was 2 weeks for both groups.The two groups were compared in terms of traditional Chinese medicine(TCM)symptom score before and after treatment and overall response after treatment,and ELISA was used to measure the changes in the levels of SDF-1αand MMP-9.Results The treatment group had significantly better overall response than the control group(P<0.05).After treatment,both groups had significant reductions in total TCM symptom score and the scores of vaginal bleeding time and bleeding volume(P<0.05),and the treatment group had significant reductions in the scores of lower abdominal pain or bulge,lumbago,dizziness and tinnitus,frequency of nocturia,and soreness and weakness of both knees(P<0.05).Compared with the control group,the treatment group had significantly greater reductions in total score and the scores of all symptoms except bleeding volume(P<0.05).The treatment group had significant increases in the levels of SDF-1αand MMP-9 after treatment(P<0.05),and the treatment group had significantly greater increases than the control group(P<0.05).Conclusion Granules for tonifying the kidney and preventing miscarriage combined with dydrogesterone has a marked clinical effect in the treatment of early threatened abortion with kidney deficiency and can improve patients'clinical symptoms and quality of li

关 键 词：先兆流产 补肾安胎冲剂 地屈孕酮 肾虚型 基质细胞衍生因子 基质金属蛋白酶 

分 类 号：R714.21[医药卫生—妇产科学]