补肾益气方联合黄体酮对复发性流产的临床疗效及其对Kisspeptin蛋白表达的影响  

Clinical effect of Bushen Yiqi Decoction combined with progesterone on recurrent abortion and its effect on Kisspeptin protein expression

作　　者：刘颖 刘亚静 底建敏[2] LIU Ying;LIU Ya-jing;DI Jian-min(Department of Obstetrics and Gynecology,Emergency General Hospital,Beijing 100028,China;Department of Obstetrics and Gynecology,the Third Hospital of Hebei Medical University,Shijiazhuang Hebei 050051,China)

机构地区：[1]应急总医院妇产科,北京100028 [2]河北医科大学第三医院妇产科,河北石家庄050051

出　　处：《临床和实验医学杂志》2022年第1期69-72,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省科学技术厅项目(编号:09276130)。

摘　　要：目的补肾益气方联合黄体酮对复发性流产的临床疗效及其对Kisspeptin蛋白表达的影响。方法回顾性分析2016年1月至2020年12月于应急总医院妇科就诊的复发性流产再次妊娠者60例,根据治疗方法将其分为对照组与观察组,每组各30例。两组均给予肌内注射黄体酮20 mg/d,观察组在黄体酮治疗基础上给予补肾益气方,组方:黄芩15 g,续断、菟丝子、桑寄生、杜仲各12 g,白芍、炒白术、紫苏梗、党参各6 g。1剂/d,水煎取汁400 mL,每天早晚2次口服,共治疗30 d。于治疗后15、30 d进行B超检查,观察两组患者治疗后的临床疗效、流产及妊娠结局。治疗前及治疗后30 d采用放射免疫法测定两组患者血清绒毛膜促性腺激素(β-HCG)、孕酮(P)及雌二醇(E2)水平,采用酶联免疫吸附试验检测血清Kisspeptin蛋白。结果观察组治疗总有效率(83.33%)显著高于对照组(70.00%),差异有统计学意义(P <0.05)。治疗后30 d,两组患者β-HCG、P及E2水平均较治疗前显著升高,观察组患者β-HCG、P及E2水平(19 564.46±75.43) mIU/mL、(116.42±10.17) nmol/L、(1 056.43±8.74) pmol/L,均显著高于对照组[(17 185.30±84.62) mIU/mL、(90.36±9.25) nmol/L、(894.02±7.84) pmol/L],差异均有统计学意义(P <0.05)。两组患者血清Kisspeptin蛋白水平均较治疗前显著升高,观察组患者Kisspeptin蛋白表达水平为(64.33±7.15),显著高于对照组(58.35±6.07),差异有统计学意义(P <0.05)。治疗后30 d后随访结果显示,观察组发生流产率为10.00%,显著低于对照组(20.00%),差异有统计学意义(P <0.05)。对照组与观察组恶心呕吐、发热发生率比较(6.67%vs. 10.00%、6.67%vs. 3.33%),差异无统计学意义(P> 0.05)。结论补肾益气方联合黄体酮可以提高复发性流产孕妇血清中的β-HCG、P及E2水平,提高血清Kisspeptin蛋白表达,具有较好的治疗疗效和保胎效果。Objective To investigate the clinical effect of Bushen Yiqi Decoction combined with progesterone on recurrent abortion and its effect on Kisspeptin protein expression. Methods A retrospective analysis was performed on 60 patients with recurrent abortion and second pregnancy treated in General Emergency Hospital from January 2016 to December 2020. According to treatment methods,they were divided into control group and observation group,with 30 cases in both groups. Two groups were given intramuscular progesterone 20 mg/d,observation group on the basis of progesterone therapy for invigorating qi fang,formula: 15 g,radix scutellariae,radix dipsaci,dodder,mulberry parasitism,eucommia bark all the 12 g,radix paeoniae alba,Fried atractylodes,purple Perilla,dangshen each 6 g. 1 dose/day,water decocted juice 400 mL,twice a day morning and evening oral. The treatment lasted for 30 days. B-ultrasound examinations were performed 15 and 30 days after treatment. The clinical efficacy,miscarriage and pregnancy outcome of the two groups of patients after treatment were observed. The levels of serum chorionic gonadotropin( β-HCG),progesterone( P) and estradiol( E2) were measured by radioimmunoassay before treatment and 30 days after treatment.Kisspeptin protein was detected by elisa. Results The total effective rate of treatment in the observation group( 83. 33%) was significantly higher than that in the control group( 70. 00%),and the difference was statistically significant( P < 0. 05). Thirty days after treatment,the levels of β-HCG,P and E2 in the two groups were significantly higher than those before treatment. Among them,the levels of β-HCG,P and E2 in the observation group were( 19 564. 46 ± 75. 43) m IU/mL,( 116. 42 ± 10. 17) nmol/L,( 1 056. 43 ± 8. 74) pmol/L,are significantly higher than the control group [( 17 185. 30 ± 84. 62) m IU/mL,( 90. 36 ± 9. 25) nmol/L,( 894. 02 ± 7. 84) pmol/L],the difference were statistically significant( P < 0. 05). The serum Kisspeptin protein level of the two groups of patients

关 键 词：复发性流产 补肾益气方 黄体酮 Kisspeptin蛋白 

分 类 号：R714.21[医药卫生—妇产科学]