安胎汤联合环孢素A对不明复发性流产免疫平衡及保胎率的影响  

Effect of Antai Decoction(安胎汤)Combined with Cyclosporine A on Immune Balance and Miscarriage Rate in Patients with Unexplained Recurrent Spontaneous Abortion

作　　者：钱艳清[1] 孙云[1] QIAN Yanqing;SUN Yun(Wenzhou Traditional Chinese Medicine Hospital,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州市中医院,浙江温州325000

出　　处：《中华中医药学刊》2022年第4期219-222,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划(2019ZB121)。

摘　　要：目的观察安胎汤联合环孢素A对不明复发性流产患者免疫平衡及保胎率的影响。方法采用随机数字表法将符合入选标准的84例不明复发性流产患者分为观察组和对照组,每组42例,对照组口服环孢素软胶囊治疗,观察组在对照组的基础上予安胎汤治疗,持续治疗至妊娠12周。比较两组治疗前后血绒毛膜促性腺激素(HCG)、孕酮(P)、雌二醇(E_(2))水平、免疫指标免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、T淋巴细胞亚群(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、白细胞介素(IL-10)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平改善状况,评估两组临床疗效、保胎成功率及不良反应发生状况。结果观察组治疗后总有效率为92.86%(39/42),显著高于对照组总有效率(73.81%,31/42)(P<0.05);治疗后两组血清HCG、P、E_(2)水平,CD_(8)^(+)指标,IL-10水平均明显高于治疗前(P<0.05);且观察组治疗以上指标均明显高于对照组(P<0.05);治疗后两组血清IgG、IgM、IgA水平,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+),TNF-α、IFN-γ水平均明显低于治疗前(P<0.05),且观察组治疗以上指标均明显低于对照组(P<0.05);观察组治疗后保胎成功率为90.48%(38/42),显著高于对照组保胎成功率73.81%(P<0.05);两组均未出现明显不良反应。结论安胎汤联合环孢素A能够调节不明复发性流产患者免疫失衡状态,改善患者机体紊乱的内分泌系统,有助于提高保胎率,安全可靠,疗效确切。Objective To observe the effect of Antai Decoction(安胎汤)combined with cyclosporine A on immune balance and miscarriage rate of patients with unexplained recurrent spontaneous abortion.Methods Eighty-four patients with unexplained recurrent abortion were randomly divided into the observation group and the control group,with 42 cases in each group.The control group was treated with Cyclosporine Soft Capsule and the observation group was treated with Antai Decoction on the basis of the control group.The treatment lasted until 12 weeks of gestation.The levels of blood chorionic gonadotropin(HCG),progesterone(P),estradiol(E2),immune indexes(IgG,IGA,IgM),T lymphocyte subsets(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+)),Interleukin(IL-10),tumor necrosis factor-α(TNF-α)and Interferon-γ(IFN-γ)between the two groups before and after treatment,and the clinical efficacy were compared.The success rate of miscarriage and incidence of adverse reactions were evaluated.Results The total effective rate of the observation group was 92.86%(39/42),which was significantly higher than that of the control group(73.81%,31/42)(P<0.05).After treatment,the levels of hCG,P,E2,CD_(8)^(+)and IL-10 in the two groups were significantly higher than those before treatment(P<0.05).The above indexes in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the serum levels of IgG,IgM and IgA,and the indexes of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),TNF-αand IFN-γof the two groups were significantly lower than those before treatment(P<0.05).The above indexes of the observation group were significantly lower than those of the control group(P<0.05).The success rate of the observation group was 90.48%(39/42),which was significantly higher than that of the control group(73.81%)(P<0.05).There was no obvious adverse reaction in the two groups.Conclusion The application of Antai Decoction combined with cyclosporine A can regulate the immune imbalance state of patients with unexplained recurrent abortion,

关 键 词：不明复发性流产 安胎汤 环孢素A 体液免疫 细胞免疫 免疫失衡 保胎率 

分 类 号：R271.914.21[医药卫生—中西医结合]