加味寿胎丸联合低分子肝素钙注射液治疗多囊卵巢综合征合并复发性流产患者血栓前状态临床研究  

Clinical Study on Modified Shoutai Pills Combined with Low Molecular Weight Heparin Calcium Injection for Prethrombotic State in Patients with Polycystic Ovary Syndrome Complicated with Recurrent Spontaneous Abortion

作　　者：沈颖 叶利群 SHEN Ying;YE Liqun

机构地区：[1]宁波市中医院,浙江宁波315000

出　　处：《新中医》2022年第13期6-11,共6页New Chinese Medicine

基　　金：浙江省“十三五”中医药重点专科建设项目[浙卫办〔2019〕1号];宁波市科技计划项目(2019A610358)。

摘　　要：目的:观察加味寿胎丸联合低分子肝素钙注射液治疗多囊卵巢综合征(PCOS)合并复发性流产患者血栓前状态的临床疗效。方法:选取150例肾虚血瘀证PCOS合并复发性流产患者,按随机数字表法分为西药组、中药组及联合组,各50例。西药组给予低分子肝素钙注射液,中药组给予加味寿胎丸,联合组给予低分子肝素钙注射液联合加味寿胎丸。7 d为1个疗程,共治疗4个疗程。比较3组临床疗效,比较3组治疗前后血清β-人绒毛膜促性腺激素(β-HCG)、雌二醇(E2)、孕激素(P)、凝血-纤溶指标[血浆凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、纤溶酶原激活物抑制因子-1 (PAI-1)、抗凝血酶Ⅲ(AT-Ⅲ)]、子宫动脉血流参数[双侧收缩期峰值流速/舒张期流速(S/D)、搏动指数(PI)、阻力指数(RI)]的变化。结果:治疗后(孕10-11周),3组β-HCG、E2、P水平均较治疗前上升,差异均有统计学意义;治疗后(孕10-11周),联合组β-HCG、E2、P水平均高于西药组、中药组,差异均有统计学意义(P<0.05)。治疗后(孕10-11周),3组PT、TT、APTT、ATⅢ指标值均较治疗前升高,D-D、FIB、PAI-1指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后(孕10-11周),联合组TT、APTT、ATⅢ指标值均高于西药组、中药组,D-D、FIB、PAI-1指标值均低于西药组、中药组,差异均有统计学意义(P<0.05)。治疗后(孕10-11周),3组双侧子宫动脉S/D、PI、RI指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后(孕10-11周),联合组双侧子宫动脉S/D、PI、RI指标值均低于西药组、中药组,差异均有统计学意义(P<0.05)。治疗后,西药组临床疗效总有效率为70%,中药组为72%,联合组为90%。联合组总有效率高于西药组及中药组,差异均有统计学意义(P<0.05)。结论:加味寿胎丸联合低分子肝素钙注射液治疗PCOS合并复发性流产患�Objective:To observe the clinical effect of the therapy of modified Shoutai pills combined with low molecular weight heparin calcium injection on prethrombotic state in patients with polycystic ovary syndrome(PCOS) complicated with recurrent spontaneous abortion. Methods:A total of 150 PCOS patients with kidney deficiency and blood stasis syndrome and complicated with recurrent spontaneous abortion were selected and randomly divided into the western medicine group,the Chinese medicine group and the combination group,with 50 cases in each group. The western medicine group was given low molecular weight heparin calcium injection,the Chinese medicine group was given modified Shoutai pills,and the combination group was given low molecular weight heparin calcium injection combined with Shoutai pills. All groups were treated for four courses, with seven days being a course. The clinical effects in the three groups were compared. Before and after treatment, the changes of serum β-human chorionic gonadotropin(β-HCG),estradiol(E2),progesterone(P),coagulation-fibrinolysis indexes,including plasma prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),plasma fibrinogen(FIB), D-dimer(D-D), plasminogen activator inhibitor-1(PAI-1), and antithrombin Ⅲ(AT-Ⅲ), and uterine artery blood flow parameters, including bilateral peak systolic velocity/diastolic velocity(S/D),pulsatility index(PI) and resistance index(RI), were compared between the three groups. Results: After treatment,during the 10thto 11thweeks of pregnancy,the levels of β-HCG,E2and P in the three groups were increased when compared with those before treatment, differences being significant;after treatment,during the 10th to 11thweeks of pregnancy,the above three levels in the combination group were higher than those in the western medicine group and the Chinese medicine group,differences being significant(P<0.05). After treatment,during the 10thto 11thweeks of pregnancy,the values of PT,TT,APTT and ATⅢ in the three groups were inc

关 键 词：多囊卵巢综合征 复发性流产 血栓前状态 加味寿胎丸 低分子肝素钙注射液 

分 类 号：R711.75[医药卫生—妇产科学] R714.21[医药卫生—临床医学]