补肾健脾法改善多囊卵巢综合征先兆流产糖代谢及胎盘微循环的临床探究  

Clinical study on improving glucose metabolism and placental microcirculation of threatened abortion with polycystic ovary syndrome by tonifying kidney and invigorating spleen

作　　者：冯晓玲[1] 任佳杰 赵小萱 康天天 韩斯斯[2] 赵颜[1] FENG Xiao-ling;REN Jia-jie;ZHAO Xiao-xuan;KANG Tian-tian;HAN Si-si;ZHAO Yan(First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150000,China;Heilongjiang University of Chinese Medicine,Harbin 150000,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150000 [2]黑龙江中医药大学,黑龙江哈尔滨150000

出　　处：《时珍国医国药》2022年第6期1304-1307,共4页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金(81973894);黑龙江中医药大学研究生创新科研项目(2020yjscx003);黑龙江中医药大学“优秀创新人才支持计划”项目(201826)。

摘　　要：目的探讨补肾健脾法治疗多囊卵巢综合征(PCOS)早孕先兆流产的优势及安胎机理。方法对符合病例选择标准的40例PCOS先兆流产患者(A组:伴有IR患者20例;B组:不伴有IR患者20例)及20例正常妊娠孕妇(C组),分别测定外周血中孕酮(P)、人绒毛膜促性腺激素(β-HCG)、雌二醇(E_(2))、纤溶酶原激活物抑制物1(PAI-1)、组织型纤溶酶原激活物因子(t-PA)、胰岛素样生长因子(IGF-1)和胰岛素样生长因子结合蛋白1(IGFBP-1)表达水平,并计算BMI及胰岛素抵抗指数(HOMA-IR),应用补肾健脾法治疗A、B两组患者,30天后对三组再次测定以上指标,并进行统计分析。结果治疗后,A、B两组的P、E_(2)、β-HCG、PAI-1、t-PA、IGF-1及IGFBP-1均与C组无明显差异;治疗后A组HOMA-IR较治疗前显著降低。结论PCOS早孕先兆流产可能与PAI-1、t-PA、IGF-1及IGFBP-1表达异常有关。补肾健脾法能够改善PCOS先兆流产患者的IR状态和胎盘界面血流循环,维持正常妊娠。Objective To explore the advantages and mechanism of tonifying kidney and invigorating spleen in the treatment of polycystic ovary syndrome(PCOS)threatened abortion during early pregnancy.Methods 40 PCOS patients with threatened abortion who met the case selection criteria(group A):20 patients with IR;Group B:And 20 normal pregnant women(group C).The inhibition of progesterone(P),human chorionic gonadotropin(β-HCG),estradiol(E_(2))and plasminogen activator in peripheral blood were determined.The expression levels of compound 1(PAI-1),tissue-type plasminogen activator factor(T-PA),insulin-like growth factor 1(IGF-1)and insulin-like growth factor binding protein 1(IGFBP-1)were calculated,and the BMI and insulin resistance index(HOMA-IR)were calculated.After 30 days,the above indexes of the three groups were measured again and analyzed statistically.After treatment,P,E_(2),β-hCG,PAI-1,T-PA,IGF-1 and IGFBP-1 in group A and B were not significantly different from those in group C.Results After treatment,homA-IR of group A was significantly lower than that before treatment.Conclusion PCOS threatened abortion in early pregnancy may be related to abnormal expression of PAI-1,T-PA,IGF-1 and IGFBP-1.Tonifying kidney and invigorating spleen can improve the IR status and placental interface blood circulation of PCOS patients with threatened abortion,and maintain normal pregnancy.

关 键 词：补肾健脾法 多囊卵巢综合征 先兆流产 糖代谢 胎盘微循环 

分 类 号：R285.6[医药卫生—中药学]