从铁死亡角度探讨寿胎丸加味方对PCOS早期先兆流产患者的疗效机制  

Exploration of Therapeutic Mechanism of Modified Shoutai Pill on EarlyThreatened Abortion Patients with PCOS from Perspective of Iron Death

作　　者：韩晗[1,2] 张跃辉[3] 韩亚鹏[3] 张诗笛 韩延华 HAN Han;ZHANG Yuehui;HAN Yapeng;ZHANG Shidi;HAN Yanhua(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150001 [3]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《中医药学报》2023年第10期67-71,共5页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金项目(82074259)。

摘　　要：目的:从铁死亡角度探讨寿胎丸加味方对多囊卵巢综合征(PCOS)早期先兆流产患者的疗效机制。方法:收集2020年3月—2022年3月黑龙江中医药大学附属第一医院收治的98例PCOS早期先兆流产患者,按照数字列表法随机分成观察组与对照组,每组49例,对照组行常规西医治疗,观察组在对照组基础上应用寿胎丸加味方治疗,治疗3个月。比较两组中医症状积分、临床疗效、激素水平[雌二醇(E2)、人绒毛膜促性腺激素β亚单位(β-HCG)、孕酮(P)]、铁死亡关键蛋白[溶质载体家族7成员11(SLC7A11)、谷胱甘肽过氧化物酶4(GPX4)、转铁蛋白受体1(TFR1)],并进行安全性分析,并比较两组妊娠结局。结果:治疗前,两组患者各指标差异均无统计学意义(P>0.05);治疗后,两组患者β-HCG、E2、P含量及GPX4、SLC7A11 mRNA表达量较治疗前显著升高(P<0.05),主要/次要症状积分及TFR1 mRNA表达量较治疗前显著降低(P<0.05);观察组β-HCG、E2、P含量及GPX4、SLC7A11 mRNA表达量显著高于对照组(P<0.05),主要/次要症状积分及TFR1 mRNA表达量显著低于对照组(P<0.05)。与对照组比较,观察组患者总有效率、自然分娩例数、新生儿Apgar评分明显升高(P<0.05),新生儿窒息例数、早产例数明显降低(P<0.05)。两组患者治疗期间均未见严重不良反应,心电图及肝肾功能等未见明显异常。结论:寿胎丸加味方对PCOS早期先兆流产患者的疗效较好,有助于缓解临床症状,改善激素水平,同时安全性高,能使患者获得更好的妊娠结局,其疗效机制可能与抑制铁死亡有关。Objective:To explore the therapeutic mechanism of modified Shoutai pill on early threatened abortion patients with polycystic ovary syndrome(PCOS)from the perspective of iron death.Methods:98 early threatened abortion patients with PCOS who were admitted to The First Affiliated Hospital of Harbin Medical University from March 2020 to March 2022 were recruited and randomly divided into observation group and control group according to a random number table,with 49 cases in each group.The control group was treated with Western medicine for 3 months,while the observation group was treated with modified formula of Shoutai plus the medicine administered in the control group for the same period of time.The TCM symptom scores,clinical efficacy,hormone level,[estradiol(E_(2)),human chorionic gonadotropin β subunit(β-HCG),progesterone(P)],iron death key protein Recombinant Solute Carrier Family 7,Member 11(SLC7A11),glutathione peroxidase 4(GPX4),transferrin receptor 1(TFR1)],and safety analysis were compared between the two groups,and the pregnancy outcomes of the two groups were analyzed.Results:Before the treatment,there was no significant difference between the indices in the two groups(P>0.05).After the treatment,β-HCG,E 2,P content,GPX4,and SLC7A11 mRNA expressions were significantly increased in both groups(P<0.05);the score of main/secondary symptoms and the expression of TFR1 mRNA in the two groups were significantly decreased(P<0.05).β-HCG,E 2,P content and GPX4,SLC7A11 mRNA expression in observation group were significantly higher than those in the control group(P<0.05);The main/secondary symptom score and TFR1 mRNA expression in the observation group were significantly lower than those in the control group(P<0.05).Compared with the control group,the total effective rate,natural delivery and Apgar score of newborns in the observation group were significantly increased(P<0.05).There were no serious adverse reactions and no obvious abnormalities in ECG,liver and kidney functions during the treatment in both gro

关 键 词：铁死亡 寿胎丸加味方 PCOS 早期先兆流产 

分 类 号：R271.1[医药卫生—中医妇科学]