当归芍药散联合依诺肝素对复发性流产患者性激素水平、凝血功能及妊娠结局的影响  

Effects of Danggui Shaoyao Powder Combined with Enoxaparin on Sex Hormone Levels,Coagulation Function,and Pregnancy Outcomes in Patients with Recurrent Miscarriage

作　　者：卢喜洋 贺燕[1] LU Xiyang;HE Yan(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医药信息》2024年第12期42-47,共6页Information on Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(20-21ZY2032)。

摘　　要：目的:探讨当归芍药散联合依诺肝素对复发性流产患者的临床疗效,及其对性激素、凝血指标及妊娠结局的影响。方法:选取符合纳入标准的复发性流产患者102例,依据数字表随机抽取法分为对照组和观察组,每组各51例。两组均给予常规治疗,对照组在常规治疗基础上给予依诺肝素治疗,观察组在对照组治疗基础上给予当归芍药散治疗,维持服用至妊娠12周。比较两组患者中医证候积分、子宫内膜容受性[下螺旋动脉阻力指数(RI)、血流搏动指数(PI)、子宫内膜厚度、子宫体积]、雌孕激素[雌二醇(E2)、孕酮(P)、β-人绒毛膜促性腺激素(β-HCG)]、凝血指标[凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)]、血流变学指标[红细胞沉降率(ESR)、血浆黏度(PV)、全血高切黏度(BVH)、全血低切黏度(BVL)]及保胎结局(早产率、足月分娩率、保胎成功率)。结果:与治疗前比较,治疗后两组患者中医证候主症、次症及总积分下降(P<0.05),RI、子宫体积均减小(P<0.05),子宫内膜厚度增厚(P<0.05),β-HCG、P、E2、TT、APTT、PT明显升高(P<0.05),D-D、PV、BVH、ESR均下降(P<0.05),观察组PI、BVL明显下降(P<0.05)。治疗后观察组中医证候积分、雌孕激素水平、凝血指标、血流变学指标、RI、子宫体积和子宫内膜厚度改善情况均优于对照组(P<0.01)。观察组早产率3.92%(2/51)明显低于对照组13.73%(7/51)(P<0.05);足月分娩率86.27%(44/51)和保胎成功率90.20%(46/51)明显高于对照组62.75%(32/51)和76.47%(39/51)(P<0.05)。结论:当归芍药散联合依诺肝素对复发性流产的治疗效果优于单用依诺肝素,可有效改善患者中医证候、子宫内膜容受性、凝血功能及血流变学指标,提高保胎成功率。Objective:To investigate the clinical efficacy of Danggui Shaoyao Powder combined with enoxaparin on recurrent miscarriage patients,and its effects on sex hormones,coagulation parameters,and pregnancy outcomes.Methods:A total of 102 patients with recurrent miscarriage meeting the inclusion criteria were randomly divided into a control group and an observation group,with 51 cases in each group.The control group received enoxaparin treatment,while the observation group received the same plus Danggui Shaoyao Powder,continuing until the 12th week of pregnancy.Traditional Chinese medicine(TCM)syndrome scores,endometrial receptivity indicators[spiral artery resistance index(RI),blood flow pulsatility index(PI),endometrial thickness,uterine volume],estrogen and progesterone levels[estradiol(E2),progesterone(P),β-human chorionic gonadotropin(β-HCG)],coagulation parameters[thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),D-dimer(D-D)],and hemorheological parameters[erythrocyte sedimentation rate(ESR),plasma viscosity(PV),high shear whole blood viscosity(BVH),low shear whole blood viscosity(BVL)]were compared between the two groups,along with pregnancy preservation outcomes(preterm birth rate,full-term delivery rate,and pregnancy preservation success rate).Results:After treatment,the main and secondary symptoms and total scores of TCM syndrome in both groups decreased(P<0.05);RI and uterine volume decreased(P<0.05),endometrial thickness increased(P<0.05),andβ-HCG,P,E2,TT,APTT,and PT levels significantly increased(P<0.05),while D-D,PV,BVH,and ESR levels decreased(P<0.05).PI and BVL decreased significantly in the observation group(P<0.05).Post-treatment improvements in TCM syndrome scores,estrogen and progesterone levels,coagulation parameters,hemorheological indicators,RI,uterine volume,and endometrial thickness were all significantly better in the observation group compared to the control group(P<0.01).The preterm birth rate in the observation group(3.92%,2/51)was significantly lower th

关 键 词：复发性流产 当归芍药散 依诺肝素 子宫内膜容受性 凝血功能 血流变学 

分 类 号：R714.21[医药卫生—妇产科学]