补肾活血方对抗磷脂抗体阳性反复种植失败患者妊娠结局的影响  

Effect of Bushen Huoxue formula on pregnancy outcome in patients with antiphospholipid antibody-positive recurrent implantation failure

作　　者：韩永梅[1] 孟鑫婉 刘新煜 何鑫雨 谢俊丹 HAN Yongmei;MENG Xinwan;LIU Xinyu;HE Xinyu;XIE Jundan(College of Integrative Medicine,Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学中西医结合学院,河南郑州450000

出　　处：《陕西中医》2025年第1期42-46,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：河南省科技攻关项目(232102311216);河南省中医药科学研究专项课题(2024ZY3026)。

摘　　要：目的:观察补肾活血方对抗磷脂抗体阳性反复种植失败(RIF)患者妊娠结局的影响。方法:选取188例抗磷脂抗体阳性RIF患者,按随机数字表法分为补肾活血方组和对照组,两组各94例。两组均给予冻融胚胎移植方案治疗,对照组同时口服拜阿司匹林治疗,治疗组在对照组基础上给予补肾活血方治疗。比较两组子宫内膜容受性超声检测指标、子宫内膜容受性分子标志物指标、中医证候积分及临床疗效、安全性。结果:两组基线时子宫内膜厚度及血流参数比较,无统计学差异(P>0.05)。两组胚胎移植前1天子宫内膜厚度及子宫内膜收缩期峰值速度/舒张末期流速(S/D)较基线时升高,子宫内膜搏动指数(PI)、阻力指数(RI)较基线时下降(P<0.05)。治疗组胚胎移植前1天子宫内膜厚度及子宫内膜S/D高于对照组,子宫内膜PI、RI低于对照组(P<0.05)。治疗组种植窗期整合素β3低于对照组,整合素β1、同源框基因11(HoxA11)高于对照组(P<0.05)。两组治疗后中医证候积分较治疗前降低,治疗组更低(P<0.05)。治疗组临床妊娠率62.22%、活产率55.56%高于对照组,胚胎种植率40.27%,流产率10.71%,与对照组比较,无统计学差异(P>0.05)。结论:补肾活血方可改善抗磷脂抗体阳性RIF患者子宫内膜容受性,提高临床妊娠率,降低早期流产率。Objective:To observe the effect of Bushen Huoxue formula on pregnancy outcome in patients with antiphospholipid antibody-positive recurrent implantation failure(RIF).Methods:188 cases of antiphospholipid antibody-positive RIF patients were selected and divided into the treatment group and the control group according to the method of random number table,with 94 cases in each of the two groups.Both groups were treated with freeze-thawed embryo transfer protocol,the control group was treated with oral aspirin,and the treatment group was treated with Bushen Huoxue formula on the basis of the control group.The two groups were compared in terms of endometrial tolerance ultrasonography indexes,endometrial tolerance molecular markers indexes,Chinese medicine evidence points,clinical efficacy and safety.Results:There was no significant difference in endometrial thickness and blood flow parameters between the two groups at baseline(P>0.05).In both groups,the endometrial thickness and the peak systolic velocity/end-diastolic velocity(S/D)of the endometrium one day before embryo transfer were increased compared with those at baseline,while the pulsatility index(PI)and resistance index(RI)of the endometrium were decreased compared with those at baseline(P<0.05).The endometrial thickness and the endometrial S/D in the treatment group one day before embryo transfer were higher than those in the control group,and the endometrial PI and RI were lower than those in the control group(P<0.05).The integrinβ3 in the implantation window period in the treatment group was lower than that in the control group,while the integrinβ1 and homeobox gene 11(HoxA11)were higher than those in the control group(P<0.05).The scores of traditional Chinese medicine syndromes in both groups after treatment were lower than those before treatment,and the scores in the treatment group were even lower(P<0.05).The clinical pregnancy rate and live birth rate of the treatment group were 62.22%and 55.56%higher than those of the control group.The embryo implant

关 键 词：妊娠结局 补肾活血方 抗磷脂抗体阳性 反复种植失败 冻融胚胎移植 阿司匹林 子宫内膜容受性分子标志物指标 

分 类 号：R714[医药卫生—妇产科学]