中西医治疗抗心磷脂抗体阳性复发性流产研究进展
|
摘要
复发性流产(RSA)是育龄期女性一种常见疾病,在祖国中医学中属"滑胎"范畴。近年其发病率日渐上升,导致疾病发生的病因复杂,自上世纪80年代末以来,发现RSA的发病与全身免疫反应有关,主要发病机制是抗磷脂综合征,其中约20%是由抗心磷脂抗体阳性引起。临床医生治疗因自身免疫原因ACA阳性引起的RSA主要采取免疫抑制、抗凝等方案,服用小剂量阿司匹林、注射丙种球蛋白和低分子肝素,这些方法虽能够提高胎儿的活产率,但存在一定的危险性。在中医领域中根据辨证论治思想理念,以补肾活血为准则,治疗ACA阳性RSA患者,作用范围广,无毒副作用。中西医治疗各有优势,文章做一简要综述,分析近年来中西医治疗ACA阳性RSA方法及疗效。
Recurrent spontaneous abortion(RSA)is a common disease among women of childbearing age and belongs to the category of"slippery foetus"in Chinese medicine. Rapidly rising trend in recent years,the incidence,cause disease etiology of complex,since the late 1980 s,found that the onset of RSA is associated with systemic immune response,its main pathogenesis is for antiphospholipid syndrome,of which about 20% are caused by anti cardiolipin antibody positive. Clinicians treating RSA caused by ACA positive for autoimmune reasons mainly adopts immune suppression,such as anticoagulant,oral low-dose heparin and aspirin,injection of gamma globulin and low molecular heparin,although these methods can improve the production rate of the fetus,there is a certain risk. Traditional Chinese medicine treatment of ACA positive RSA patients with tonifying kidney and invigorating blood as the basic principle,syndrome differentiation,wide range,non-toxic side effects. Chinese and Western medicine has the advantage,the article makes a brief review,the analysis in recent years the Chinese and Western medicine treatment ACA positive RSA method and the curative effect.
Recurrent spontaneous abortion(RSA)is a common disease among women of childbearing age and belongs to the category of"slippery foetus"in Chinese medicine. Rapidly rising trend in recent years,the incidence,cause disease etiology of complex,since the late 1980 s,found that the onset of RSA is associated with systemic immune response,its main pathogenesis is for antiphospholipid syndrome,of which about 20% are caused by anti cardiolipin antibody positive. Clinicians treating RSA caused by ACA positive for autoimmune reasons mainly adopts immune suppression,such as anticoagulant,oral low-dose heparin and aspirin,injection of gamma globulin and low molecular heparin,although these methods can improve the production rate of the fetus,there is a certain risk. Traditional Chinese medicine treatment of ACA positive RSA patients with tonifying kidney and invigorating blood as the basic principle,syndrome differentiation,wide range,non-toxic side effects. Chinese and Western medicine has the advantage,the article makes a brief review,the analysis in recent years the Chinese and Western medicine treatment ACA positive RSA method and the curative effect.
引文
[1]Bo Eun Lee,Young Joo Jeon,Ji Eun Shin.Tumor Necrosis Factor-αGene Polymorphisms in Korean Patients With Recurrent Spontaneous Abortion Reproductive[J].Science,2013,20(4):408-413.
[2]马韵,郑梅玲.不明原因复发性流产发病机制研究进展[J].中华妇幼临床医学杂志,2016,12(2):237-240.
[3]Cervera R.Antiphospholipid syndrome[J].Thrombosis Research,2017,151(1):43-47.
[4]冯晓玲,张伟平.抗心磷脂抗体阳性复发性流产的中西医治疗进展[J].中医药临床杂志,2014,26(5):539-540.
[5]马芳芳,王厚照.D-二聚体和抗心磷脂抗体与反复自然流产的关系研究[J].中国优生与遗传杂志,2016,24(3):77-78.
[6]吴晓彤,任春娥,姜爱芳,等.抗心磷脂抗体感染与复发性流产的相关性研究[J].潍坊医学院学报,2017,39(2):120-122.
[7]王爱娟,孙振高,张兴兴,等.复发性流产的免疫学病因研究进展[J].中国优生与遗传杂志,2017,25(4):1-4.
[8]胥风华,张晓爽,韩亚光.抗心磷脂抗体阳性复发性流产的研究进展[J].中华中医药学刊,2015,33(8):1851-1853.
[9]李凤中,陈波,黄永建.抗心磷脂抗体检测在孕妇不良妊娠结局中的临床意义[J].实验与检验医学,2014,32(1):68-70.
[10]张丽.补肾益气和血方联合阿司匹林治疗ACA阳性所致先兆流产临床研究[J].中医临床研究,2015,7(35):69-70.
[11]王欢欢,刘永林,张丽,等.不同中医证型复发性流产及其妊娠结局与细胞因子的相关性研究[J].浙江中医杂志,2017,52(17):794-795.
[12]黄烨.补肾活血方治疗抗心磷脂抗体阳性复发性流产疗效观察[J].江西医药,2014,49(11):1265-1267.
[13]朱姝,陆启滨.抗心磷脂抗体导致妊娠丢失的免疫病理机制及安子合剂的干预作用[J].中国实验方剂学杂志,2012,18(11):177-181.
[14]詹新林,冯宗文,蔡仁燕,等.消抗地黄汤对抗心磷脂抗体阳性反复自然流产患者子宫内膜和血流动力学的影响[J].中国中医药科技,2012,19(3):245-246.
[15]路小英,龚瑾.消抗二号治疗抗心磷脂抗体阳性不孕临床观察[J].四川中医,2015,33(9):143-144.
[16]李久现,胡小芳,韩永梅,等.补肾活血方药联合低分子肝素干预早期复发性流产血栓前状态的临床观察[J].上海中医药杂志,2017,51(10):69-71.
[17]商威,张立新.张立新应用中医药治疗习惯性流产经验[J].辽宁中医杂志,2015,42(7):1206-1207.
[18]张杨,王玲,李娜,等.补肾活血方对不明原因复发性流产小鼠蜕膜细胞TNFR1、PI3K/Bcl-xl的影响[J].中华中医药杂志,2017,32(2):768-771.
[19]Keller SE,Weiss JM,Schleifer SJ,et al.Stress-induced suppression of immunity in adrenalectomized rats[J].Science,1983,221(4617):1301-1304.
[20]王宁.柏子仁研究进展[J].生物技术世界,2015(8):249.
[21]李得鑫,韩超,杨金凯,等.远志茯神口服液对昆明小鼠的抗应激作用[J].动物医学进展,2016,37(11):70-73.
[22]左军,王海鹏,柴剑波,等.酸枣仁抗抑郁作用现代药理研究进展[J].辽宁中医药大学学报,2017,19(7):179-181.
[23]杨晶晶,胡丽娜.肝素联合阿司匹林治疗抗磷脂抗体引起的复发性流产研究进展[J].现代医药卫生,2015,41(15):2299.
[24]吴淑燕,张建平.复发性流产的抗凝治疗[J].中国实用妇科与产科杂志,2017,33(7):671-674.
[25]梁荣丽,黄信,余凤花.低分子肝素联合滋肾育胎丸治疗抗心磷脂抗体阳性复发性流产的临床研究[J].中国当代医药,2016,23(10):150-152.
[26]欧玉华,张建平.低分子肝素在复发性流产中应用的现状研究[J].中国计划生育和妇产科,2017,9(10):10-14.
[27]Lu E,Shatzel JJ,Salati J,et al.The Safety of Low-MolecularWeight Heparin and After Pregnancy[J].Obstetrical and Gynecological Survey,2017,72(12):721-729.
[28]G Ozturk,P Akpinar,AD Karamanlioglu,et al.Pregnancyrelated osteoporotic vertebral compression fractures associated with low-molecular-weight heparin during pregnancy:case reports[J].Gynecological Endocrinology,2017,34(5):1-3.
[29]谷玥儒,冯晓玲,王炜,等.抗心磷脂抗体阳性复发性流产的中医治疗概述[J].中医药临床杂志,2015,27(2):275-276.
[30]臧玲,孟安琪,张凤暖.自拟滑胎补肾Ⅲ号膏方治疗抗心磷脂阳性所致复发性流产临床观察[J].辽宁中医药大学学报,2017,19(8):122-124.
[2]马韵,郑梅玲.不明原因复发性流产发病机制研究进展[J].中华妇幼临床医学杂志,2016,12(2):237-240.
[3]Cervera R.Antiphospholipid syndrome[J].Thrombosis Research,2017,151(1):43-47.
[4]冯晓玲,张伟平.抗心磷脂抗体阳性复发性流产的中西医治疗进展[J].中医药临床杂志,2014,26(5):539-540.
[5]马芳芳,王厚照.D-二聚体和抗心磷脂抗体与反复自然流产的关系研究[J].中国优生与遗传杂志,2016,24(3):77-78.
[6]吴晓彤,任春娥,姜爱芳,等.抗心磷脂抗体感染与复发性流产的相关性研究[J].潍坊医学院学报,2017,39(2):120-122.
[7]王爱娟,孙振高,张兴兴,等.复发性流产的免疫学病因研究进展[J].中国优生与遗传杂志,2017,25(4):1-4.
[8]胥风华,张晓爽,韩亚光.抗心磷脂抗体阳性复发性流产的研究进展[J].中华中医药学刊,2015,33(8):1851-1853.
[9]李凤中,陈波,黄永建.抗心磷脂抗体检测在孕妇不良妊娠结局中的临床意义[J].实验与检验医学,2014,32(1):68-70.
[10]张丽.补肾益气和血方联合阿司匹林治疗ACA阳性所致先兆流产临床研究[J].中医临床研究,2015,7(35):69-70.
[11]王欢欢,刘永林,张丽,等.不同中医证型复发性流产及其妊娠结局与细胞因子的相关性研究[J].浙江中医杂志,2017,52(17):794-795.
[12]黄烨.补肾活血方治疗抗心磷脂抗体阳性复发性流产疗效观察[J].江西医药,2014,49(11):1265-1267.
[13]朱姝,陆启滨.抗心磷脂抗体导致妊娠丢失的免疫病理机制及安子合剂的干预作用[J].中国实验方剂学杂志,2012,18(11):177-181.
[14]詹新林,冯宗文,蔡仁燕,等.消抗地黄汤对抗心磷脂抗体阳性反复自然流产患者子宫内膜和血流动力学的影响[J].中国中医药科技,2012,19(3):245-246.
[15]路小英,龚瑾.消抗二号治疗抗心磷脂抗体阳性不孕临床观察[J].四川中医,2015,33(9):143-144.
[16]李久现,胡小芳,韩永梅,等.补肾活血方药联合低分子肝素干预早期复发性流产血栓前状态的临床观察[J].上海中医药杂志,2017,51(10):69-71.
[17]商威,张立新.张立新应用中医药治疗习惯性流产经验[J].辽宁中医杂志,2015,42(7):1206-1207.
[18]张杨,王玲,李娜,等.补肾活血方对不明原因复发性流产小鼠蜕膜细胞TNFR1、PI3K/Bcl-xl的影响[J].中华中医药杂志,2017,32(2):768-771.
[19]Keller SE,Weiss JM,Schleifer SJ,et al.Stress-induced suppression of immunity in adrenalectomized rats[J].Science,1983,221(4617):1301-1304.
[20]王宁.柏子仁研究进展[J].生物技术世界,2015(8):249.
[21]李得鑫,韩超,杨金凯,等.远志茯神口服液对昆明小鼠的抗应激作用[J].动物医学进展,2016,37(11):70-73.
[22]左军,王海鹏,柴剑波,等.酸枣仁抗抑郁作用现代药理研究进展[J].辽宁中医药大学学报,2017,19(7):179-181.
[23]杨晶晶,胡丽娜.肝素联合阿司匹林治疗抗磷脂抗体引起的复发性流产研究进展[J].现代医药卫生,2015,41(15):2299.
[24]吴淑燕,张建平.复发性流产的抗凝治疗[J].中国实用妇科与产科杂志,2017,33(7):671-674.
[25]梁荣丽,黄信,余凤花.低分子肝素联合滋肾育胎丸治疗抗心磷脂抗体阳性复发性流产的临床研究[J].中国当代医药,2016,23(10):150-152.
[26]欧玉华,张建平.低分子肝素在复发性流产中应用的现状研究[J].中国计划生育和妇产科,2017,9(10):10-14.
[27]Lu E,Shatzel JJ,Salati J,et al.The Safety of Low-MolecularWeight Heparin and After Pregnancy[J].Obstetrical and Gynecological Survey,2017,72(12):721-729.
[28]G Ozturk,P Akpinar,AD Karamanlioglu,et al.Pregnancyrelated osteoporotic vertebral compression fractures associated with low-molecular-weight heparin during pregnancy:case reports[J].Gynecological Endocrinology,2017,34(5):1-3.
[29]谷玥儒,冯晓玲,王炜,等.抗心磷脂抗体阳性复发性流产的中医治疗概述[J].中医药临床杂志,2015,27(2):275-276.
[30]臧玲,孟安琪,张凤暖.自拟滑胎补肾Ⅲ号膏方治疗抗心磷脂阳性所致复发性流产临床观察[J].辽宁中医药大学学报,2017,19(8):122-124.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |