寿胎丸合芍药甘草汤加味对复发性流产患者的影响
|
摘要
目的:观察寿胎丸合芍药甘草汤加味对复发性流产脾肾气虚证患者的影响,探讨其作用机制。方法:将180例符合条件的患者随机分为对照组和治疗组,各90例。在淋巴细胞免疫治疗基础上,对照组给予地屈孕酮片,观察组给予寿胎丸合芍药甘草汤加味。观察组患者凝血功能[部分纤溶酶原激活物抑制剂-1(PAI-1),纤维蛋白原(FIB),组织型纤溶酶原活化因子(t-PA),凝血酶原时间(PT),D-二聚体(D-D),组织因子(TF),纤维蛋白肽A(FPA),纤维蛋白原(Fig),α颗粒膜糖蛋白-140(GMP-140),纤溶酶-抗纤溶酶复合物(PAP),血小板血酶-抗凝血酶复合物(TAT)],血清封闭抗体(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+),炎性因子[γ-干扰素(IFN-γ),肿瘤坏死因子-α(TNF-α),白细胞介素-1β(IL-1β),白细胞介素-10(IL-10)]水平和中医辨证"数堕胎"脾肾气虚证评分;比较两组患者足月分娩率和不良反应发生率。结果:研究期间脱落5例,治疗组足月分娩率92. 0%,高于对照组的73. 6%(P <0. 05)。治疗组总有效率97. 7%,高于对照组的81. 6%(P <0. 05)。治疗组患者的凝血功能指标(PAI-1,FIB,t-PA,D-D,PAP,GMP-140,TAT),封闭抗体(CD3~+,CD4~+,CD4~+/CD8~+),炎症因子(IFN-γ,TNF-α,IL-1β)和中医证候评分较对照组明显降低(P <0. 05);凝血功能指标(PT,TF,FPA,Fig),血清封闭抗体CD8~+和炎症因子IL-10较对照组明显升高(P <0. 05)。治疗组不良反应发生率10. 3%(9/87)低于对照组的22. 7%(20/88)(P <0. 05)。结论:寿胎丸合芍药甘草汤加味可有效提高复发性流产脾肾气虚证患者的足月分娩率,明显改善其中医证候的评分、凝血功能、血清封闭抗体,炎性因子水平,降低淋巴细胞免疫治疗的不良反应。
Objective: To observe the effect of Shoutaiwan and Shaoyao Gancao Tang on recurrent spontaneous abortion due to spleen and kidney Qi deficiency. Method: Totally 80 eligible patients were randomly divided into the control group and the treatment group,with 90 cases in each group. The control group was treated with lymphocyte immune; the Shoutaiwan and Shaoyao Gancao Tang combined with lymphocyte immune was applied in the treatment group. Coagulation function [the part plasminogen activator inhibitor-1(PAI-1),fibrinogen(FIB),type plasminogen activator(t-PA),prothrombin time(PT),D-dimer(D-D) and tissue factor(TF),fibrin peptide A(FPA),fibrinogen(Fig),Plasminase-antifibrinolytic complex(PAP),glycoprotein platelet particle-140(GMP-140),thrombin-antithrombin complex(TAT) ],serum closed antibody(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+),inflammatory factor interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),Interleukin-1β(IL-1β),interleukin-10(IL-10) ] were scored after the treatment. The rates of birth and adverse reactions in each group were compared. The traditional Chinese medicine(TCM) syndrome differentiation of abortion spleen and kidney Qi deficiency was scored. Result: 5 cases were lost during the study period. The term delivery rate was 92. 0% in the treatment group,which was higher than 73. 6% in control group(P < 0. 05). The total effective rate was 97. 7% in the treatment group,which was higher than 81. 6% in control group(P < 0. 05).The coagulation function indexes(PAI-1,FIB,t-PA,D-D,PAP,GMP-140,TAT),closed antibodies(CD3~+,CD4~+,CD4~+/CD8~+), inflammatory factors(IFN-γ, TNF-α, IL-1β) and TCM syndrome scores were significantly lower in the treatment group than that in control group(P < 0. 05). Coagulation function indexes(PT,TF,FPA,Fig),serum blocking antibodies(CD8~+),inflammatory factors IL-10 were significantly increased compared with the control group(P < 0. 05). The incidence of adverse reactions in treatment group was 10. 3%(9/87),which was lower than 22. 7% in control group(20/88)(P < 0. 05). Conclusion: Shoutaiwan and Shaoyao Gancao Tang have a remarkable effect on recurrent spontaneous abortion case by spleen and kidney Yang deficiency.
Objective: To observe the effect of Shoutaiwan and Shaoyao Gancao Tang on recurrent spontaneous abortion due to spleen and kidney Qi deficiency. Method: Totally 80 eligible patients were randomly divided into the control group and the treatment group,with 90 cases in each group. The control group was treated with lymphocyte immune; the Shoutaiwan and Shaoyao Gancao Tang combined with lymphocyte immune was applied in the treatment group. Coagulation function [the part plasminogen activator inhibitor-1(PAI-1),fibrinogen(FIB),type plasminogen activator(t-PA),prothrombin time(PT),D-dimer(D-D) and tissue factor(TF),fibrin peptide A(FPA),fibrinogen(Fig),Plasminase-antifibrinolytic complex(PAP),glycoprotein platelet particle-140(GMP-140),thrombin-antithrombin complex(TAT) ],serum closed antibody(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+),inflammatory factor interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),Interleukin-1β(IL-1β),interleukin-10(IL-10) ] were scored after the treatment. The rates of birth and adverse reactions in each group were compared. The traditional Chinese medicine(TCM) syndrome differentiation of abortion spleen and kidney Qi deficiency was scored. Result: 5 cases were lost during the study period. The term delivery rate was 92. 0% in the treatment group,which was higher than 73. 6% in control group(P < 0. 05). The total effective rate was 97. 7% in the treatment group,which was higher than 81. 6% in control group(P < 0. 05).The coagulation function indexes(PAI-1,FIB,t-PA,D-D,PAP,GMP-140,TAT),closed antibodies(CD3~+,CD4~+,CD4~+/CD8~+), inflammatory factors(IFN-γ, TNF-α, IL-1β) and TCM syndrome scores were significantly lower in the treatment group than that in control group(P < 0. 05). Coagulation function indexes(PT,TF,FPA,Fig),serum blocking antibodies(CD8~+),inflammatory factors IL-10 were significantly increased compared with the control group(P < 0. 05). The incidence of adverse reactions in treatment group was 10. 3%(9/87),which was lower than 22. 7% in control group(20/88)(P < 0. 05). Conclusion: Shoutaiwan and Shaoyao Gancao Tang have a remarkable effect on recurrent spontaneous abortion case by spleen and kidney Yang deficiency.
引文
[1]宋艳丽,孙自学,门波,等.滋肾健脾化瘀方对复发性流产患者凝血功能的影响[J].中国实验方剂学杂志,2018,24(19):195-200.
[2] Lia G S,Denga L J,CAO Y J,et al. Effect of sodium chloride on fine coal flotation and discussion based on froth stability and particle coagulation[J]. Int J Miner Process,2017,169(10):47-52.
[3]宋晓捷,周艳艳,赵莉娜.胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产患者的疗效及其对辅助性T淋巴细胞17/调节性T淋巴细胞免疫失衡的影响[J].中国实验方剂学杂志,2018,24(18):164-169.
[4] Gana K,Jie X B,Gaic Y J,et al. In-situ coagulation of yttria-stabilized zirconia suspension via dispersant hydrolysis using sodium tripolyphosphate[J]. J Eur Ceram Soc,2017,37(15):4868-4875.
[5]李华,傅晓冬,柳怡,等.补肾调冲方联合常规西药治疗复发性流产肾虚血瘀型疗效及对患者血清Th1/Th2细胞因子平衡偏移的影响[J].中国实验方剂学杂志,2018,24(5):171-175.
[6] Samira H,Fazel S K,Soheila A P,et al. A shift in the balance of T17 and Treg cells in menstrual blood of women with unexplained recurrent spontaneous abortion[J]. J Reprod Immunol,2016,116(8):13-22.
[7]田丹,戴海青,李兆萍,等.补中益气汤治疗脾肾两虚证封闭抗体阴性所致复发性流产38例[J].中国实验方剂学杂志,2015,21(18):167-170.
[8]王巍,马海兰,蓝雪琴,等.淋巴细胞免疫治疗不明原因反复流产115例妊娠结局分析[J].中国妇幼保健,2015,30(11):1720-1724.
[9]田葱,李娟,常兴隆.安胎种子丸治疗不明原因复发性流产临床研究[J].新中医,2011,43(1):53-55.
[10]魏竞男,王爱丽,陈彦,等.寿胎丸合四物汤加减治疗肾虚血瘀型复发性流产患者对细胞免疫因子的影响[J].辽宁中医杂志,2017,44(9):1887-1889.
[11]王革新.加味安奠二天汤对原因不明复发性流产患者细胞免疫因子的影响[J].中华中医药学刊,2010,28(11):2378-2380.
[12]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,2010:311-313.
[13]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:130-131.
[14] Amber B O,Miranda V E. Lipoproteins as modulators of atherothrombosis:from endothelial function to primary and secondary coagulation[J]. Vasc Pharm,2016,82(6):1-10.
[15] YANG Z G,XIN T B,ZHANG B P,et al. Enhanced permeation and antifouling performance of polyvinyl chloride(PVC)blend Pluronic F127 ultrafiltration membrane by using salt coagulation bath(SCB)[J]. J Memb Sci,2018,548(15):32-41.
[16] Yating Q B,XIN W G,Ruanc H J,et al. Circular RNAs expressed in chorionic villi are probably involved in the occurrence of recurrent spontaneous abortion[J].Biomed Pharmacother,2017,88(4):1154-1162.
[17] Dina M R,Yomna A B,Mohamed S,et al. Intralipid supplementation in women with recurrent spontaneous abortion and elevated levels of natural killer cells[J].Int J Gynecol Obstet,2016,135(3):324-327.
[18] Mohammad H B,Mojgan M K,Safura K,et al. Evaluation of HLA-G14-bp ins/del and+3142G> C polymorphisms with susceptibility to recurrent spontaneous abortion[J].Taiwan J Obstet Gynecol,2017,56(3):276-280.
[19]杨彬,黄俊卿,张继伟.基于HMGB1/TLR4/NF-κB信号通路考察木瓜提取物对脊髓损伤大鼠的保护作用[J].中国实验方剂学杂志,2018,24(15):167-175.
[20] Penga F L,Jib W L,Zhub F,et al. A study on phthalate metabolites,bisphenol A and nonylphenol in the urine of Chinese women with unexplained recurrent spontaneous abortion[J]. Environ Res,2016,150(10):622-628.
[21]赵雯红,胡蜀宾,张国瑛,等.中医疗法对慢性肾功能衰竭患者t-PA,PAI-1的干预作用[J].中国实验方剂学杂志,2013,19(7):297-299.
[22]卢芬萍,苏宁,朱明明,等.羟基红花黄色素A联合黄芪甲苷-Ⅳ对TNF-α诱导内皮细胞凋亡的影响[J].中国实验方剂学杂志,2018,24(5):88-94.
[23]滕方舟,蔡唐彦,郭洁梅,等.痛风宁对急性痛风性关节炎模型大鼠IL-1β,TNF-α及NALP3炎性体的影响[J].中国实验方剂学杂志,2018,24(17):120-125.
[24]李华,傅晓冬,柳怡,等.补肾调冲方联合常规西药治疗复发性流产肾虚血瘀型疗效及对患者血清Th1/Th2细胞因子平衡偏移的影响[J].中国实验方剂学杂志,2018,24(5):171-175.
[2] Lia G S,Denga L J,CAO Y J,et al. Effect of sodium chloride on fine coal flotation and discussion based on froth stability and particle coagulation[J]. Int J Miner Process,2017,169(10):47-52.
[3]宋晓捷,周艳艳,赵莉娜.胎元饮合寿胎丸加减联合主动免疫治疗不明原因复发性流产患者的疗效及其对辅助性T淋巴细胞17/调节性T淋巴细胞免疫失衡的影响[J].中国实验方剂学杂志,2018,24(18):164-169.
[4] Gana K,Jie X B,Gaic Y J,et al. In-situ coagulation of yttria-stabilized zirconia suspension via dispersant hydrolysis using sodium tripolyphosphate[J]. J Eur Ceram Soc,2017,37(15):4868-4875.
[5]李华,傅晓冬,柳怡,等.补肾调冲方联合常规西药治疗复发性流产肾虚血瘀型疗效及对患者血清Th1/Th2细胞因子平衡偏移的影响[J].中国实验方剂学杂志,2018,24(5):171-175.
[6] Samira H,Fazel S K,Soheila A P,et al. A shift in the balance of T17 and Treg cells in menstrual blood of women with unexplained recurrent spontaneous abortion[J]. J Reprod Immunol,2016,116(8):13-22.
[7]田丹,戴海青,李兆萍,等.补中益气汤治疗脾肾两虚证封闭抗体阴性所致复发性流产38例[J].中国实验方剂学杂志,2015,21(18):167-170.
[8]王巍,马海兰,蓝雪琴,等.淋巴细胞免疫治疗不明原因反复流产115例妊娠结局分析[J].中国妇幼保健,2015,30(11):1720-1724.
[9]田葱,李娟,常兴隆.安胎种子丸治疗不明原因复发性流产临床研究[J].新中医,2011,43(1):53-55.
[10]魏竞男,王爱丽,陈彦,等.寿胎丸合四物汤加减治疗肾虚血瘀型复发性流产患者对细胞免疫因子的影响[J].辽宁中医杂志,2017,44(9):1887-1889.
[11]王革新.加味安奠二天汤对原因不明复发性流产患者细胞免疫因子的影响[J].中华中医药学刊,2010,28(11):2378-2380.
[12]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,2010:311-313.
[13]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:130-131.
[14] Amber B O,Miranda V E. Lipoproteins as modulators of atherothrombosis:from endothelial function to primary and secondary coagulation[J]. Vasc Pharm,2016,82(6):1-10.
[15] YANG Z G,XIN T B,ZHANG B P,et al. Enhanced permeation and antifouling performance of polyvinyl chloride(PVC)blend Pluronic F127 ultrafiltration membrane by using salt coagulation bath(SCB)[J]. J Memb Sci,2018,548(15):32-41.
[16] Yating Q B,XIN W G,Ruanc H J,et al. Circular RNAs expressed in chorionic villi are probably involved in the occurrence of recurrent spontaneous abortion[J].Biomed Pharmacother,2017,88(4):1154-1162.
[17] Dina M R,Yomna A B,Mohamed S,et al. Intralipid supplementation in women with recurrent spontaneous abortion and elevated levels of natural killer cells[J].Int J Gynecol Obstet,2016,135(3):324-327.
[18] Mohammad H B,Mojgan M K,Safura K,et al. Evaluation of HLA-G14-bp ins/del and+3142G> C polymorphisms with susceptibility to recurrent spontaneous abortion[J].Taiwan J Obstet Gynecol,2017,56(3):276-280.
[19]杨彬,黄俊卿,张继伟.基于HMGB1/TLR4/NF-κB信号通路考察木瓜提取物对脊髓损伤大鼠的保护作用[J].中国实验方剂学杂志,2018,24(15):167-175.
[20] Penga F L,Jib W L,Zhub F,et al. A study on phthalate metabolites,bisphenol A and nonylphenol in the urine of Chinese women with unexplained recurrent spontaneous abortion[J]. Environ Res,2016,150(10):622-628.
[21]赵雯红,胡蜀宾,张国瑛,等.中医疗法对慢性肾功能衰竭患者t-PA,PAI-1的干预作用[J].中国实验方剂学杂志,2013,19(7):297-299.
[22]卢芬萍,苏宁,朱明明,等.羟基红花黄色素A联合黄芪甲苷-Ⅳ对TNF-α诱导内皮细胞凋亡的影响[J].中国实验方剂学杂志,2018,24(5):88-94.
[23]滕方舟,蔡唐彦,郭洁梅,等.痛风宁对急性痛风性关节炎模型大鼠IL-1β,TNF-α及NALP3炎性体的影响[J].中国实验方剂学杂志,2018,24(17):120-125.
[24]李华,傅晓冬,柳怡,等.补肾调冲方联合常规西药治疗复发性流产肾虚血瘀型疗效及对患者血清Th1/Th2细胞因子平衡偏移的影响[J].中国实验方剂学杂志,2018,24(5):171-175.