孕宝煎剂对先兆流产患者孕激素诱导阻滞因子及内分泌因子影响的临床研究
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摘要
目的:通过观察孕宝煎剂对血清孕酮(P)、雌二醇(E_2)、β-人绒毛膜促性腺激素(β-HCG)、孕激素诱导阻滞因子(PIBF)的浓度的影响,以及治疗先兆流产的临床疗效,探讨孕宝煎剂对先兆流产患者PIBF及内分泌因子的影响,从母胎免疫调控及内分泌角度探讨孕宝煎剂的安胎机制。方法:采用随机对照研究方法,以2016年2月-12月在河南省中医院妇科门诊就诊的患者为研究对象,按照纳入、排除标准共纳入120例确诊为先兆流产的患者,采用SPSS 22.0统计软件产生的随机分组表,将患者随机分为两组,试验组60例,对照组60例。试验组给予孕宝煎剂量口服,对照组给予孕康口服液口服。采用化学发光酶免疫分析法检测血清P、β-HCG、E_2的浓度;采用酶联免疫吸附试验(ELISA)法检测血清PIBF浓度变化。结果:治疗后,与对照组同期比较,试验组治疗后外周血清PIBF、E_2、P、β-HCG值均有显著性提高(P<0.05),外周血清β-HCG与PIBF具有正相关性(r=0.766)。结论:孕宝煎剂能明显改善先兆流产患者先兆流产的症状,提高外周血清PIBF、E_2、P、β-HCG的水平,改善黄体功能,提高母胎免疫耐受能力,极大地提高了保胎成功率,进一步论证了固肾安胎是中医治疗先兆流产的法则。
Objective: To study the clinical curative of Yunbao Decoction in the treatment of threatened abortion patients,discuss the influence of Yunbao Decoction on the endocrine and progesterone-induced blocking factor(PIBF),and research the mechanism of Yunbao Decoction from the angle of maternal-fetal immune regulation and endocrine by determining the changes of serum progesterone(P),β-human chorionic gonadotropin(β-HCG),estradiol(E2) and PIBF.Methods: This prospective,randomized controlled study was conducted on Gynecology Outpatients of Traditional Chinese Medicine Hospital of Henan Province from February 2016 to December 2016.A total of 120 threatened abortion patients were recruited for the study.The volunteers were screened before enrolled and randomly allocated into two groups: 60 cases of Chinese medicine group and 60 cases of western medicine group.The patients in Chinese medicine group were given Yunbao Decoction,and the patients in western medicine group were given progesterone and HCG.Method of chemiluminescence was used to detect the concentration of serum P,β-HCG and E2.Serum PIBF concentration was measured by enzyme-linked immunosorbent assay(ELISA).Results: Compared with western medicine group,the levels of PIBF,E2,P and β-HCG in the peripheral serum of the Chinese medicine group were significantly higher(P<0.05),and the serum β-HCG was positively correlated with PIBF(r=0.766).Conclusion: The Yunbao Decoction can significantly improve the endocrine hormone and the levels of cytokines in patients with threatened abortion.The treatment can increase PIBF,E2,P,β-HCG in the peripheral serum and improve corpus luteum function.It can significantly improve the maternal fetal immune tolerance and further demonstrate that tonifying kidney for preventing miscarriage is the solution of TCM in the treatment of threatened abortion.
Objective: To study the clinical curative of Yunbao Decoction in the treatment of threatened abortion patients,discuss the influence of Yunbao Decoction on the endocrine and progesterone-induced blocking factor(PIBF),and research the mechanism of Yunbao Decoction from the angle of maternal-fetal immune regulation and endocrine by determining the changes of serum progesterone(P),β-human chorionic gonadotropin(β-HCG),estradiol(E2) and PIBF.Methods: This prospective,randomized controlled study was conducted on Gynecology Outpatients of Traditional Chinese Medicine Hospital of Henan Province from February 2016 to December 2016.A total of 120 threatened abortion patients were recruited for the study.The volunteers were screened before enrolled and randomly allocated into two groups: 60 cases of Chinese medicine group and 60 cases of western medicine group.The patients in Chinese medicine group were given Yunbao Decoction,and the patients in western medicine group were given progesterone and HCG.Method of chemiluminescence was used to detect the concentration of serum P,β-HCG and E2.Serum PIBF concentration was measured by enzyme-linked immunosorbent assay(ELISA).Results: Compared with western medicine group,the levels of PIBF,E2,P and β-HCG in the peripheral serum of the Chinese medicine group were significantly higher(P<0.05),and the serum β-HCG was positively correlated with PIBF(r=0.766).Conclusion: The Yunbao Decoction can significantly improve the endocrine hormone and the levels of cytokines in patients with threatened abortion.The treatment can increase PIBF,E2,P,β-HCG in the peripheral serum and improve corpus luteum function.It can significantly improve the maternal fetal immune tolerance and further demonstrate that tonifying kidney for preventing miscarriage is the solution of TCM in the treatment of threatened abortion.
引文
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[4]丰有吉,沈铿.妇产科学.北京:人民卫生出版社,2010:264
[5]曹泽毅.中华妇产科学.北京:人民卫生出版社,1996:321
[6]CFDA.中药新药临床研究指导原则.北京:中国医药科技出版社,2002:253
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[8]褚玉霞.先兆流产与习惯性流产诊治经验.河南中医,2013,33(1):90-91
[9]文乐兮,尤昭玲.尤昭玲中医安胎思路的构想与实践.中国中医基础医学杂志,2015,21(4):398-399
[2]朱蕴璞,许小凤.早期流产中西医相关病因之研究.吉林中医药,2010,30(8):649-651
[3]褚玉霞,吴琼,杜少辕.“孕宝”煎剂治疗先兆流产120例临床观察.河南中医药学刊,1995,10(2):24-27
[4]丰有吉,沈铿.妇产科学.北京:人民卫生出版社,2010:264
[5]曹泽毅.中华妇产科学.北京:人民卫生出版社,1996:321
[6]CFDA.中药新药临床研究指导原则.北京:中国医药科技出版社,2002:253
[7]国家中医药管理局.中医病证诊断疗效标准.南京:南京大学出版社,1994:67
[8]褚玉霞.先兆流产与习惯性流产诊治经验.河南中医,2013,33(1):90-91
[9]文乐兮,尤昭玲.尤昭玲中医安胎思路的构想与实践.中国中医基础医学杂志,2015,21(4):398-399