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
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摘要
目的:研究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。方法:选取于2014年2月—2015年8月该院收治的60例肾虚血瘀型复发性流产患者为研究对象,按随机数字表均分到观察组和对照组,对照组患者采用黄体酮胶囊治疗,观察组采用黄体酮胶囊加寿胎丸合四物汤治疗,观察两组患者临床疗效和妊娠情况,测定两组患者相关指标水平,并比较两组患者的中医证候评分。结果:观察组总有效率为96.67%;对照组总有效率70.00%,两组比较有显著差异(P<0.05)。观察组妊娠成功35例,再次流产4例;对照组妊娠成功18例,再次流产12例,观察组妊娠情况明显好于对照组(P<0.05)。经治疗,两组患者D-二聚体、TNF-α水平均有下降,而IL-10水平则上升;观察组治疗后D-二聚体、TNF-α水平明显低于对照组,IL-10水平明显高于对照组(P<0.05)。两组治疗后中医症状评分均有下降,观察组治疗后中医证候评分明显小于对照组(P<0.05)。结论:寿胎丸合四物汤加减可显著改善肾虚血瘀型复发性流产患者细胞免疫因子水平,增加妊娠成功率。
Objective: To study the effect of Shoutai Pill and Siwu Decoction on the immune factors of patients with kidney deficiency and blood stasis type of recurrent spontaneous abortion. Methods: From February 2014 to August 2015,60 cases of recurrent spontaneous abortion patients with kidney deficiency and blood stasis in our hospital were selected as the research objects. According to the random number table they were divided into observation group and control group. The control group were treated with progesterone capsules and the observation group were treated with Shoutai Pill and Siwu Decoction. To observe the clinical curative effect and pregnancy rate of two groups and determine the level of inflammatory factors. Compare the two groups of patients with TCM symptom score. Results: The total effective rate of observation group was 96. 67% and that of the control group was70%. There were significant differences between the two groups( P < 0. 05). In the observation group,35 cases were successful and 4 cases had abortion again. 18 cases were successful in the control group and 12 had abortion again. The observation group was significantly better than the control group( P < 0. 05). After treatment,two groups' D-two dimers and TNF-levels were decreased while the level of IL-10 increased. D-two dimers and TNF-levels after treatment in observation group were significantly lower than those of the control group. The level of IL-10 was significantly higher than that of the control group( P < 0. 05).After treatment,the TCM symptom scores of the two groups were decreased and the symptom scores of the observation group were significantly less than those of the control group( P < 0. 05). Conclusion: Shoutai Pill and Siwu Decoction can significantly improve immune cytokines levels of patients with kidney deficiency and blood stasis type of recurrent abortion and increase the success rate of pregnancy.
Objective: To study the effect of Shoutai Pill and Siwu Decoction on the immune factors of patients with kidney deficiency and blood stasis type of recurrent spontaneous abortion. Methods: From February 2014 to August 2015,60 cases of recurrent spontaneous abortion patients with kidney deficiency and blood stasis in our hospital were selected as the research objects. According to the random number table they were divided into observation group and control group. The control group were treated with progesterone capsules and the observation group were treated with Shoutai Pill and Siwu Decoction. To observe the clinical curative effect and pregnancy rate of two groups and determine the level of inflammatory factors. Compare the two groups of patients with TCM symptom score. Results: The total effective rate of observation group was 96. 67% and that of the control group was70%. There were significant differences between the two groups( P < 0. 05). In the observation group,35 cases were successful and 4 cases had abortion again. 18 cases were successful in the control group and 12 had abortion again. The observation group was significantly better than the control group( P < 0. 05). After treatment,two groups' D-two dimers and TNF-levels were decreased while the level of IL-10 increased. D-two dimers and TNF-levels after treatment in observation group were significantly lower than those of the control group. The level of IL-10 was significantly higher than that of the control group( P < 0. 05).After treatment,the TCM symptom scores of the two groups were decreased and the symptom scores of the observation group were significantly less than those of the control group( P < 0. 05). Conclusion: Shoutai Pill and Siwu Decoction can significantly improve immune cytokines levels of patients with kidney deficiency and blood stasis type of recurrent abortion and increase the success rate of pregnancy.
引文
[1]罗振宇,柴冬宁,李萍,等.复发性流产病因分析及免疫治疗[J].中国妇幼保健,2016,31(4):782-784.
[2]OO Ajayi,MA Charles-Davies,OG Arinola.Progesterone,selected heavy metals and micronutrients in pregnant Nigerian women with a history ofrecurrentspontaneous abortion[J].Afr Health Sci,2012,12(2):153-159.
[3]张珺,杨菁.Th17/Treg免疫失衡与原因不明复发性流产关系的研究进展[J].生殖医学杂志,2015,24(11):960-964.
[4]郑艳萍,杨菁.原因不明性复发性流产患者Th17/Treg细胞失衡及主动免疫治疗效果[J].医学分子生物学杂志,2015,26(5):267-271.
[5]郭兰娇,王孟丽,兰芳,等.主动免疫治疗对复发性流产患者血液相关指标的影响研究[J].中国妇幼保健,2016,31(9):1934-1936.
[6]Audrey J Gaskins,Janet W Rich-Edwards.Maternal Prepregnancy Folate Intake and Risk of Spontaneous Abortionand Stillbirth[J].Obstet Gynecol,2014,124(1):23-31.
[7]张晓,余洁.孕育口服液防治复发性流产脾肾两虚证[J].吉林中医药,2015,35(11):1122-1125.
[8]李莉.小剂量阿司匹林联合肝素与地屈孕酮片治疗复发性流产的效果[J].中国医药,2015,10(11):1660-1662.
[9]付雪梅,王丹,郝鹏锴,等.阿司匹林联合低分子肝素治疗血栓前状态致复发性流产84例临床分析[J].中国妇幼保健,2016,31(8):1681-1683.
[10]帅志容,曾玖芝,马蓉宁,等.复发性流产诊治中检测生殖免疫抗体的临床意义[J].实用医院临床杂志,2015,15(6):50-51,52.
[11]张高,程玲慧.低分子肝素联合小剂量阿司匹林对复发性流产患者激素水平、免疫功能的影响[J].中国生化药物杂志,2015,24(11):67-69.
[12]Diego Rafael U1ates,Héctor Alejandro Guidobaldi.Versatile Action of Picomolar Gradients of Progesteroneon Different Sperm Subpopulations[J].PLo S One,2014,9(3):e91181.
[13]曾志玲.寿胎丸和穴位贴敷结合免疫治疗对不明原因复发性流产的效果[J].中国妇幼保健,2016,31(4):850-852.
[14]王力,闻姬,韩彩艳,等.寿胎丸调节原因不明复发性自然流产患者免疫失衡机制[J].北京中医药大学学报,2012,35(11):781-785.
[15]张慧珍,张晓芬.寿胎丸合补中益气汤治疗脾肾两虚型早期先兆流产38例[J].中国实验方剂学杂志,2012,18(16):329-331.
[16]武颖,刘雁峰,何军琴,等.不同证型复发性流产影响因素及血栓前状态的相关性分析[J].标记免疫分析与临床,2016,23(3):237-240.
[17]任建荣,张文静,范艳霏,等.自拟复黄保胎方对黄体功能不全型复发性流产患者内分泌功能的影响[J].现代中西医结合杂志,2016,25(14):1548-1551.
[18]谢知慧,裴冬雪,尹璐,等.温肾暖宫方对复发性流产患者子宫内膜容受性的影响[J].中医药学报,2016,44(3):132-134.
[2]OO Ajayi,MA Charles-Davies,OG Arinola.Progesterone,selected heavy metals and micronutrients in pregnant Nigerian women with a history ofrecurrentspontaneous abortion[J].Afr Health Sci,2012,12(2):153-159.
[3]张珺,杨菁.Th17/Treg免疫失衡与原因不明复发性流产关系的研究进展[J].生殖医学杂志,2015,24(11):960-964.
[4]郑艳萍,杨菁.原因不明性复发性流产患者Th17/Treg细胞失衡及主动免疫治疗效果[J].医学分子生物学杂志,2015,26(5):267-271.
[5]郭兰娇,王孟丽,兰芳,等.主动免疫治疗对复发性流产患者血液相关指标的影响研究[J].中国妇幼保健,2016,31(9):1934-1936.
[6]Audrey J Gaskins,Janet W Rich-Edwards.Maternal Prepregnancy Folate Intake and Risk of Spontaneous Abortionand Stillbirth[J].Obstet Gynecol,2014,124(1):23-31.
[7]张晓,余洁.孕育口服液防治复发性流产脾肾两虚证[J].吉林中医药,2015,35(11):1122-1125.
[8]李莉.小剂量阿司匹林联合肝素与地屈孕酮片治疗复发性流产的效果[J].中国医药,2015,10(11):1660-1662.
[9]付雪梅,王丹,郝鹏锴,等.阿司匹林联合低分子肝素治疗血栓前状态致复发性流产84例临床分析[J].中国妇幼保健,2016,31(8):1681-1683.
[10]帅志容,曾玖芝,马蓉宁,等.复发性流产诊治中检测生殖免疫抗体的临床意义[J].实用医院临床杂志,2015,15(6):50-51,52.
[11]张高,程玲慧.低分子肝素联合小剂量阿司匹林对复发性流产患者激素水平、免疫功能的影响[J].中国生化药物杂志,2015,24(11):67-69.
[12]Diego Rafael U1ates,Héctor Alejandro Guidobaldi.Versatile Action of Picomolar Gradients of Progesteroneon Different Sperm Subpopulations[J].PLo S One,2014,9(3):e91181.
[13]曾志玲.寿胎丸和穴位贴敷结合免疫治疗对不明原因复发性流产的效果[J].中国妇幼保健,2016,31(4):850-852.
[14]王力,闻姬,韩彩艳,等.寿胎丸调节原因不明复发性自然流产患者免疫失衡机制[J].北京中医药大学学报,2012,35(11):781-785.
[15]张慧珍,张晓芬.寿胎丸合补中益气汤治疗脾肾两虚型早期先兆流产38例[J].中国实验方剂学杂志,2012,18(16):329-331.
[16]武颖,刘雁峰,何军琴,等.不同证型复发性流产影响因素及血栓前状态的相关性分析[J].标记免疫分析与临床,2016,23(3):237-240.
[17]任建荣,张文静,范艳霏,等.自拟复黄保胎方对黄体功能不全型复发性流产患者内分泌功能的影响[J].现代中西医结合杂志,2016,25(14):1548-1551.
[18]谢知慧,裴冬雪,尹璐,等.温肾暖宫方对复发性流产患者子宫内膜容受性的影响[J].中医药学报,2016,44(3):132-134.