寿胎丸合四物汤联合孕酮片对原因不明复发性流产患者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联合孕酮片对原因不明复发性流产患者的细胞免疫因子的影响。方法:选取于2015年2月至2016年2月收治的84例原因不明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,对照组患者采用孕酮片治疗,观察组在此基础上加服寿胎丸合四物汤,观察2组患者临床疗效和妊娠情况,测定2组患者炎性反应因子水平,并比较2组患者的中医症候评分。结果:观察组痊愈21例,有效19例,总有效率95.24%,妊娠成功35例,再次流产率93.02%;对照组痊愈10例,有效17例,总有效率64.29%,妊娠成功12例,再次流产率71.43%,2组差异有统计学意义(P<0.05)。观察组治疗后中医症状评分(5.86±1.24)分;对照组为(8.67±1.48)分,差异有统计学意义(P<0.05)。经过治疗后,2组患者D-二聚体、IL-10和TNF-α水平与治疗前均有所变化;观察组患者治疗后D-二聚体和TNF-α水平降低程度更明显,而IL-10水平显著上升,2组比较差异有统计学意义(P<0.05)。结论:寿胎丸合四物汤联合孕酮片治疗原因不明复发性流产安全有效,可显著改善细胞免疫因子水平,增加妊娠成功率。
Objective: To study the effects of Shoutai Pill and Siwu Decoction combined with progesterone tablet on the immune factors of patients with unexplained recurrent spontaneous abortion. Methods: A total of 84 cases of unexplained recurrent abortion patients who were admitted in our hospital from February 2015 to February 2016 were chosen as the research object,and divided into observation group and control group according to the random number table. The control group was treated with progesterone tablets,and the observation group were treated with Shoutai Pill and Siwu Decoction on the basis of the observation group. The clinical curative effect and pregnancy rate of two groups were observed,and the level of inflammatory factors was determined. TCM symptom score of 2 groups were compared. Results: In the observation group,21 cases were cured,and 19 cases were effective with the total efficiency of 95. 24%. 35 cases were successful pregnancy with repeated abortion rate of 93. 02%; In the control group,10 cases were cured and 17 cases were effective with total efficiency of 64. 29%. 12 cases were successful pregnancy with repeated abortion rate of 71. 43%. The differences between 2 groups were statistically significant( P < 0. 05). After treatment,TCM symptoms score was 5. 86 ± 1. 24 in observation group and 8. 67 ± 1. 48 in control group. The difference was statistically significant( P < 0. 05). After treatment,levels of D dimer,IL-10 and TNF-a of 2 groups were changed compared with before treatment; the decrease of D-dimer and TNF-levels in observation group was more significant,and the level of IL-10 increased significantly. The difference between 2 groups was statistically significant( P < 0. 05). Conclusion: Shoutai Pill and Siwu Decoction combined with progesterone tablets in the treatment of unexplained recurrent abortion is safe and effective,which can significantly improve the cell immune factor level and increase the success rate of pregnancy.
Objective: To study the effects of Shoutai Pill and Siwu Decoction combined with progesterone tablet on the immune factors of patients with unexplained recurrent spontaneous abortion. Methods: A total of 84 cases of unexplained recurrent abortion patients who were admitted in our hospital from February 2015 to February 2016 were chosen as the research object,and divided into observation group and control group according to the random number table. The control group was treated with progesterone tablets,and the observation group were treated with Shoutai Pill and Siwu Decoction on the basis of the observation group. The clinical curative effect and pregnancy rate of two groups were observed,and the level of inflammatory factors was determined. TCM symptom score of 2 groups were compared. Results: In the observation group,21 cases were cured,and 19 cases were effective with the total efficiency of 95. 24%. 35 cases were successful pregnancy with repeated abortion rate of 93. 02%; In the control group,10 cases were cured and 17 cases were effective with total efficiency of 64. 29%. 12 cases were successful pregnancy with repeated abortion rate of 71. 43%. The differences between 2 groups were statistically significant( P < 0. 05). After treatment,TCM symptoms score was 5. 86 ± 1. 24 in observation group and 8. 67 ± 1. 48 in control group. The difference was statistically significant( P < 0. 05). After treatment,levels of D dimer,IL-10 and TNF-a of 2 groups were changed compared with before treatment; the decrease of D-dimer and TNF-levels in observation group was more significant,and the level of IL-10 increased significantly. The difference between 2 groups was statistically significant( P < 0. 05). Conclusion: Shoutai Pill and Siwu Decoction combined with progesterone tablets in the treatment of unexplained recurrent abortion is safe and effective,which can significantly improve the cell immune factor level and increase the success rate of pregnancy.
引文
[1]郭兰娇,王孟丽,兰芳.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.
[2]付雪梅,王丹,郝鹏锴.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.
[3]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,2015,12(6):50-51,52.
[4]Gaskins AJ,Rich-Edwards JW,Hauser R,et al.Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth[J].Obstet Gynecol,2014,124(1):23-31.
[5]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.
[6]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.
[7]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,(11):67-69.
[8]U1ates DR,Guidobaldi HA,Gatica LV,et al.Versatile action of picomolar gradients of progesterone on different sperm subpopulations[J].PLo S One,2014,9(3):e91181.
[9]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.
[10]林丽虹,李继红.复发性流产病因分析及免疫治疗效果观察[J].吉林医学,2015,(13):2733-2734.
[11]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.
[12]陈丹,孟昱时.Th17和Treg细胞在不明原因复发性流产中的研究进展[J].中国生育健康杂志,2016,27(3):296-297,300.
[13]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,2015,37(5):267-271.
[14]王力,闻姬,韩彩艳.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]何慧.补中益气汤合寿胎丸加减治疗胎盘低置状态[J].光明中医,2014,29(3):588-589.
[2]付雪梅,王丹,郝鹏锴.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.
[3]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,2015,12(6):50-51,52.
[4]Gaskins AJ,Rich-Edwards JW,Hauser R,et al.Maternal prepregnancy folate intake and risk of spontaneous abortion and stillbirth[J].Obstet Gynecol,2014,124(1):23-31.
[5]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.
[6]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.
[7]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,(11):67-69.
[8]U1ates DR,Guidobaldi HA,Gatica LV,et al.Versatile action of picomolar gradients of progesterone on different sperm subpopulations[J].PLo S One,2014,9(3):e91181.
[9]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.
[10]林丽虹,李继红.复发性流产病因分析及免疫治疗效果观察[J].吉林医学,2015,(13):2733-2734.
[11]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.
[12]陈丹,孟昱时.Th17和Treg细胞在不明原因复发性流产中的研究进展[J].中国生育健康杂志,2016,27(3):296-297,300.
[13]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,2015,37(5):267-271.
[14]王力,闻姬,韩彩艳.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]何慧.补中益气汤合寿胎丸加减治疗胎盘低置状态[J].光明中医,2014,29(3):588-589.