摘要
目的 探讨滋肾育胎丸加减方预防抗磷脂抗体(ACA)阳性者不良妊娠结局的效果及机制研究。方法 选取2016年2月至2019年2月我院收治的89例ACA阳性,先兆性流产或有习惯性流产(RSA)史患者,将采用西医治疗的40例作为对照组,将采用西医联合滋肾育胎丸加减方治疗的49例作为观察组,比较两组中医证候疗效、中医证候积分、ACA-IgA、ACA-IgM、ACA-IgG、凝血指标[血小板聚集功能(PAF)、活化蛋白C(PC)、抗凝血酶(AT)、纤溶酶原激活抑制物-1(PAI-1)]、Th1/Th2细胞因子[干扰素γ(IFN-γ)、白介素-2(IL-2)、白介素-4(IL-4)、白介素-10(IL-10)]、妊娠结局、安全性。结果 治疗2周后检测ACA,观察组2例未降低,对照组11例未降低,观察组未降低患者占比低于对照组(P<0.05);观察组总有效率100.00%高于对照组85.00%(P<0.05);观察组治疗4周、7周后中医证候积分低于对照组(P<0.05);观察组治疗4周、7周后ACA-IgA、ACA-IgM、ACA-IgG低于对照组(P<0.05);观察组治疗4周、7周后PAF、PAI-1低于对照组,PC、AT高于对照组(P<0.05);观察组治疗4周、7周后IFN-γ、IL-2低于对照组,IL-4、IL-10高于对照组(P<0.05);观察组活产率95.92%高于对照组80.00%(P<0.05);组间不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 动态监测ACA对滋肾育胎丸加减方精准应用具有指导意义,指导滋肾育胎丸加减方通过调理脏腑、气血、经络功能,改善先兆性流产或有RSA史患者临床症状及凝血因子指标,降低ACA水平,并可改善患者免疫耐受功能,提高胎儿活产率,且安全性高。
Objective To investigate the effect and mechanism of Zishen Yutai Pill Modified Prescription in preventing adverse pregnancy outcomes in anti cardiolipin antibody(ACA) positive patients. Methods From February 2016 to February 2019, 89 patients with ACA positive, threatened abortion or history of recurrent spontaneous abortion(RSA)were selected from our hospital. 40 cases treated with Western medicine were used as the control group, and 49 cases treated with Western medicine combined with Zishen Yutai Pill Modified Prescription as the observation group. The efficacy of TCM syndromes, TCM syndrome scores, ACA-IgA, ACA-IgM, ACA-IgG, coagulation indicators(platelet aggregation function(PAF), activated protein C(PC), antithrombin(AT), plasminogen activation inhibitor-1(PAI-1)),Th1/Th2 cytokines(interferon γ(IFN-γ), interleukin-2(IL-2), interleukin-4(IL-4), interleukin-10(IL-10)],pregnancy outcome and safety were compared between the two groups. Results ACA was detected after 2 weeks of treatment. There were 2 cases in the observation group and 11 cases in the control group. The proportion of patients in the observation group was lower than that in the control group(P<0.05);The total effective rate in the observation group was 100.00% higher than 85.00% in the control group(P<0.05);The TCM syndrome score in the observation group was lower than that in the control group after 4 and 7 weeks of treatment(P<0.05);After 4 and 7 weeks of treatment, the levels of ACA IgA, ACA IgM and ACA IgG in the observation group were lower than those in the control group(P<0.05);After 4 and 7 weeks of treatment, PAF and PAI-1 in the observation group were lower than those in the control group,and PC and at were higher than those in the control group(P<0.05);IFN in the observation group after 4 and 7 weeks of treatment-γ, IL-2 was lower than that in the control group, and IL-4 and IL-10 were higher than those in the control group(P<0.05);The survival rate of the observation group was 95.92% higher than that of the control group(80.00%)(
作者
崔佳
杨朝菊
赵培
贾敏
马倩
王建升
Cui Jia;Yang Chaoju;Zhao Pei;Jia Min;Ma Qian;Wang Jiansheng(Hebei Provincial People's Hospital,Shijiazhuang 050051,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2022年第4期1549-1556,共8页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
河北省中医药管理局中医药类科研计划课题(2021159):动态检测抗磷脂抗体指导滋肾育胎丸预防不良妊娠结局的价值,负责人:崔佳。
关键词
抗磷脂抗体
动态检测
滋肾育胎丸加减方
不良妊娠结局
凝血指标
TH1/TH2细胞因子
Anti cardiolipin antibody
Dynamic detection
Zishen Yutai Pill Modified Prescription
Adverse pregnancy outcome
Coagulation index
Th1/Th2 cytokine
