摘要
目的观察益母固肾汤联合主动免疫治疗不明原因复发性流产的临床疗效。方法将56例不明原因复发性流产患者随机分为治疗组与对照组,每组28例。对照组予主动免疫疗法,治疗组在对照组基础上加服益母固肾汤治疗。观察临床疗效、妊娠结局及用药安全性,比较与免疫功能相关的免疫球蛋白G(Ig G)、免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)、补体C3(C3)、补体C4(C4)、T淋巴细胞亚群CD4^+及CD8^+的水平,以及孕酮、血绒毛膜促性腺激素(HCG)水平的变化情况。结果 (1)治疗组、对照组总有效率分别为89.3%、64.3%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。(2)组间治疗后比较,Ig G、Ig A、Ig M、C3水平差异有统计学意义,治疗组明显较对照组降低(P<0.05);组间治疗后比较,治疗组CD8^+水平明显高于对照组,而CD4^+、CD4^+/CD8^+水平明显低于对照组(P<0.05)。(3)组间治疗后比较,HCG、孕酮水平差异有统计学意义,治疗组明显较对照组升高(P<0.05)。(4)组间流产率比较,治疗组明显低于对照组(P<0.05)。(5)试验期间,两组未出现与本研究干预措施相关的不良反应。结论在主动免疫治疗基础上加用益母固肾汤治疗不明原因复发性流产,可改善母体免疫功能失衡及性激素水平,进一步降低流产风险,改善妊娠结局,且较为安全。
Objective To observe the clinical efficacy of Yimu Gushen Decoction combined with active immunotherapy in the treatment of unexplained recurrent abortion.Methods 56 patients with unexplained recurrent abortion were randomly divided into the treatment group and control group,28 cases in each group.The control group was treated with active immunotherapy,and the treatment group was treated with Yimu Gushen Decoction based on the treatment for the control group.The clinical efficacy,pregnancy outcome and medication safety were observed.The changes on the levels of immune indexes such as immunoglobulin G（ Ig G）,immunoglobulin A（ Ig A）,immunoglobulin M（ Ig M）,complement C3（ C3）,complement C4（ C4） and T lymphocyte subsets CD（4＋）and CD（8＋）,and the levels of sex hormones such as progesterone and human chorionic gonadotropin（ HCG） were compared.Results（1）The total effective rates were 89.3% in the treatment group and 64.3% in the control group,the clinical efficacy in the treatment group was obviously better than that in the control group（ P〈0.05）.（2）After treatment,there were statistically significant differences on the levels of Ig G,Ig A,Ig M and C3 between the two groups,and the levels were obviously reduced in the treatment group compared with those in the control group（ P〈0.05）.After treatment,the CD（8＋）level in the treatment group was obviously higher than that in the control group,while the levels of CD（4＋）and CD（4＋）/CD（8＋）were obviously lower than those in the control group（ P〈0.05）.（3）After treatment,there were statistically significant differences on the levels of HCG and progesterone between the two groups,and the levels were obviously increased in the treatment group compared with those in the control group（ P〈0.05）.（4）The abortion rate in the treatment group was obviously lower than that in the control group（ P〈0.05）.（5） No adverse reaction related to the intervention in this study was observed during the trial.Conclusion The active immunotherapy combined with Yimu Gushen Decoction in the treatment of unexplained recurrent abortion can improve the immune imbalance and sex hormone levels,reduce the risk of miscarriage as well as improve the pregnancy outcome,which is more safe.
作者
徐新亚
张科群
徐子宁
XU Xinya;ZHANG Kequn;XU Zining(Department of Chinese Medical Gynecology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, China;Department of Gynecology, Cixi People＇ s Hospital, Cixi 315300, China)
出处
《上海中医药杂志》
2018年第7期63-65,共3页
Shanghai Journal of Traditional Chinese Medicine
基金
浙江省卫计委2016年省医药卫生一般研究计划(B类)项目(2016KYB238)
关键词
复发性流产
滑胎
益母固肾汤
主动免疫
免疫耐受异常
recurrent abortion
habitual abortion
Yimu Gushen Decoction
active immunity
abnormality of immune tolerance
