摘要
目的:观察补肾安胎饮加减联合小剂量阿司匹林对复发性流产(RA)患者凝血功能、血管生成及成纤维细胞生长因子21 (FGF21)表达水平的影响。方法:选择82例RA患者,按随机数字表法分为对照组和联合组各41例。对照组口服小剂量阿司匹林进行治疗,联合组在对照组基础上给予补肾安胎饮加减治疗。比较2组治疗前后中医证候积分、凝血功能[血清蛋白S (PS)、蛋白C (PC)、抗凝血酶Ⅲ(AT-Ⅲ)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、血管生成指标[血清丝氨酸/苏氨酸蛋白激酶(AKT)、磷脂酰肌醇-3-激酶(PI3K)、血管内皮抑素(ES)]、FGF21,并评价中医证候疗效及保胎成功率。结果:联合组中医证候总体疗效优于对照组,保胎成功率高于对照组(P<0.05)。治疗后,2组腰膝酸软、小腹坠痛、头晕耳鸣、面色无华、阴道出血评分及总积分较治疗前下降,且联合组各项评分低于对照组,差异均有统计学意义(P<0.05)。2组治疗后血清PS、PC、AT-Ⅲ、AKT、PI3K、FGF21含量较治疗前均明显增加,PT、APTT明显延长,ES水平下降(P<0.05),且联合组血清PS、PC、AT-Ⅲ、AKT、PI3K、FGF21含量高于对照组,PT、APTT长于对照组,ES水平低于对照组(P<0.05)。结论:补肾安胎饮加减联合小剂量阿司匹林治疗RA可有效改善患者临床症状,改善机体血液流变状态,促进母胎界面血管生成,调节胎盘组织血管内皮功能,提高保胎效果。
Objective:To observe the effect of modified Bushen Antai Decoction combined with lowdose Aspirin on the coagulation function, angiogenesis and the expression level of fibroblast growth factor 21(FGF21) of patients with recurrent abortion(RA). Methods:A total of 82 patients with RA were selected and divided into the control group and the observation group according to the random number table method, with 41 cases in each group. The control group was treated with low-dose aspirin, and the combination group was additionally given modified Bushen Antai Decoction based on the treatment of the control group. Before and after treatment, the traditional Chinese medicine(TCM) syndrome scores,coagulation function,including serum protein S(PS),protein C(PC),antithrombin-Ⅲ(AT-Ⅲ),prothrombin time(PT) and activated partial thromboplastin time(APTT),angiogenesis indexes,including serum serine/threonine protein kinase(AKT),phosphatidylinositol-3-kinase(PI3K) and endostatin(ES),and FGF21 in the two groups were compared. The curative effect of TCM syndrome and the success rate of fetal preseration in both groups were evaluated. Results: The total effective rate of TCM syndrome in the combination group was better than that in the control group,and the success rate of fetal preseration in the combination group was higher than that in the control group(P<0.05). After treatment,the scores of sore and weak waist and knees, bearing-down pain of lower abdomen, dizziness and tinnitus, white complexion and vaginal bleeding as well as the total scores in the two groups were decreased when compared with those before treatment,and the above five scores in the combination group were lower than those in the control group,differences being significant(P<0.05). After treatment,the contents of serum PS, PC, AT-Ⅲ, AKT, PI3K and FGF21 in both groups were significantly increased when compared with those before treatment,the PT and APTT were obviously extended,and the ES level was decreased(P<0.05);the contents of serum PS,PC,AT-Ⅲ,AKT,PI3K and FGF21 in the combination group were higher than those in the control group,the PT and APTT were longer than those in the control group,and the ES level was lower than that in the control group(P<0.05). Conclusion:Modified Bushen Antai Decoction combined with low-dose Aspirin for RA can effectively improve the clinical symptoms of patients and hemorheology,promote the angiogenesis of maternal-fetal interface,regulate the vascular endothelial function of placenta tissue,and enhance the effect of fetal protection.
作者
徐颜红
谢文娟
苑帆
XU Yanhong;XIE Wenjuan;YUAN Fan
出处
《新中医》
CAS
2023年第5期144-149,共6页
New Chinese Medicine
基金
2018年许昌市科技攻关项目(20170213258)。
