摘要
目的观察加味当归散合寿胎丸对复发性流产患者抗磷脂抗体异常的影响。方法纳入抗磷脂抗体异常的复发性流产患者80例,随机分为治疗组40例和对照组40例。治疗组予加味当归散合寿胎丸治疗,1个月为1个疗程,连续3个疗程,确认妊娠后继续服用3个疗程。对照组予阿司匹林治疗,1个月为1个疗程,备孕前疗程不超过3个月,确认妊娠后续服3个月。评价两组的临床疗效;治疗1个疗程、2个疗程、3个疗程后,检测所有患者的抗心磷脂抗体(ACA)、抗β2糖蛋白1抗体(anti-β2-GP-1 Ab)水平,比较两组患者的抗体转阴率;于患者确认妊娠1个月、2个月、3个月后,检测其血浆纤维蛋白原(FIB)、D-二聚体(D-D)水平;随访至妊娠结束,比较两组患者的妊娠成功率及不良反应发生率。结果治疗3个疗程后,治疗组的临床总有效率为85.0%,对照组为65.0%,治疗组的临床疗效优于对照组(P<0.05)。治疗2个、3个疗程后,治疗组患者ACA、anti-β2-GP-1 Ab转阴率均明显高于对照组(P<0.05,P<0.01)。妊娠后3个月中,治疗组患者的D-D、FIB水平均显著低于对照组(P<0.05,P<0.01)。治疗后,治疗组妊娠成功率为82.5%,对照组为62.5%,治疗组的妊娠成功率明显高于对照组(P<0.05)。治疗过程中,治疗组的不良反应发生率为5.0%,对照组为27.5%,治疗组的不良反应发生率明显低于对照组(P<0.05)。结论加味当归散合寿胎丸能够有效促进抗磷脂抗体异常的复发性流产患者ACA、anti-β2-GP-1 Ab转阴,改善患者妊娠期的高凝状态,提高妊娠成功率。
Objective To observe the effect of Modified Danggui Powder combined with Shoutai Pill on the abnormal anti-phospholipid antibodies in patients of recurrent abortion.Methods Eighty patients of recurrent abortion with abnormal anti-phospholipid antibodies were enrolled and randomly divided into the treatment group(40 cases)and the control group(40 cases).The patients in the treatment group were treated with Modified Danggui Powder combined with Shoutai Pill with a course of three months,each month was one treatment course,and three treatment courses were continued after pregnancy.The patients in the control group were treated with aspirin,each month was one treatment course,the treatment course was not more than three months before pregnancy,and three months treatment was continued after pregnancy.The clinical effects of the two groups were evaluated;After one treatment course,two treatment courses,and three treatment courses,the anti-cardiolipin antibodies(ACA)and anti-β2 glycoprotein 1 antibodies(anti-β2-GP-1 Ab)were detected,and the negative conversion rates of the antibodies were compared between the two groups;after pregnancy of one month,two months,and three months,the levels of plasma fibrinogen(FIB)and D-dimer(DD)were tested;all the pregnant women were followed up until the end of pregnancy,and the pregnancy success rate was compared between the two groups;the incidence of adverse reactions was compared between the two groups.Results After three courses of treatment,the clinical total effective rates of the treatment group and the control group were 85.0% and 65.0% respectively,and the effect of the treatment group was better than that of the control group(P<0.05).After two courses and three courses of treatment,the negative conversion rates of ACA and anti-β2-GP-1 Ab in the treatment group were significantly higher than those in the control group(P<0.05,P<0.01).In the first three months of pregnancy,the levels of D-D and FIB in the treatment group were significantly lower than those in the control group(P<0.05,P<0.01).After treatment,the pregnancy success rates of the treatment group and the control group were 82.5% and 62.5% respectively,and the pregnancy success rate of the treatment group was obviously higher than that of the control group(P<0.05).In the course of treatment,the incidences of adverse reactions in the treatment group and the control group were 5.0% and 27.5% respectively,and the incidence of adverse reactions in the treatment group was obviously lower than that in the control group(P<0.05).Conclusion Modified Danggui Powder combined with Shoutai Pill can effectively promote the ACA and anti-β2-GP-1 Ab to change to negative,improve the hypercoagulability in pregnancy period,and enhance the pregnancy success rate in patients of recurrent abortion with abnormal anti-phospholipid antibodies.
作者
周琦
宋丽娜
唐丹艺
张琼
ZHOU Qi;SONG Lina;TANG Danyi;ZHANG Qiong(Department of Gynecology,Yangpu District Hospital of Traditional Chinese Medicine,Shanghai 200090,China;Department of Gynecology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《上海中医药杂志》
2020年第10期68-71,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市杨浦区卫计委科研课题项目(YP15Q01)。
关键词
复发性流产
抗磷脂抗体异常
加味当归散
寿胎丸
中医药疗法
recurrent abortion
abnormal anti-phospholipid antibody
Modified Danggui Powder
Shoutai Pill
traditional Chinese medical therapy
作者简介
周琦,女,硕士,主治医师,主要从事中西医结合治疗妇科内分泌疾病、不孕症的临床研究工作;通信作者:张琼,主任医师,硕士研究生导师。E-mail:zhangqiong65514@163.com。
