3种疗法用于不明原因复发性流产的临床对比研究

Clinical comparison study on three kinds of therapy for unexplained recurrent spontaneous abortion

目的观察安胎种子丸、主动免疫疗法及安胎种子丸联合主动免疫3种方法对不明原因复发性流产(URSA)患者封闭抗体,Th1、Th2型细胞因子及妊娠的影响。方法将98例患者随机分为中药组33例、免疫组31例和联合组34例。中药组采用安胎种子丸治疗,免疫组采用主动免疫方法治疗,联合组采用中药安胎种子丸与主动免疫联合治疗。3组均在治疗前后分别检测封闭抗体,Th1、Th2型细胞因子并观察妊娠情况。结果治疗后,联合组封闭抗体转阳率79%,与中药组(52%)和免疫组(55%)相比有显著性差异(P均<0.05)。中药组IL-2、IL-10水平与免疫组相比无显著性差异(P均>0.05);联合组IL-2、IL-10水平与免疫组相比无显著性差异(P均>0.05);与中药组相比,联合组IL-2水平降低,IL-10水平升高,均有显著性差异(P均<0.05)。联合组妊娠成功率94%,与中药组(76%)和免疫组(74%)相比有显著性差异(P均<0.05)。结论中药联合主动免疫治疗URSA,能促使封闭抗体的产生,调节细胞因子平衡,利于妊娠的维持。

Objective It is to observe the effects of three therapy （Antai Zhongzi pill, active immune therapy,and Antai Zhongzi pill combine with active immune therapy） on closed antibody, Thl and Th2 cytokines, and pregnancy outcome in patients with unexplained recurrent spontaneous abortion. Methods 98 cases of patients were randomly divided into Chinese medicine group with 33 cases, immune therapy group with 31 cases and the combination therapy group of 34 patients. Chinese medicine group was given Antai Zhongzi pill, immune therapy group was treated with active immune therapy, combined treatment group was treated with Chinese medicine and active immune combination therapy. Before and after treatment, Th2 Thl cytokines, closed antibody were detected and pregnancy was observed in the three groups. Results The positive rate of closed antibodies in combined treatment group was 79% , compared with that of immune therapy group and Chinese medicine group which were 55% and 52% respectively, the differences were significant. There was no significant difference in the levels of IL- 2 and IL - 3 （P 〉 0.05 ） between Chinese medicine group and immune therapy group. The same results were also found be- tween combined group and immune therapy group. Compared with that in Chinese medicine group, the level of IL - 2 was low- er and the level of IL - 10 was higher in combined group, the differences were significant（ P 〈 0. 05 ）. The successful pregnancy rate of combined group was 94% , compared with that in Chinese medicine group and immune group which were 76% and 74% respectively, the differences were significant （P 〈 0. 05）. Conclusion Chinese medicine combined with initiative immunotherapy can contribute to immunization blocking antibodies production, adjust the cytokines balance, and maintain pregnancy.