补肾活血方联合地屈孕酮对复发性流产患者临床疗效及Th1/Th2型细胞因子的影响

Effects of Bushen Huoxue Fang combined with dydrogesterone on clinical efficacy and Th1/Th2 cytokines balance in patients with recurrent spontaneous abortion

目的探讨补肾活血方联合地屈孕酮治疗复发性自然流产(RSA)的疗效及可能免疫作用机制。方法选择中医辨证属肾虚血瘀型RSA妊娠患者62例,随机分为中药组(21例)、西药组(20例)、中西药组(21例)。中药组采用自拟补肾活血方治疗,西药组采用地屈孕酮治疗,中西药组采用两者联合治疗。同时,随机选取正常妊娠者20例为正常对照组,不予任何药物治疗。观察各组治疗前后中医证候积分、证候疗效、临床综合疗效、外周血中IL-2、IL-10水平及IL-2/IL-10比值的变化。结果治疗后中医证候积分中西药组优于西药组(P<0.05);治疗组各组治疗后较治疗前IL-10水平均明显升高,IL-2水平及IL-2/IL-10比值明显降低(P<0.01)。治疗后与中药组、西药组相比,中西药组血清IL-10水平显著升高,血清IL-2及IL-2/IL-10比值显著降低(P<0.05),中药组与西药组间比较,则均无明显差异(P>0.05)。结论补肾活血方联合地屈孕酮治疗肾虚血瘀型RSA临床疗效确切,从整体上调节机体免疫平衡使妊娠得以维持。

Objective To investigate the effects of Bushen Huoxue Fang （BSHXF） combined with dydrogesterone on clinical efficacy and immunoregulation in patients with recurrent spontaneous abortion （RSA）. Methods We randomly assigned 62 pregnant patients with RSA, whose traditional Chinese medicine （TCM） syndrome differentiation was of the type of kidney deficiency and blood stasis into three groups. In the Chinese medicine group 21 patients were treated with BSHXF, in the Western medicine group 20 patients were treated with dydrogesterone, and in the integrative medicine group 21 patients were given a combination of both. In addition, 20 women with normal pregnancy were randomly selected as the control group, without given any medication. We observed the changes of TCM syndrome scores and TCM syndome efficacy clinical efficacy, serum levels of IL-2 and IL-10, and the ratio of IL-2/IL-10 in each group before and after treatment. Results After treatment the TCM syndrome scores in the integrative medicine group was better than that in the Western medicine group （P^0.05）. After treatment, the serum level of IL-10 in each treatment group was significantly higher than before, while the serum IL-2 level and the ratio of IL-2/IL-10 were significantly lower than before （P〈0.01）. After treatment, compared with the Chinese medicine group and Western medicine group, the serum IL-10 levels were increased in the integrative medicine group, and the serum IL-2 levels and the ratio of IL-2/IL-10 were decreased in the medicine group （P〈0.05）. In contrast, the Chinese medicine group and Weste significantly （P〉0.05）. Conclusion BSHXF combined with dydrogesterone treating RSA patients whose TCM syndrome differentiation is of the type of kidn can regulate the balance of immunity on the whole to maintain the patients＇ pregn ：rn medicine group did not differ has a definite clinical efficacy in tey deficiency and blood stasis. It ancy.