3种方案治疗原因不明性复发性流产的临床对照研究

A comparative study of three different methods for clinical efficacy in the treatment of unexplained recurrent spontaneous abortion

目的通过比较3种不同治疗方案治疗原因不明性复发性流产的临床疗效,为临床治疗原因不明性复发性流产提供安全有效的治疗手段。方法选择确诊的原因不明性复发性流产患者208例,清宫术后根据患者意愿分为免疫治疗组62例、西药治疗组78例和中西医结合组68例,分别采用淋巴细胞免疫治疗、激素保胎、补肾益气养血方+激素保胎治疗,统计3组妊娠成功率。结果免疫治疗组成功妊娠47例(75.80%),其中封闭抗体阳性者59例,妊娠成功47例,封闭抗体阴性者3例,均发生再次流产,封闭抗体阳性者妊娠成功率明显高于封闭抗体阴性者(P<0.05);西药治疗组成功妊娠45例(57.69%);中西医结合组成功妊娠56例(82.35%)。免疫治疗组及中西医结合组妊娠成功率均明显高于西药治疗组(P均<0.05),免疫治疗组妊娠成功率与中西医结合组比较差异无统计学意义(P>0.05)。结论免疫治疗与中西医结合治疗原因不明性复发性流产疗效均优于单纯激素保胎治疗,免疫治疗与中西医结合治疗效果相当。

Objective It is to compare the clinical efficacy of three different treatment programs for unexplained recurrent spontaneous abortion（URSA） so as to provide the basis for the choice of clinical treatment. Methods 208 cases of URSA pa- tients were chosen and divided into three groups after complete curettage of uterine cavity as 62 cases of immune treatment group, 78 cases of western medicine treatment group and 68 cases of Chinese and western medicine group. Lymphocyte im- mune therapy, hormone spuc and Bushen Yiqi Yangxue Recipe ＋ hormone therapy were adopted for corresponding group. The successful pregnancy rates in every group were compared. Results There were 47 successful pregnancy cases in immune treat- ment group,and the pregnancy success rate was 75.80%. In this group, 59 cases were positive and 47 cases were succeed to gain a successful pregnancy,while 3 cases of negative closed antibodies were failed to continue the pregnancy. There was sta- tistically differences between the negative and the positive closed antibodies cases（P 〈0.05）. There were 45 successful preg- nancy cases in western medicine treatment group,and the pregnancy success rate was 57.69% ;56 successful pregnancy cases in combination of Chinese and western group, and the pregnancy success rate was 82.35%. The pregnancy success rate of the immune treatment group and the combination of Chinese and western group were higher than that in the western medicine treat- ment group（ P 〈 0.05 ） , no significant difference was found between the former two groups （ P 〉 0.05 ）. Conclusion The cura- tive effect of immue-therapy and combination of Chinese and western treatment on URSA were better than that of simple west- ern medicine hormone, the curative effects of the former two treatment method are about the same.